The fantastic breakthrough with Covid-19 vaccines has given terrific hope to people the world over. In this country, everybody is anxiously awaiting tomorrow's Government announcement on the proposed roll-out of the vaccine. Last Tuesday, the Minister for Health released the first report on the proposed priority groupings for the vaccine. I note the list is referred to as a provisional list so I hope it means there is potential to make changes to the list. I want to make a case for that now. This relates to people with underlying health conditions. We know from analysis done on cases in terms of mortality, admission to hospital and admission to intensive care units that having one or more underlying health condition is a very significant factor. For that reason, it was quite surprising and disappointing that on the list of 14 cohorts of people, people with underlying conditions in their late 60s are fifth and adults with health conditions under 65 are seventh. It is very hard to understand why those cohorts are so far down the list. The Tánaiste should explain that to us and I hope the Government can revisit the list.

I am particularly concerned about the final cohort, which is the 14th grouping, and these are due to get the vaccine last. These are people under 18. I want to make the case for the very many people under 18 in this country who have serious underlying health conditions. I take the point that the vaccines have not been tested on children under 12 but I am talking about teenagers, or those aged between 12 and 18. A significant number of teenagers in this country have serious underlying health conditions. I spoke to the mother of one of them this morning, a 17-year-old girl who is a transplant recipient. Her mother explained what an awful year she has had since last March, when she had to cocoon, and how her life has been so drastically affected. Just yesterday the House discussed the mental health effects on young people in particular but this is especially pertinent in the case of young people with serious health conditions, as the impact is multiplied several times over. In this girl's case, her 19-year-old sister had to move out of the home because of the high risk involved. The girl is being homeschooled and this is having a major impact on her mental well-being.

It was a terrible blow to people in such circumstances to hear that they are last on the list of people to get the vaccine. I earnestly appeal to the Tánaiste and Minister for Health to please consider those categories of people who have had such a difficult time and bring them up the list to ensure they are early recipients of the vaccine.

I thank the Deputy for raising this important matter. She made a valid case that must be listened to. The task force report on the deployment and administration of the vaccine is expected to be completed tomorrow and it will go to the Cabinet on Tuesday.

Last Tuesday, the Cabinet approved the prioritisation of the vaccine, including which groups will receive it first and last. That was based on advice from the National Public Health Emergency Team, NPHET, and the national immunisation advisory committee. It is based on medical and scientific advice and we did not make any modifications to it. We accepted it as it was presented to us, starting with the highest-risk group, which we all accept comprises people aged over 65 in nursing homes, before moving to healthcare workers in direct contact with patients. We all know the reasons for that. It then moves to other groups.

This is not set in stone and can evolve as new information emerges and we learn more about the virus and vaccines. As more vaccines are approved, the list may need to be modified. We expect one vaccine from Pfizer BioNTech to be approved within weeks but, within months, six could be approved and they will not be the same. They will have different characteristics and profiles, and we may need to modify the advice in respect of that.

There are two reasons the last group comprises people under 18 and pregnant women. The number of people under 18 or pregnant women who have become very sick or died as a result of this virus is very low and such people are in the safest group in that sense. There is also the obvious reason that not many children or pregnant women have been involved in the clinical trials. People engage in clinical trials voluntarily and not many people would offer a well child or themselves if they are pregnant unless there was a particular reason to participate. It is not that we think it is unsafe at all for children or pregnant women; it is just that it is not often that children and pregnant women are involved in trials for a new vaccine or medicine.

The Deputy's case that older teenagers with an underlying medical disease may be a high-risk group is valid and should be considered. I will certainly take it up with the Chief Medical Officer, CMO, the next time I see him, which will probably be next week.

I thank the Tánaiste and I appreciate that positive response. It was suggested there would be an announcement by the Cabinet tomorrow but I note the Tánaiste's indication that it will be next Tuesday. I hope this allows time for the Cabinet to reconsider the matter.

I am not making the case for everybody under 18 to be brought up the priority list at all but I refer to a particular category of people under 18 - teenagers - in this very difficult position. I very much appreciate that the Tánaiste will discuss this with NPHET and reconsider the matter because it has been desperately hard. It is hard for young people with an underlying health condition. The past year has been appalling and it has had a major impact on them. I ask that the Government also considers raising up the list the other group of people with underlying health conditions who are under 65.

On the vaccine task force report, we expect to receive it tomorrow but it has not been decided yet whether it will be published tomorrow. The Taoiseach is in Brussels on other business and it is unlikely that we will be able to convene a Cabinet meeting. We believe the report should be seen and approved by Cabinet so it may be Tuesday before it is published. However, that has not been decided yet. The report does not deal with prioritisation, which is a separate matter that has been decided based on the advice of scientists and doctors. As I said earlier, it is not set in stone and it can evolve. The case Deputy Shortall makes for people who have chronic diseases and who are at risk, even those in their teenage years, needs to be considered. I will certainly raise that with the CMO next week.