Dáil Éireann debate -
Thursday, 17 Dec 2020

Vol. 1002 No. 7

Covid-19 Task Force: Statements

Minister for Health (Deputy Stephen Donnelly)

The experts tell us that the Covid-19 pandemic is a once-in-a-century event. Let us hope they are right. There have been more than 70 million confirmed cases worldwide and many more people who have never been diagnosed. It has caused 1.6 million recorded deaths and many hundreds of thousands more deaths have gone unrecorded. Millions of survivors are living with the exhaustion and adverse health effects of what is called "long Covid". Individuals, families and entire communities have suffered greatly. Many in Ireland have lost loved ones to the disease - family, friends and work colleagues. The measures we have had to introduce have resulted in people losing their livelihoods and many facing isolation. The global economic slump is the largest since the Second World War.

Out of the ashes of all of this suffering and, at times, despair, we now have hope. The unprecedented work of the global medical and scientific community has brought us to a point where the first Covid vaccine is likely to be authorised for Ireland in a matter of days. What a wonderful thing to say in Dáil Éireann. Data from clinical trials of the Pfizer and Moderna vaccines suggest they reduce the effects of Covid in approximately 95% of people vaccinated. Over time, this should help the country return to life as we knew it before Covid. We may still be in the tunnel, but for the first time we can see light.

Following a Government decision, we announced the launch of the national Covid-19 vaccination strategy and implementation plan on Tuesday following a Government decision. This was another significant step forward in our fight against Covid-19. In November, the Government established a high-level task force led by Professor Brian MacCraith. The task force was charged with developing an overall strategy and implementation plan for the delivery of a Covid-19 vaccination programme. I am most grateful to Professor MacCraith, the members of the task force and everyone who has contributed to its work. They have been able to produce this strategy within a tight timeframe.

It is important to point out that the strategy builds on many months of hard work by many different people and organisations in the world of healthcare in Ireland. These include the Department of Health, the HSE, the Health Products Regulatory Authority, the National Immunisation Office, the national immunisation advisory committee, the Health Protection Surveillance Centre and many more. It has been a show of Team Ireland and what can be done.

Similar to all other EU member states, Ireland is awaiting news from the European Medicines Agency, EMA, which assesses the safety and efficacy of all drugs. This week, we learned that the EMA would bring forward to next week a meeting to consider the Pfizer vaccine. As colleagues will know, the original date set for this meeting was 29 December. We heard in recent days that it was being brought forward to 21 December. We have great hope that other candidate vaccines, including those produced by Moderna and AstraZeneca, will be in a position to receive authorisation early in the new year.

Once initial supplies are received - they are likely to be limited in quantity at the start - the HSE will be in a position to begin vaccinating the highest risk groups. The national Covid-19 vaccination strategy and implementation plan describe Ireland's high-level plan for safe, effective and efficient vaccination of the population while maximising the continuation of service delivery in the rest of our healthcare system. The plan will evolve as we plan, deliver and refine our approach in light of national and international experience with the vaccines.

The report outlines the strategy in terms of logistics, deployment, workforce planning, communications and other essential aspects of the vaccination programme plan. Vaccines will be rolled out in three phases. The first will be the initial roll-out, which will be followed by a mass ramping up and, finally, the third phase, which will be open access. Vaccines will be administered in long-term care facilities, large-scale healthcare sites, mass vaccination centres, GP clinics and community pharmacies. They will be provided at no cost to members of the public. All vaccinators will be qualified and registered healthcare professionals who will receive comprehensive and specialist training on Covid-19 vaccines.

The initial vaccine roll-out will focus on the highest priority groups. At its heart, our approach is to protect those who are most likely to contract Covid-19 and at greatest risk of serious adverse consequences if they contract it, including death. Given that supplies will initially be limited, an important consideration is how to prioritise groups. This matter has been addressed by the recent announcement of an allocation strategy, which was agreed by the Government last week. This strategy identifies population cohorts at a relatively high risk. A further subdivision of these cohorts may be needed to assist in focusing available vaccine supplies where they can bring the greatest benefit. Decisions on matters such as the approach to vaccination of key workers in essential jobs will need to be considered at programme level. As supply increases, it may well be possible to vaccinate different groups at the same time.

Ireland is taking part in a procurement exercise that is being operated by the European Commission on behalf of member states to procure suitable, safe and effective vaccines in sufficient quantities to combat the disease. We have already opted into five advance purchase agreements, APAs, with pharmaceutical companies and a process is in place to opt into a sixth.

It is important to remember that, while this is a time of hope and we are seeing the light at the end of the tunnel, the vaccines are not a silver bullet. We will still be observing public health measures well into 2021. It is vital that we understand this and continue to show one another the wonderful solidarity that has been displayed throughout our country during the pandemic. Right now, the situation across Europe is precarious. In recent days, our own case numbers have increased. I will speak more to that issue shortly. Nonetheless, our 14-day incidence rate is now the lowest in the EU at 88 per 100,000 population. To put that in perspective, the rate is 547 in the Netherlands, 341 in Germany and 1,208 in Croatia.

