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Sam Boal

Vaccines: Pharmacists 'frustrated' with slow involvement, while NIAC Johnson & Johnson advice reported

The head of the the Irish Pharmacy Union says no clarity has been given to pharmacists as to when they can administer the vaccine.

LAST UPDATE | 27 Apr 2021

THE IRISH PHARMACY Union has criticised the ”eternal process” to get pharmacists involvement in the vaccine rollout, while reports have said the Johnson & Johnson jab has been recommended for people aged 50 and over.

The HSE said last week that 15 pharmacies will begin administering Covid-19 vaccines “towards the end” of this month, however, CEO of the IPU Darragh O’Loughlin said there is little sign of a large scale rollout.

“It just makes no sense. The reopening of Ireland is being delayed because vaccinations are not being rolled out in pharmacies,” he told The Journal.

Reports have said the National Immunisation Advisory Committee (NIAC) recommended that the Johnson & Johnson vaccine should be given to people aged 50 and over.

Reports also said the recommendation is for the vaccine to be given to people under 50 if there is no other option available and for hard-to-reach communities.

The single-dose J&J vaccine is seen as key to Ireland’s vaccine effort over the coming months, with over 600,000 doses due here up to the end of June. 

NIAC had examined the use of this vaccine following a safety review by the European Medicines Agency (EMA). The EMA said the “overall benefits” of the J&J vaccine outweigh any potential risks, following reports of rare blood clotting events.

The Chief Medical Officer Dr Tony Holohan will issue advice to government following this recommendation.

From the outset of the vaccination programme, the government stated that pharmacies would have a role to play, said the IPU’s O’Loughlin. 

Pharmacists have been working with the HSE in “good faith” he said, ensuring that operational guidance is drawn up, that an IT system is trialled, and with pharmacists doing additional training to ensure standards are met. 

However, he said the HSE is constantly “moving the goalposts” for pharmacists as to what is needed for them to safely give jabs to the public. 

“It has taken months,” he said, adding that pharmacists are getting “very frustrated” at how long it is taking for them to get the green light from the health authorities.

Pharmacists are wondering how long this “eternal process” will take before they can actually vaccinate people, he said.

“It is because of the HSE it is taking this long,” he said.

The “finish line” is being moved all the time, he added.

Pharmacists are “getting fed up”, said O’Loughlin, stating that some are walking away from the process as it is not worth their while and it taking too long.

O’Loughlin said pharmacists have kitted out their premises to ensure it can be done safely, but said if they are going to be administering the jabs, they need to get their staff and rosters in order now.

Despite months of discussions with the HSE, pharmacists still have “no clue” as to when they will be called upon. 

“A lot [of pharmacists] are starting to feel like the HSE is not genuine in wanting them to vaccinate people,” he said. 

“Reopening depends on the vaccine programme” and its success, he said. 

Pointing to other countries, O’Loughlin said it appears that Ireland is the only one being caught up in red tape. 

US President Joe Biden has announced that he will increase the number of pharmacies giving the jab, said O’Loughlin, meanwhile, Irish pharmacists are left wondering what the plan is, he said. 

Pharmacists in Canada are also central to their vaccine plan, with pharmacists in Northern Ireland and the UK allowed to administer the jabs.

He also highlighted that many people, particularly older people, would be more comfortable going to their local pharmacist for the vaccine.

Speaking about one case, he said a 68-year-old woman was left queuing for more than two hours in one vaccine centre. He said pharmacists would be better placed to look after people rather than have them standing around for hours.  

“People are nervous, they have a lot of questions, legitimate questions, and if they go to a pharmacy we are able to give them reassurances about the risk versus the benefits. They know their pharmacist,” he explained, stating that the public trust their local pharmacist. 

He said it was “crazy” that some people in some areas of the country were being forced to travel long distances to vaccine centres when the majority of people have a local pharmacy that could look after them.

Obstacles such as distance and the time it takes for one to travel is hampering the rollout and could deter people, while these people could be served at a more local level.

“GPs are worn out” giving the vaccines, said O’Loughlin, who raised concerns about recent reports about missed diagnoses due to the GPs being “swamped”. 

“It is getting urgent now,” he said and called on the HSE to give details now on when and how pharmacists will play a role. 

Health Minister Stephen Donnelly has stated that pharmacists will “have a role to play in the vaccination programme”. 

It was announced last week that a trial with 15 pharmacies would happen “towards the end” of this month.

In a statement to The Journal, the HSE said it has been working closely with the pharmacy sector in recent months, including representatives from Irish Pharmacy Union (IPU) and the Pharmaceutical Society of Ireland (PSI) to enable community pharmacists to join the COVID-19 vaccination programme.

“A draft Operating Guidance has been issued together with an expression of interest process to the pharmacy sector to determine those that would be in a position to join the programme. Submissions from the expression exercise are being reviewed and are informing a detailed mapping exercise.

“In addition, a technology solution has been developed to enable pharmacists to work with the programme; HSE PharmaVax. This and the Operating Guidance are currently being piloted with 15 pharmacies.

“Meetings are taking place on a weekly basis to plan for the rollout to community pharmacy and the implications of the revised vaccine distribution plan; the CEO of the IPU and additional members are fully engaged as partners in this process.”

The fees payable to GPs and pharmacists for administering the vaccine were set out following consultation with the Irish Medical Organisation and the Irish Pharmacy Union.

The fee structure agreed by the government provides for a payment of €25 per dose of vaccine administered, plus a once-off administration fee of €10 per patient. Thus, in the case of vaccines requiring two doses the total cost per patient will be €60, while if a single-dose vaccine becomes available the cost per patient would be €35.

The Oireachtas Health Committee was told last week that the HSE is still working through the model of how people will be assigned to pharmacists.

The HSE told the committee it has to give consideration to the vaccine types that may be available because some of those could be challenging for pharmacists. 

The committee was also told the supply is not there yet to activate pharmacies as a channel, but that some of the decisions about the Janssen vaccine could influence that thinking.

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