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We continue to progress through the pre-Recovery phase of the COVID-19 pandemic with the planned easing of restrictions during March and April now complete.  Through our collective efforts, we are keeping the virus under control as the vaccine programme is gaining momentum.  The Cabinet will meet again on Thursday of this week to consider latest advice from NPHET and to agree the detailed plan for the further easing of restrictions, to commence on 4th May.

Vaccine Programme Update

The vaccine programme is a key enabler to the reopening of society and the economy and continues to progress well, with over 1 million of our citizens now having received the first dose of the vaccine, and more than 1.4m doses administered overall.  

Roll out is substantially advanced in those residents aged 65 and older and staff of Long-Term Residential Care Facilities, Front-Line healthcare workers and the over 70s.  Roll out continues to very high-risk groups through vaccination centres, community vaccination teams and GPs.  (See Notes to Editors).

Over the past week, the online registration process has opened for those aged between 60 and 64, with those aged 65-69 now beginning to receive their first dose of the vaccine.  Last week saw more than 180,000 vaccines administered.  Progress will continue this week, in alignment with supply, as follows:

• Continued roll out to over-70s.
• Continued roll out to those in Group 4 (very high risk) through the Hospital Groups and GPs.
• Continued roll out to those aged 65 to 69 years through Vaccination Centres.

In addition to the significant contribution of GPs, the HSE continues to build capacity to operate the vaccine programme at scale, in line with available supply. 860 trained and available vaccinators are now in place to meet targets needed for April and May to administer vaccines through the Vaccination Centres. Planning is underway to ensure sufficient trained and available vaccinators are in place for June and beyond.

Updated advice on the use of certain Covid-19 vaccines

The programme is underpinned by an agile and responsive framework which will continue to support rapid reaction to developments in relation to the vaccines. The National Immunisation Advisory Committee (NIAC), having considered a number of factors, including the situation with the virus in Ireland and the availability of alternative vaccines, has made a series of recommendations to the CMO who has endorsed them in advice to the Minister for Health.  The Minister has accepted this advice, as follows (see Notes to Editors for further information):

• All EMA authorised COVID-19 vaccines, including Janssen and AstraZeneca, can be offered to those aged 50 years and older, including to individuals at very high or high risk of severe COVID-19 disease.
• A number of recommendations on interval dosage for the AstraZeneca vaccine.
• There should be no change to the recommended interval of four weeks between the two doses of the Pfizer or Moderna mRNA vaccines.
• A number of recommendations in relation to the administration of the vaccine in those who have had COVID-19 within the previous 6 months.
• Recommendations in regard to the administration of the vaccine for pregnant women.   The ultimate impact is that more vaccines will be available to more people, thus supporting the acceleration of the vaccine programme.  As with other changes to the programme, the overall impact of these new parameters for the use of vaccines will be modelled and operationalised by the High-Level Taskforce and the HSE in the coming days.  

Notes to Editors

As of 26th April:

• • 1,416,350 vaccines administered.
  • Front Line Healthcare workers - 254,456 dose 1 vaccines administered. Process for new staff/ student placements continues.
  • Those over 70:  A total of 664,276 have been administered.
  • Group 4 (Very High-Risk Group): Over 139,836 people have received their first dose vaccine.
  • Those aged 65-69, including those who are very high risk or high risk; Over 63,782 first doses have been administered to this group.

Revised parameters for the use of certain Covid-19 vaccine:

• All EMA authorised COVID-19 vaccines, including Janssen and AstraZeneca, can be offered to those aged 50 years and older, including to individuals at very high or high risk of severe COVID-19 disease.
• Those aged under 50 years, including those at very high or high risk of severe COVID-19 disease should receive an mRNA vaccine - Pfizer or Moderna. The exception to this is where a two-dose mRNA vaccine schedule may not be feasible, in which case consideration may be given to Janssen for those aged 18-49 years.
• Those of any age with immunocompromising conditions should receive Pfizer or Moderna mRNA vaccine if feasible and timely.
• Those aged 50 years and older who have already received their first dose of the AstraZeneca vaccine, and those under 50 years at very high or high risk of severe COVID-19 disease, should receive their second dose 12 weeks after receipt of their first dose.
• Those under 50 years of age who do not have a very high or high risk of severe COVID-19 disease should have their second dose 16 weeks after the first dose, to allow for assessment of emerging evidence regarding the risk and benefits of the second dose of this vaccine.
• There should be no change to the recommended interval of four weeks between the two doses of the Pfizer or Moderna mRNA vaccines.
• All pregnant women should be offered Pfizer or Moderna mRNA vaccine between 14-36 weeks, following medical advice. Previous advice from NIAC recommended that COVID-19 vaccines should be offered to pregnant women at high risk of severe disease and healthcare workers (due to their increased exposure to infection).
• There is good evidence that those with prior COVID-19 infection who subsequently received a single dose of an mRNA vaccine have a similar antibody response to those who have never had COVID-19 and who had received two doses of an mRNA vaccine. Further, a second dose of an mRNA vaccine in those who have previously had a COVID-19 infection does not appear to increase the power of this immune response. There is some evidence that those aged older than 50 years have a less robust immune response than those under 50 years old. On that basis, NIAC have recommended that, for those individuals who have had a laboratory confirmed COVID-19 infection within the previous 6 months:
  • Those aged 50 years and older should receive a full COVID-19 vaccine schedule.
  • Those aged under 50 years and immunocompromised should receive a full COVID-19 vaccine schedule.
  • Those aged under 50 years and who are not immunocompromised and who have had a COVID-19 infection in the previous 6 months should receive a single dose of COVID-19 vaccine, at which point they should be considered fully vaccinated.