Huge credit goes to those who have worked gruelling hours for many months, that is, the doctors, nurses and others on the front line as well as those who were redeployed earlier in the year; Mr. Paul Reid and his team of managers, who have worked under huge pressure; Dr Tony Holohan, Dr. Ronan Glynn and all the other members of the National Public Health Emergency Team, NPHET, as well as the many people in my Department who may not be household names but who have made an outstanding contribution at this most challenging time.

I would like to finish today by saying there are still big challenges ahead, not least in the logistical matters detailed in the implementation plan. It will not all be smooth sailing from the start of January or the end of this month. I urge members of the public to remember that every contact counts.

Before I came in here for the debate this evening, I had a long conversation post NPHET with the Chief Medical Officer, CMO, and the deputy CMO. They have been reviewing the latest information right up to today and the situation is precarious. The R number for last week was calculated somewhere between 0.9 and 1.0. As of today, the latest we have from Professor Nolan is an R number of between 1.1 and 1.3. If we assume it is approximately 1.2, the modelling we saw from NPHET and from Professor Nolan's team shows that at anything above approximately 1.2, particularly given the level of cases we are at, the cases can rise very quickly.

We know the positivity in testing is up. The referrals for PCR testing and the incidences of doctors and GPs recording flu-like symptoms in their surgeries are also up. The lead indicators we watch to see what is coming in the next few days and weeks are all pointing to a serious increase in cases. We have seen the number of contacts per person who tests positive rise from 2.8 recently to 3.6 today.

Ireland has done incredibly well. In fact, we have done the best in the western world as a nation and a body politic in working together to drive the virus down and keep people alive. The conversation I just had with the CMO was sobering. He will be doing a press conference with Dr. Glynn this evening and will be relaying some of this.

I will, however, re-emphasise that the debate this evening is one of hope. It is a debate about the vaccinations. Earlier in the year, I spoke to infectious disease experts, as, I am sure, did my colleagues, who said it could be years before we had a vaccine, or that we may never get a vaccine. They said this based on what happened with previous similar diseases where vaccines were not developed and, in some cases, still have not been developed.

It is, however, essential now as Ireland is in this privileged position of opening up for Christmas, we are able to meet our friends and family, we have a very low case rate, and we are looking at this wonderful hope at the end of the year, which is the imminent arrival of vaccines, and it is as important now as any other time that we keep minding each other, keep each other safe and keep following the public health advice which has served us well.

I will finish by repeating some of the clearest advice I ever heard, which was from Dr. Ronan Glynn many months ago. He said whatever number of people a person is planning on meeting in the next week, just think forward about who it is, whether it is family, friends, colleagues or whoever, and just plan to reduce and bring the number down, because if we bring the number of contacts down, we bring the R number down, and if we bring that down, we slow down the growth rate, keep people safe, keep people in nursing homes safe and protect our hospitals and healthcare system, which need to stay open for non-Covid work. I will make a final appeal. I know the House has been united in this right the way through. We must keep communicating with the people we represent and say to them to keep minding each other, keep contacts down and let us keep each other safe through the Christmas period.

Deputy David Cullinane

I am sharing time with an Teachta O'Reilly. First, in what will be my final contribution in this House before Christmas, I wish the Minister and his family a happy and peaceful Christmas and, indeed, all the staff in the Department and those in the HSE. I thank sincerely all the front-line workers who work in our acute hospitals and in primary, mental health and community care, as well as those in our nursing homes who have done a really difficult and challenging job and Trojan work over recent months in what has been a very difficult situation.

I commend Professor MacCraith on his work and, indeed, all the expert group. I am on record as saying the plan they produced is not just credible, it is very good and is a very good framework. Like all plans, however, it comes down to resourcing. We must look under the bonnet to see how well this plan will be resourced and how quickly it can be delivered if and when any of the vaccines get approval from the European Medicines Agency, EMA. We hope that will happen as soon as it is safe to do so.

I say sincerely that it is important we do not unrealistically raise anybody's expectations about the vaccine. I do not say that as any criticism of the Minister but as a general point. We really need to be honest with people about how quickly the vaccine will come on stream. It is possible that the European Medicines Agency will sign off and approve any number of the vaccines before the end of the year or early next year. However, at the Joint Committee on Health this week, even with the advance purchase agreements we have with different pharmaceutical companies, totalling more than 14 million doses of different vaccines, we were told the most likely candidate for first approval would be the Pfizer-BioNTech vaccine. We are in for 2.2 million doses of that particular vaccine. We were told, however, only 5,000 of those doses would come in the first phase, and then a couple of hundred thousand, but no more than that. We were not even given a figure of what a couple of hundred thousand will mean. Is it 200,000 or 500,000? My point is we do not know how quickly the supply of the doses will come, and that will determine how quickly people will become vaccinated. I say that in terms of not raising people’s expectations because we must be careful and we cannot be complacent.

