Vaccine delivery and reopening targets
Deputy Kelly raises concern that vaccine delivery will miss promised targets and asks what the Government knew about supply issues. The Tánaiste says the public can be hopeful, outlines improving public health indicators, and explains that NIAC and NPHET can clarify their advice on dosing intervals and programme decisions.
Today, the people have hope. Our economy and society are on the verge of reopening and that is very welcome. However, the Minister for Health came to the House earlier and dropped a bombshell as regards vaccine delivery. There are a number of issues I want to raise with the Tánaiste as a result of that. These are not gotcha questions; they are just to elicit information so that the public can be aware. There is no way in which we can meet the 82% first-dose target or the 55% target for full vaccination by the end of June. We were meant to receive 470,000 doses of Janssen next month from a total order of 600,000. It was meant to be our workhorse vaccine. Obviously, the Tánaiste was aware of this, but will he inform the House as to what he expects to be the percentages we will get to in the context of the administering of first and second doses by the end of June? I know it will be a guesstimate but, for the information of the public, I would appreciate if he could give us an indication. I never believed that 55% was achievable for second doses but I did believe that 82% was achievable.
I want also to ask about the Government's discussions with the National Public Health Emergency Team, NPHET, as a result of the information that came from the Minister for Health this morning. Was NPHET fully aware, in its discussions from which it has given advice to the Government, that this drop in vaccine delivery was going to happen? Was that considered as part of the advice NPHET gave? Will the Tánaiste confirm whether that variable was part of the mix in the context of the advice NPHET gave to the Government? A big announcement is due to be made on Friday and I do not want the public to have an anxious 24 hours, given the positive vibe that has been given out by the Tánaiste and other members of the Government regarding the advice coming through from NPHET. Was this part of the discussion and was NPHET fully aware of what was happening?
My third issue relates to a question I have asked previously. I want some information. There are more than 400,000 people, some of whom are watching this debate, who are aged between 60 and 69 years. A study from Public Health England shows the first dose of AstraZeneca is only 33% effective against the Indian variant. The Minister for Health clearly stated earlier that there is no intention of giving a second dose of Pfizer or Moderna to this cohort. He was less clear about reducing the gap between doses from between 12 and 16 weeks to eight weeks. I accept that doing so could be disruptive of supply. However, that is secondary to the fact these people are likely to be the most vulnerable, will have to wait the longest to be fully vaccinated and are at risk from new variants. Will the Government please ask the national immunisation advisory committee, NIAC, to discuss this matter? I am not an expert, nor is the Tánaiste. Can we just get advice from NIAC on it?
To conclude, I reiterate that these are not gotcha questions. What will be the levels of first and second dose by the end of June? Was NPHET fully aware of the vaccine drop-off as regards the advice it gave to the Government this week? Will the Government ask NIAC about reducing the gap between doses for 60- to 69-year-olds?
Comment on this
The people have every reason to be hopeful about the summer ahead. The number of people in hospital is below 100, the number in ICU is below 50 and cases are stable at approximately 400 or 500 a day, as I predicted they would be several months ago, without falling much below that given the level of reopening. We are ahead of ourselves in terms of where we thought we would be regarding hospitalisations and cases. For that reason, we can look forward to a very positive announcement on Friday regarding the reopening of society and economy and the phased return to international travel, events, etc.
The vaccine programme is going really well. Most people acknowledge that. I recognise all those involved, namely, the task force, the staff and the volunteers, for what they are doing. As we have always said, the only constraint is supply. It is still the case that once vaccines come into the country, 95% of them are in somebody's arm within a week. The targets we gave were always on the basis of the caveat relating to supply. That was made clear by the Taoiseach at the time. Where we stand now is that more than 2.5 million vaccine doses have been administered, and by the end of this week, more than half the adult population will have received at least one dose of the vaccine. That is very good progress. We expect to open the portal to people between 40 and 44 years of age in the coming days.
The targets, as I said, have always been subject to supplies arriving on time. If the supplies do not arrive on time, there is a risk we will miss those targets. That now appears to be likely. If we do miss the target, it will be because of factors beyond our control, namely, supplies of the vaccine. We hope to be able to provide revised targets as part of the announcement on Friday.
I do not know what NPHET was aware of or at what point in time. I have not had any direct engagement with the Chief Medical Officer, CMO, or anyone in NPHET for a couple of weeks. What I can say is that when I met the Commissioner Thierry Breton, who is in charge of vaccine supply, in Brussels last week, he indicated that there would be an issue with Johnson & Johnson supplies but was unable to come up with a number or tell me what it would be. It is only in recent days that anyone would have been aware of what the reduction in supplies was likely to be. We still do not know for sure, as the Deputy will know from the Minister for Health's comments this morning. If we do miss targets, I think we will only miss them by a few weeks because orders that were expected to arrive at the end of June might now arrive in early July. We are able to vaccinate 300,000 to 400,000 a week, so once we get the vaccines, we will get them out.
In the context of the AstraZeneca vaccine interval, I understand the case the Deputy has made on this and I am sympathetic to it. The most recent advice from NIAC, only in the past couple of days, is that the interval should remain at 12 weeks. That is its existing advice. If that changes, it changes. We know from the manufacturer that the interval can be as low as 56 days, but the advice from NIAC remains a 12-week interval.
Comment on this
I appreciate that this is just a process of trying to get information out to people. As regards the Tánaiste's response, it is reasonable that the Government will tell us on Friday, as long as it is Friday, what the expected level of first and second doses by the end of June is. That is reasonable and I have no issue with it. I am concerned, however, about one part of the Tánaiste's reply, namely, whether NPHET was fully aware of the issues regarding vaccine delivery when giving the advice upon the basis of which the Government is making the decisions it will announce on Friday. The Tánaiste has been clear that he does not know whether NPHET was aware of those issues. That will create a level of anxiousness among the public. That is a concern, particularly as we all want society to reopen.
I stress that the Government must ask NIAC or NPHET to state, in a comprehensive way, why they are not considering, from a scientific point of view, reducing the interval between first and second doses for those aged 60 to 69. I have been inundated with messages from people all over the country in respect of this matter since I first raised it. It is a genuine concern. I am not qualified in respect of this matter, so I would appreciate if NIAC would make that advice public. Will the Tánaiste ask it to do so?
Comment on this
It is worth pointing out that the vaccine programme is run by the HSE rather than NIAC or NPHET, although obviously NIAC and NPHET have a role. They are much the same people, a lot of the time, writing letters to each other but that is another day's work.
The Deputy asked that NIAC should explain its advice as to why we should continue to have a 12-week interval between the two doses of the AstraZeneca vaccine. That is a reasonable request. In fairness to both NIAC and Professor Butler, they have been very willing to do that in weeks gone by and I am sure they would be willing to do it again. The manufacturer says a gap of 56 days is possible, not less than that. The current advice here is that 12 weeks is still the optimum. As long as that is the advice, it is reasonable that the experts should explain that and I am sure they will.