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Explainer: Gardaí and teachers unhappy as Ireland dumps vaccine roll-out plan to follow aged-based UK model

The overhaul of the vaccine categories follows recommendations from NIAC.

LAST UPDATE | 30 Mar 2021

THE GOVERNMENT HAS signed off on an overhaul of the current vaccination grouping system, instead sorting by age once vulnerable people are vaccinated.

The Cabinet today agreed a number of measures to ease certain Covid-19 restrictions on a phased basis in April. 

Following recommendations from the National Immunisation Advisory Committee (NIAC), the Cabinet also agreed to change the current vaccine allocation groups. 

Once everyone aged over 70, those with underlying health conditions and vulnerable groups are vaccinated, people will begin to receive vaccines on the basis of age.

Under the provisional groups before today’s change, the rollout progressed by job category such as essential workers and ‘people in occupations important to the functioning of society’, alongside age categories.

PastedImage-91859 Over 800,000 vaccine doses have now been administered. HSE HSE

The cohorts will now be divided into different age categories once high-risk people have been vaccinated.

It removes the categories that related to people’s occupations and “amalgamates” Cohorts 10-15 so that the remaining vaccinations are based solely on age.  

There are now to be only 9 cohorts.

The Taoiseach said NIAC made “clear that age, from a clinical perspective, is the better way” to progress the vaccine rollout from there. 

“It also will accelerate and simplify the rollout of the vaccination programme from an operational perspective,” Martin added. 

“Older age cohorts in different professions will get vaccinated more quickly than they might have.” 

He said the rationale from NIAC was clear and “quite strong”. He also said the original programme could have been delayed as it was difficult to identify people in the various job groups. 

The deputy Chief Medical Officer Dr Ronan Glynn said this change will result in those at most risk of severe outcomes or death receiving vaccines as soon as possible. 

He said this is the “base upon which” NIAC issued its most recent set of recommendations. 

This change has been criticised by various groups, including the Association of Garda Sergeants and Inspectors which said it shows a “scant regard for the unique and high-risk job that Gardaí do”. 

The Irish National Teachers’ Organisation said earlier this evening that this change abandons “carefully considered priority groups who are working on the frontline”. 

Opposition parties have also been critical of the change

What the allocation groups now look like

The vaccine cohorts from 1-8 remain the same but the aged-based Cohort 9 of those remaining will be administered in this order: 

  • 64-55 years
  • 54-45 years
  • 44-35 years
  • 34-25 years
  • 24-16 years

Outlining the change this evening, Health Minister Stephen Donnelly said that the age-based approach would “make the roll-out more efficient at higher volumes of vaccinations”

“The move to an allocation strategy focused largely on clinical risk – that is age and medical conditions – makes Ireland’s vaccination programme more efficient, more transparent and fairer,” he said.

We have the benefit of learning from our own experience over the past three months, and what has been shown to be most effective internationally. It means for the first time that we can give better information to the very reasonable question ‘when will I be vaccinated?’ 

Vaccination allocation

This latest change to the vaccine sequencing strategy comes following a number of other changes since it was first announced in December.

The most significant change was made last month when people with underlying health conditions were moved up the list.

Vaccinating this group has proved difficult, however, even allowing for the delay caused by the temporary pause in use of the Oxford/AstraZeneca vaccine.

People with underlying conditions at severe risk from Covid-19 were moved up the queue to Cohort 4 and became next-in-line to be vaccinated but there immediate issues in identifying people in those groups. 

Chief Clinical Officer at the HSE Dr Colm Henry said that there was no national register of people in this category and that some may be known to GPs and others through hospitals. 

The HSE had said that identifying people in this category will likely take place “right through the month of March” and that the number of people involved is “in the order of 60,000″.

The HSE subsequently said that from initial feedback from hospitals and community estimates there are around 150,000 people at high risk requiring a vaccine

In the first week of Cohort 4 it was planned that 10,000 doses would be administered but just over 4,000 vaccinations took place.

As of last Saturday 27 March, just over 20,000 vaccine doses to Cohort 4 had been administered.

The issues with identifying this group are perhaps an omen of potential difficulties that could have pertained if the government was to continue with the previous plan of prioritising people in specific occupations. 

The Taoiseach acklowledged this today, saying it could have “delayed” the roll-out. 

“When NIAC looked at this and the HSE looked at this, the operationalising of the various cohorts would prove to be very, very difficult and could delay the vaccination program, that’s a key point here. Already you can see with Cohort 4, there is no national disease registry. ” he said. 

Likewise with many of the categories of workers in the 10 to 15 cohorts, 10 to 15 are not readily identifiable.

UK model

PastedImage-4412 PA Images PA Images

The remaining vaccination priority plan essentially follows the approach being undertaken in the UK which is based almost solely on age. 

In the UK, the vaccine order of priority began with people in care homes but was then prioritised based on age, with the oldest people first. 

The UK’s Joint Committee on Vaccination and Immunisation advised that vaccination in order of age remains the quickest way to cut deaths, with age still a dominant risk factor for serious illness and death from Covid-19.

UK Prime Minister Boris Johnson, who is 56, received his first dose of vaccine as part of Cohort 8 a fortnight ago. Similarly, Northern Ireland First Minister Arlene Foster, who is 50, received her first dose of the vaccine last week as part of Cohort 9

- With reporting by Rónán Duffy

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