The Minister quite rightly pointed out that the positivity rates in this State are increasing. The 14-day and seven-day incident rates, the five-day average and the hospitalisations are increasing, and of course all that is a concern. We can see what is happening in the North with high figures and huge pressures on our front line. We need to bear that in mind as we approach the end of the year. As we know, January, February and March in any given year are a difficult and challenging time, especially for people who work in our acute services. We must do everything we possibly can to check ourselves and take personal responsibility to ensure we do what is right over the Christmas period. Obviously, the HSE, the Department and the Government have a role and responsibility to give and reiterate that message time and again. The virus has not gone away. It is still here and it is still spreading. We cannot be complacent. We must remain vigilant.

I want to start to go under the bonnet of the plan a little bit and raise not what I see as concerns but suggestions as to how we can give confidence to people that the vaccine will be rolled out as quickly as it can. The document quite rightly says that the vaccinators will all be qualified medical professionals. That is how it should be. People need to have confidence in the administration of the vaccine and in the vaccine itself and I expect the vast majority of people will. How many vaccinators will there be? How quickly can we get all the training done? The plan also says these vaccinators will have to be trained.

Maybe some of them will not need training but some will. Timelines and urgency are important in this.

The plan also talks about mass vaccination centres. The Minister will know that I published a plan on providing a framework for how the vaccine could and should be rolled out. One of the things we called for was these mass vaccination centres. We highlighted in our submission at the time that we felt that community settings, such as sporting facilities, for example, would be a good place for these vaccination centres, because we need to engender a community spirit and to encourage as many people as possible to get vaccinated. We were told at the Joint Committee on Health that there will be 15 vaccination centres. We do not know the geographical spread of those yet. That needs to be there. We also do not know the level of staff that will be required for these centres. The more vaccination centres we have and the more staff we have trained and in place, the quicker the vaccines can be rolled out and the quicker people can become vaccinated.

That is my point on not raising expectations because my understanding from what was being said by the experts is that we might not reach peak vaccination in this State by the summer of next year. It could be closer to the end of next year. We would all hope it will be sooner than that and it can be done as quickly as possible. That will come down to the Minister giving reassurance on how many doses of the vaccine we will get and when we will get them. When the Minister has that information, it should be clearly communicated to people. Second, when we get the doses, the storage capacity should be right, the distribution and logistical requirements should be right and the role of GPs, pharmacies and so on should also be advanced and all of the work should be done.

I met GPs and the head of the pharmacy union in recent days. They have other issues aside from the vaccine. The Minister met them recently as well about a new contract for pharmacists. They need to be communicated with on the vaccine. They need to know what their role will be and when they will play a role in all of this. When we have mass vaccination centres, for example, is it envisaged that GPs and pharmacists will also be administering the vaccine in tandem with these centres? Is that the plan? These are the questions that will need to be teased out and answered. One of the requirements I asked of the Minister, which he was supportive of anyway, was that the vaccine should be free. If it is being administered by GPs and pharmacies, that has to be worked out quickly. There cannot be any problems, delays or issues that arise that could and should have been foreseen so now is the time to make sure we get all of that right.

I want to touch on the need for public education because I am supportive of vaccines. I understand the importance of vaccines and how they have all but eliminated many diseases in the past. The crucial role they have played, not just in the elimination of diseases but in their suppression in some cases, is extraordinary. The development of vaccines and of new technologies and research in this area has been phenomenal. That is something we should celebrate and something that makes them as safe as they can possibly be, which is why I will be at the front of the queue if and when the opportunity comes to be vaccinated. My family and I will be vaccinated because I want to play my part in suppressing the virus. There will be people who will have questions, however, and politicians should not be the ones who give medical advice. The medical advice should be given by medical professionals and the medical professionals are people like Professor Karina Butler, who has done a first-class job in recent weeks in communicating a clear and coherent message and we need more of that.

Public information will be important. If people have questions, we should not knock them. We should encourage them to go to a GP and to get information from credible, sound and reliable sources, as opposed to the unreliable sources we have seen with other vaccines in the past. We should encourage that and make sure they go to their GPs and get factual information to equip them to be in a position to then take the vaccine. That will be an important part of all of this.

I have been heartened by the uptake in the flu vaccine this year. Even though we had more doses this year than in previous years, there still was not enough because of the demand. That tells me that people will want to be vaccinated. We have a huge job of work to do. The Minister has a heavy responsibility and I wish him, his Department and all of those who have done a lot of work in this area well in that. It will be the biggest challenge that will face us next year and one we collectively have to rise to.

Deputy Louise O'Reilly

I am grateful for the opportunity to speak about this important task force, to which, as my colleague pointed out, we offer our full support. We know that vaccination programmes save lives. There can be no equivocation on that and they must, in and of themselves, be supported. When we speak this evening, the words of Dr. Mary Favier are in my mind. More importantly, she said that vaccines themselves do not save lives but that getting vaccinated saves lives. That is what is important. Talking about it and planning for it are important but when we roll up our sleeves and get it is when we will see the real benefit.

This crisis constitutes the greatest public health crisis we have encountered in 100 years. Over 2,000 people have died in Ireland and over 1 million people have died globally in this crisis. Some 76,000 people have contracted Covid-19 in this State, including people we work alongside. Thankfully, many have made a recovery due to the hard work of our medical and health professionals and due to modern medicine. However, we still do not know the long-term implications of Covid-19, with many of those who have recovered saying that they still experience post-viral symptoms. This further underlines the need to ensure that people do not contract the virus. There are countless people alive and healthy today due to the public health measures, the commitment of the public in adhering to them, and the great work of our medical and healthcare professionals.

