There will be plenty more twists to come before we win this game of rollout roulette
ABUNDANCE of caution. That’s all we hear about these days. Especially when it comes to the rollout of vaccines. The experts are definitely erring on the side of caution.
While the vast majority of us are craving a jab to lift our spirits, the Government has to cope with the helter skelter of vaccine research, advice and supply.
In all my experience of government, I don’t think I have ever come across a situation which keeps changing so quickly, from one minute to the next.
Last week, the ministers were collectively in the doldrums. They had just been hit by a double whammy. The health experts, who, very recently, had assured us all that there are little or no problems with the AstraZeneca vaccine, did a quick about-turn advising that this particular vaccine should only be given to the over-60s.
And, on top of all that, the EU rollout of the Johnson & Johnson vaccine was halted, due to concerns about it emanating from the US.
The Government’s promise of widespread vaccination by June seemed to be in disarray.
Then, literally within minutes, all was back on an even keel, after Micheál Martin took a call from EU Commission president Ursula von der Leyen.
Unfair
She gave him the good news that Ireland would receive an additional 545,000 doses of the Pfizer vaccine starting immediately, instead of much later in the year. Happy days! At least, for the Government.
But, not so great news for those in the 60-to-69 age cohort. All this chopping and changing means that this cohort will have to put up with the fact that they, and they alone, will be given the AstraZeneca vaccine, whether they like it or not.
I heard a health expert trying to justify the changes, saying that the AZ vaccine is recommended for all over 60, and, he added, that includes ‘those from 60 up to 120(!)’.
But, the reality is that the vast majority of over 70s already have been vaccinated with either the Pfizer or the Moderna vaccine. So, in reality, the 60-69 cohort will be the only ones to get the AZ vaccine, despite the fact that it is subject to the most qualifications.
Most EU countries have restricted the AZ vaccine to older age groups. Denmark has gone as far as declaring that they will not give the AZ vaccine to any of its population.
As someone in the 60-69 age cohort, I have no problem taking the AZ vaccine. It seems that the vast majority of the over 60s want it, if the number of people registering on the HSE portal is anything to go by.
But, many of my counterparts have expressed misgivings about why they cannot get an alternative vaccine.
On the face of it, it seems a little unfair. Just because one happens to be a sixtysomething, they have to take the AZ dose. Anyone on either side of the 60s will get a less controversial vaccine!
Then, there is the issue of extending the gap between the vaccines. AZ recipients have to wait at least three months for the second dose, which is a pretty long time before they can say they are fully vaccinated.
Currently, those lucky enough to have received the Pfizer or Moderna vaccine already are getting promised dates for their second dose in a matter of just a few weeks.
The body responsible, the
National Immunisation Advisory Committee, recommends that the second dose of Pfizer be given in an interval of 21 to 28 days after the first one.
For Moderna, the optimal time window for the second dose according to NIAC is 24-28 days from the first dose.
Given the nature of the Pfizer and Moderna vaccines, as opposed to the user-friendly AZ vaccine, it may be that the time period between the two doses of the former vaccines cannot be extended too far. We will have to see what is the experience of other countries in this respect.
An additional complicating factor is that the AZ vaccine has already been given to many under-60-year-olds, especially in the health services. In that situation, the 12-week time lag for it has been extended to 16 weeks between doses.
Over last weekend, reports circulated that the Government was considering extending the time lag between the first and second doses of the Pfizer and the Moderna vaccines out to sixto-eight weeks. So, I wonder will it happen that those who get Pfizer or Moderna vaccines will be fully vaccinated well ahead of the 60-year-olds, who get the AZ vaccine? On the other hand, the head of the HSE Paul Reid told us last week that the majority of under-60s will not be vaccinated until June at the earliest.
So, it’s swings and roundabouts, when it comes to the different vaccines.
It is also reported that consideration is now being given to the possibility of ‘mixing’ vaccines, because of the restrictions of the AZ vaccine. As I said previously, most of the frontline workers in the health service have already received a first dose of the AZ vaccine, but anyone in that group, under 60, can not now get an AZ second dose. So, the question arises, will they get an alternative vaccine as a second dose?
I note that the detailed advice from NIAC, in its current documentation, stresses in bold letters that the different type of vaccines are not interchangeable. So, will they now have to do a U-turn on this as well?
Spanner
To confuse matters even further, we learn that Minister for Health Stephen Donnelly considered fast-tracking vaccination for 18 to 30-year-olds, on the basis that that cohort of young people is the most likely to mix socially in large numbers as the restrictions are lifted.
Up to this, the Government has resolutely stated that it would stick rigidly to the vaccine schedule, whereby doses would be distributed to groups, in descending order of age.
Ministers have faced down teachers and other groups who called for special treatment for their members.
And yet, Donnelly throws this spanner into the works. Government sources were out quickly to state that there was no change in vaccine priority.
Indeed, the minister himself was retreating fast, in his interview on RTÉ yesterday.
The Health Minister, or someone on his behalf, recently, was querying why he wasn’t getting much mention on Twitter. Safe to say, that, after the 18-to-30year-old story, he will get a lot more mentions, though, maybe, not the type he might like.
All in all, the confusing and constantly changing vaccine landscape clearly illustrates the extremely difficult tightrope the Government and its health experts have to walk to get the rollout done, as effectively as possible.
The principle of ‘abundance of caution’ has made their task all the more onerous.
In the meantime, most of the public are not that concerned about the bigger picture. All they want is to get the fully vaccinated with the safest vaccine as soon as possible.
The Government on the other hand will have to balance all considerations so as to ensure coordination of the overall supply.
As we have seen, especially over last week, the situation can change in a second.
Be warned, there are more twists and turns to come in this saga.