Worryingly, there have been two variant strains of Covid-19 identified in the past two months, one of which has just been identified in Britain in recent days. It must be reiterated that not getting Covid-19 is the best protection against Covid-19 and its long-term implications until we can roll out the vaccine. Therefore, I would implore people not to let their guards down as we begin the roll-out of the vaccine, to stay alert and safe, to mind themselves and to listen to the public health experts.

Thanks to the brilliance and dedication of the scientific and medical community, which has spent every waking minute of the last year investigating and researching this virus, we have these vaccines in the pipeline. We cannot fully quantify the levels of intelligence of these people or the amazing work they have done. They are the foremost scientists in the world. They have spent so much time investigating and researching this and they have come up with these vaccines. They have been through all of the necessary trials and they are among the most researched treatments in human history. Thankfully, they appear to be effective, which is the main thing. Hearing that effective vaccines have been approved felt as good as when Dublin won five all-Irelands in a row. I am sure they will do the business for us at the weekend and I will have similar feelings when they win six all-Irelands in a row. A task force is needed and welcome. I wish it every success in the work it will be doing.

We need a comprehensive vaccination awareness and uptake campaign to pave the way to ensure a maximum uptake of this vaccine. I would implore the Minister, the HSE and the Department to work to combat misinformation. By way of example, I cite leaflets that were dropped in my constituency in Balbriggan. They seem to target working-class areas. That is very worrying. The authors of the leaflets say there is no need for a vaccine because there is no virus. I would like them to tell that to my cousins, who lost their Dad to this virus. These leaflets are slick and a lot of money went into them. They look exactly like the HSE leaflets and the advice we get in the door. They also make reference to 5G, which helpfully marks them out for the misinformation they are. I am deeply troubled that these leaflets will be dropped in these areas.

We need to be on the ground with an information campaign to combat that. We need to go to where people are. There is no point in us all saying people should just get the vaccine and wagging our fingers at them. We need to be able to speak to people in a way that they can hear and understand how important this is. We need to be able to cut through this misinformation. It straight up frightened me when I saw the state of these leaflets because they are so well produced and slick.

It is one thing to have people going around the country with the lit-up billboard saying, "No vaccines", "No virus", "No masks", etc. They look a little bonkers and maybe people will have a laugh at that. However, these leaflets look exactly like the HSE information leaflets. It is so important that we combat the misinformation contained within those. We are willing to work with the Minister to ensure that we can do that.

Deputy Alan Kelly

As it is the last time I will speak in the Chamber before Christmas, I wish the Minister and all his staff who have worked incredibly hard and indeed all the workers across the healthcare systems the very best and thank them for all their efforts in this extraordinary year. I particularly also thank the HSE, led by Mr. Paul Reid, who has done an incredible job and deserves great credit.

We all go through our political careers in one way or another. We all face various different obstacles - I am no different - but this is the biggest challenge the Minister will ever face. The Minister is like the front-row forward, 'Ginger' McLoughlin, when he was playing for Ireland and the whole pack got on top of him, pushed him over the line and brought half the English pack with them. That is the support the Minister will need to roll out this vaccine. There will be no difference between me and the Minister on this issue. I will support the Minister wholeheartedly. I will make suggestions from time to time but I will support the Minister 100%. It is the biggest challenge the Minister will ever face. If we can get this right, and as comprehensive as possible, I believe there is nothing more the Minister could achieve in his political career. I sincerely wish the Minister well.

I asked the Tánaiste earlier today for confirmation of what the President of the European Commission, Dr. von der Leyen, said in relation to the roll-out of vaccines and he confirmed that we will have vaccines here on 27, 28 and 29 December. That is good news.

I want to make a few points in support of the Minister, but also some suggestions. We have signed up for six vaccines in advance. I presume there may be others. The Minister might let us know where negotiations are with them because they are always in advance.

We have 15 locations for the roll-out. I presume that is a working map. There are some geographical coverage issues but I will not labour that.

I want to ask the Minister a little about resources. Have we looked at a plan of bringing people out of retirement, and doing other things, because this will be a mass issue? I suspect and hope that by March-April next year we could have a lot of vaccine potential that we need to roll out on a mass scale. I presume that is being planned for.

One question relates to the key workers. The Minister will have heard this previously. At some point in the next few weeks, we need to distinguish between teachers, special needs assistants, SNAs, and child care workers and whether these will fit in to that key workers category or be down below. Events, maybe even the past few hours in Killorglin in County Kerry, may influence our thinking if that is to happen more frequently.

In relation to the roll-out and the interaction with pharmacies and GPs, we need to learn lessons from the flu vaccine roll-out. No doubt it was not perfect. It was good but it was not perfect. Issues there relating to how the distribution model worked were real, particularly in geographically isolated areas. Obviously, we need to learn from that.

I would like to know how the Minister got on with his meeting on Friday last with the Data Protection Commission, DPC. For three or four weeks now, I have been raising whether there are any issues here that we need to deal with as a legislature. Many people had issues with the public services card. I did not have many but I do not want to run into hurdles. The data we are collecting here is as sensitive, if not far more sensitive, because we will have to match vaccines to people with underlying illnesses as we build up data. Some vaccines might suit me more than the Minister or anyone with an underlying illness or medical condition. Where are we with that?

The information technology, IT, system is something that I have been speaking about for months because we do not have one. Deputy Stephen Donnelly and I sat for years on health committees talking about ehealth. We now have to build it in a couple of weeks. That is the reality. This system has to be robust. It will have to gather all that information I spoke about. In addition, it will probably have to be rolled out on an ongoing basis because the likelihood is these vaccines will need to be given annually for a number of years until we see where we are going. I would like an update on that.

I have received confirmation that if anyone privately wants to try and get the vaccine, if we get to a stage next year where private institutions or private companies want to do it, that will not happen. It will all be co-ordinated by the State. We rigorously have to stick to that because money can never be the medium by which people are vaccinated. Even if one of the producing companies is based in Ireland, it still has to be done by the State.

I have two other issues, one of which I am passionate about. I attended the world vaccination conference last year. Dr. Glynn was at it with me. The public awareness campaign needs to start before the vaccine roll-out. We have such a campaign. I am deeply worried about some of the misinformation and, dare I say it, some of the misinformation that is coming from Members in this House. There are Members in this House giving out misinformation in relation to vaccines. It is a disgrace and they should be ashamed of themselves. We need to follow the science. If people have concerns, they can go through their medical professionals. The Minister should remember we all deal with the public. We deal with vulnerable people, impressionable people and elderly people and if they do not get the vaccine they could be in serious trouble. We all have a duty and a responsibility as public representatives to deal with that appropriately.

Lastly, I am quite conscious of rules. We will have an interim period next year where some people have been vaccinated and others will not. Will we create a passport or certificate? The Tánaiste said we would but he was not clear on it - it is not his fault. If there are events or activities happening in the middle of next year, will there be a situation where private organisations of private events can look for a certificate to say one is vaccinated because that would raise moral, legal, ethical and, dare I say it, civil liberty issues and we would need to have a standard on that in advance?

Deputy James O'Connor

I very much welcome the national Covid-19 vaccination strategy announced on Tuesday by the Government.

I would like to raise the point of vaccine allocation sequencing. I welcome the approach of prioritising those who are over the age of 65 and are residents of long-term care facilities. We have seen a rapid spread of Covid-19 over the course of the pandemic in certain areas relating to people who are part of that age group. We must try and deal with that first, where possible, in terms of the vaccination roll-out. We are all aware that it is a major challenge and unfortunately, in terms of fatalities, it has been a difficult experience for many older people in our communities who are very worried about Covid-19.

I have been listening to some of my colleagues here in the House today on the issue of misinformation. That is something, on a political level, that has become a major challenge in Irish politics over the past number of years, but particularly in 2020, which was a general election year. We must be absolutely clear with the public that the vaccination is a clear way for our population to deal with this outbreak of Covid-19 and get on to a future without it, recognising that vaccinations were a major part in the eradication of multiple diseases and illnesses throughout the course of modern human history. It is outrageous that Members of this House are willing to come in here and pander to the message of anti-vaxxers in this country which is disgusting.

The Covid-19 vaccine has seen more investment than any other vaccination in history throughout the planet to deal with this pandemic. The virus has sadly ended the lives of hundreds of thousands of people throughout the European Continent and North America, and here, in Ireland as well, has sadly ended the lives of so many people with and without underlying health conditions. The message from Government has to be absolutely crystal clear that we need to embrace the vaccination. Also, I would like to say on the record of the House that when it is available to me, I will take that vaccination.

The Minister has put a great deal of work into his role. Few Ministers for Health, as Deputy Stephen Donnelly will be aware, get thanks. People can be easily critical of the job that the Minister is doing.

The Government has done everything it can. Those involved in the task force have been fantastic. I am delighted to see some decent names on it with good experience of working in logistics from IDA Ireland, academia and our universities. That is critically important in ensuring public confidence in the vaccination roll-out.

It is important we continue to look at other areas alongside the vaccination strategy which will take some time before it is available to everybody. It is important we continue research into antigens. We cannot forget that Ireland is home to many of the world's leading pharmaceutical companies. I stand to be corrected but from my recollection nine out of the top ten pharmaceutical companies in the world have their European headquarters in Ireland. We are at the forefront of the war on Covid-19. We should lead the world in research on this issue, as well as messaging with our European colleagues on further research into this area.

As the youngest Member in the House, as well as the youngest Deputy elected in quite some time, I am hopeful the work we are doing now, as a society and as a backbencher supporting the Government, at an international level will in the future give us a better ability to deal with upcoming illnesses, diseases and new pandemics. Having the template of this task force is good for the country and for public health.

It would be remiss of me if I did not mention the extraordinary efforts put in by our front-line care staff and those working on the front line of the Covid-19 pandemic. They have borne the brunt and the consequences of this. We have to support them in every way possible.

I wish the Minister well. The work he is doing will never be forgotten. He might not be thanked for it for some time. I must admit that the one thing I heard many of my colleagues here talking about was around misinformation. It is highly irresponsible for Members of this House, without any basis of fact or science, to be engaging in that style of debate.

I am conscious that this is my final time speaking here for 2020. I wish everybody in the Houses of the Oireachtas and my constituents a very happy and peaceful Christmas. I am very hopeful that next year will bring some better times for everybody.

Deputy Seán Crowe

This year will go down in history as one of the toughest the world has faced in generations. The election for the Dáil was only in February but it feels like a lifetime ago now. This is a year many of us would like to forget. Ireland has seen more than 76,000 cases of Covid and more than 2,000 deaths from it. The losses endured by thousands of families are unimaginable. Loved ones snatched away by a virus that has swept the globe and left no corner untarnished. The damage to the financial and employment situation of households across the country is almost beyond counting.

There is now a flickering light, however, at the end of the tunnel. The global medical community has come together in a way never seen before. We now have a vaccine that will help break the back of Covid and allow us to start thinking about a future free of this wretched and debilitating illness.

Some have asked how we were able to come up with the vaccine so fast when vaccines for other diseases can take years to create or may never be found. The answer is simple. The world has never had to face a problem like Covid-19. Never before has so much energy, know-how, money and resources been powered into finding an answer to a medical problem. Covid effectively locked down the world. This could not be allowed to continue.

The Government has unveiled its plans to roll out a vaccine to the whole of the State. While I welcome the plan, I would have preferred more detail particularly as to how GPs and the healthcare workforce will be utilised in vaccinating millions of people. Greater clarity is needed on what specific medical conditions will be prioritised and how those who have recovered from Covid already will fit in. Questions remain over the registration process and what is considered an essential business.

As Chair of the Oireachtas health committee, I hope I can be of help in asking some of the questions the public want answered and help to address their fears. It is only natural there will be real fears. There will be those who have legitimate fears about the vaccine. They may be wary of doctors and injections in general. They may be fearful of this new and unknown Covid vaccine and still making up their mind about it. I urge all of those people to listen to the medical experts, to trust in the science and voice their fears to all of us collectively in order that we can answer some of their deep-rooted concerns.

There will also be those who will seek to spread false information, to sow fear and doubt. We saw this in the early days of the pandemic. Some groups chose to frighten or sell half-baked ideas to confuse in order to further their own aims and agendas. We cannot allow this to happen again. The mass vaccination programme is the only option we have to stamp out Covid and get life as close to the old normal as we can.

I call on anyone who would knowingly spread disinformation to stop and think about the real damage and harm they are doing. That is a message which must be echoed by all parties and none in this House. Vaccines are safe. They are one of the most effective weapons in the fight against disease. Smallpox, polio and TB are viruses which have been either eradicated or banished to the poorest or remotest parts of the world by vaccines. It is important this work continues. Vaccines are not to be feared. I will be taking that vaccine when my number comes up in the roll-out. I encourage all others to do the same.

Deputy Róisín Shortall

I am glad to have the opportunity to speak on these statements this evening. However, I would make the point that it is not the ideal format for us. There are two major issues facing the country. They are being discussed here tonight at the tail end of the Dáil session and they are only statements. We are going into an almost four-week break over Christmas. It would have been really helpful if in both cases, the vaccine and Brexit, we could have had a question and answer session. It is quite unsatisfactory and difficult for the rest of us just to deal with this because of the failure to provide that opportunity.

Those of us who are members of the health committee met with a number of the key people involved on Wednesday. Unfortunately, there was not an awful lot more information forthcoming at that stage. It was unsatisfactory. We have not had a briefing for quite a long time. It would have been helpful to have a briefing on the vaccine strategy. I hope the Minister will keep that in mind over the recess and, if the need arises, that he would arrange a briefing for us.

It is welcome the vaccine strategy has been announced. We await the further detail. The excitement and the welcome has to be tempered with a realisation of just where we are at the moment too. We are facing into a lifting of restrictions tomorrow, a Christmas period when people will be mixing to a much greater extent than they have been recently. We are in a situation where all of the indicators are worryingly going in the wrong direction, however. We have not heard this evening's figures yet but the Minister talked earlier about the R number, as well as several of the underlying indicators being of concern.

In that context, I would just be afraid that, while the vaccine is really welcome and offers people hope for the future, it is important that we bear in mind that it is for the future, not now. There may have been too much talking up of the vaccine at this point. When it starts to be administered, hopefully by the end of the year, only a tiny number of vaccines, 5,000 will be available. We do not have any idea about the scheduling of further deliveries. It would be helpful if we got information about the likely schedule, the phasing, the time delay between putting in an order and approval from the company, as well as getting those orders delivered. It could be well into the middle of next year by the time the general population is vaccinated.

It is a long way to go until then.

A very clear message must go out about the very real dangers over the coming weeks. We see what is happening in the North, Germany, the Netherlands and the UK. We are about to embark on a period of opening up. Irish people are very sociable. We all want to see our families and do those pleasant things. We just have to keep repeating the messages, and I am not sure the messages are getting out there clearly enough. In terms of limiting contact with other households and household visits, it is not three households in the morning and another three households in the afternoon or the next day. All of this needs to be kept at the forefront of people's minds. More could be done in this regard.

With regard to the vaccine strategy itself, there are many questions that have not yet been answered. I am particularly concerned about the IT system to underpin the vaccine strategy. We do not know when it will be finalised with IBM and Salesforce. There are issues with regard to what data will be gathered, how there will be unique identifiers, and the problems associated with the fact we do not have disease registers. It is a self-registration programme. How will we cross-check those registering with those who have particular underlying health conditions? What about those who do not register? There will be people who do not get those messages or for whatever reason do not come forward. How do we encourage those people to come forward for the vaccine?

What about those who do not have access to computers or who may not be computer savvy? Many of these people are concerned about how they register. There is no information available. Clearly people want to register and get into the system as quickly as possible but those questions have not been answered. There are also questions about data protection. It is not clear that the issue has been resolved. We are still waiting to hear from the Data Protection Commissioner. If there are concerns about the security of data, it will discourage people from coming forward. We need to be absolutely clear that the system is secure and safe.

There are a few other points that need to be raised. An issue that has come to the fore is the safety of the vaccines in respect of fertility. We know pregnant people are at the end of the list. We also know it is not advisable for people who are breastfeeding. There are question marks raised about people considering planning a pregnancy or fertility treatment. We need clarification on these issues as quickly as possible.

The other point I want to raise is one I raised last week with regard to teenagers aged under 18 with underlying health conditions. I was hopeful there would be progress on this and that there would be a positive announcement this week. Many families in this situation were hopeful the Minister might say something on it this week. He undertook to speak to the Chief Medical Officer about it. It really would be very helpful if at least those aged 16 and 17 with underlying health conditions could be included. There is an overall question about people with disabilities as opposed to underlying health conditions, especially people with Down's syndrome who are at greater risk. There does not seem to be provision for people in this category at this stage. It is something that needs to be addressed very quickly.

Deputy Paul McAuliffe

I am reflecting a little bit on Deputy O'Connor's contribution as he said it would be his last contribution for the year. It makes us reflect on the year we have had. Certainly the election in February seems more than just a number of months ago. Since then, we have had to tackle two major issues. One is the impact of the virus itself, and I believe we have managed the virus well in this country. The numbers and comparisons with other European countries over recent weeks have shown we have managed the virus well. We should not be triumphalist about it and things will change over time. As the previous speaker said, the level of interaction we see in the city would cause some concern, and perhaps we came out of the second restricted period with a more relaxed attitude than we did coming out of the first. All that being said, the numbers do speak for themselves and we have managed the virus well.

The other major issue is that an economic price has been paid for this by many people. People have lost their jobs. People have been made redundant. People have lost income. Again, we have managed some of the worst elements of this economic impact with economic supports for jobs such as the Covid restrictions support scheme, the restart grant and, principally, the pandemic unemployment payment, which I believe we should look at as being a progressive form of basic income.

On this second score of managing the economic hardships, we have done well. Therefore, it bodes well heading into this third phase, where we will start to roll out the vaccine, that equally we should have confidence in this country's ability to deliver the vaccine programme. It should be summed up as two sides of a coin. One side is public support for the campaign and the other is public service excellence in delivering the vaccine campaign. There are a number of elements in both of these points. On public support, of course there needs to be leadership and we have to be careful that those who have genuine concerns about the vaccine need to be won over. They need to be persuaded that their genuine concerns can be answered in a rational and reasonable way. We can explain how the vaccine can be another tool, along with a face mask and 2 m social distancing.

With regard to this conversation, we have to differentiate between people with genuine concerns and those who do not want to be persuaded because of an ideological opposition to vaccination or because they took an earlier position that they do not believe Covid is as serious as we do. I do not know how the people in this category have come to that conclusion. Vaccine deniers and Covid deniers have their own form of twisted logic. The conversation with them should not overtake the genuine conversation we have to have with people who have genuine concerns. In the public health messaging we need to make sure we concentrate on the middle ground and those with genuine questions and the questions we can genuinely answer and that we do not get caught with people who want a black-and-white argument and do not want sophisticated and nuanced answers. They just want to be Covid deniers and vaccine deniers.

In the public support message we need to talk about trusted advisers. We need to talk about GPs, pharmacists and health professionals in people's families, and empower them with the simple messaging that the vaccine is an additional tool and will be crucial in us tackling the virus.

The issue of certification, data protection and the technology is very important. There are always restrictions with any IT system or data management system but they should not dictate the ambition of the roll-out programme. We need to make sure we record everyone who takes the vaccination. If people wish to have evidence they have taken the vaccination, we need to make it available to them. A big part of the pandemic has been people associating with other people who they trust and know are being responsible in the pandemic and, therefore, are willing to be part of their bubble and to trust them.

That is the way we will make progress on the vaccine also. If I am going to be with other people in a social setting I will want to be with people who I trust also availed of the vaccine.

We should not be overly concerned about passports and certificates. That is not the way this country has dealt with this crisis to date. There will be times when we will need to provide evidence that we have taken the vaccine and that should be available as part of the IT and administration systems. However, if we return to the idea of environments we can control and in which we can have trust, we will not need that overly-prescriptive approach. However, there are groups that are not in that position. I refer to those who, either in their work or because of where they live, are put in a position where they are forced to be in an environment with people they may not have the information or knowledge to trust.

I welcome the prioritisation given by the task force. I have great experience of dealing with Professor Brian MacCraith. As a former president of DCU he had great confidence in administering that university and I hope that he and all the people on the task force will bring all that skill to it.

Looking at the prioritisation and the categorisation, it would appear that priority is being given to small groups first and expanding out to those people who cannot control the environment around them. I refer to those people who live in congregated settings or who, because of their housing condition or their health, are forced to share space with other people or those who work in those environments. We must make sure that they can avail of the vaccine earlier than others.

There is always a different focus brought by different sectoral groups in terms of the restrictions that should and should not apply. I imagine the same will happen with vaccination but if we trust the prioritisation of the task force we can have confidence that they will deliver the programme to those people who need it most.

We need to examine the definition of key workers, which is essential. The one area I talk about most is education. Teachers and special needs assistants, SNAs, have put themselves in a position where social distancing is possible most of the time but they are in contact with large groups of people, perhaps larger groups of people than most people have been in contact with. I would equate bus drivers and other transport workers in the same category. Teachers and SNAs must be able to continue to have confidence that schools will remain open, and they should remain open. I despair at the constant rumour mill of schools possibly closing and not closing. The Government has made a commitment to keep schools open as long as is possible and in a safe a manner as possible. I wish we would continue to hear that message rather than the constant attempts to shorten weeks and times.

On that issue, if that commitment is being given, equally we should stand by the teachers and the SNAs who are in that position. Social distancing is possible some of the time but there are occasions when it is not. When I asked my 11 year old daughter about the conditions in her school she said, “Well, you know, the babies cannot keep the social distance the same as the rest of us”. That is the reality. Younger children in schools may breach the distance more than others. I ask that the position of key workers be examined and fleshed out. I know every group will want to be in that category. The political reality is that there will be calls and lobbying from every group but the education sector has been one of the real success stories of this pandemic in terms of how we have managed to respond to it. I would like to see them and the risk that they take acknowledged in the vaccination programme.

Equally, there are those people who have underlying conditions or medical conditions who will seek protection. I ask the Minister to examine their position.

The categorisation is very clear. Although one might be in category seven, eight or nine, the numbers above that are quite small. That is because we focus the need on those people who need it most. As we get to each category, more and more people are brought into the programme. Those are the practical realities of delivering the programme.

I said at the outset that the country has done well in managing the virus and the economic impact of the virus. I am confident that we will do well again in administering this vaccination programme.

Deputy Thomas Gould

I take this opportunity to speak about the Covid-19 vaccine. I want to state on the record that as soon as it is available to me personally, I will be taking the vaccine. When the swine flu vaccine came out 11 years ago, I was one of those people deemed a vulnerable person and myself and my baby daughter were some of the people who were vaccinated. I know people have concerns about the vaccine but I would tell them to follow the medical advice and the advice of the experts. They are the people we are putting our trust in and I will certainly be putting my trust in them.

This has been a very tough year for everyone. I very much hope that the development of these vaccines is the light at the end of the tunnel for people but I want to raise a few issues with the Minister. The Government needs to commit to listen to people on the ground and to take on board what they are saying. There has been much talk in recent days about concern for vulnerable people and groups, and we need to listen to them. That needs to be a group effort and as a country we need to come together. Excluding certain groups or pushing them down the list is not the way to do that. Engaging with people on the ground and letting them have their say is vital to ensuring significant uptake of the vaccine.

I ask the Minister that consideration be given to those in active addiction and to set up an outreach programme that will ensure they will take up the vaccine when possible. It is very important that we reach people. We need to make sure that the vaccine is not just available but also accessible. Those in active addiction need to be reached out to and consideration must be given to their specific vulnerabilities when determining how the order will be rolled out.

It is very important that we keep those in addiction in mind. It took the Minister months to give details of funding that was promised to addiction groups. I contacted him weekly on the issue. Those groups had been crying out for funding. The same issue arose with regard to the guidelines for peer support meetings for those in recovery including Alcoholics Anonymous, Narcotics Anonymous and Smart Recovery Ireland, which are essential, yet it took the Minister of State, Deputy Feighan, months to give those groups the go-ahead to meet.

I raise concerns about comments the Minister of State, Deputy Feighan, made with regard to those in recovery. He stated that these people were medically vulnerable. That was extremely harmful to many people who have been in recovery for a long time or in recovery for behavioural addiction. They have contacted me to say they were upset by the Minister of State’s comments. I ask the Minister of State again, as I have done previously, to withdraw those comments. Being in recovery does not automatically make one medically vulnerable. This is clear because they are not a priority for the vaccine roll-out and they are not looking to be a priority. It is vital that we listen to the people on the ground and that we try to bring everyone together.

Unfortunately, in the past few days we have seen an increase in positive rates. I ask everyone to enjoy their Christmas. I very much hope they do because it has been a very tough year but I ask them to consider and protect the most vulnerable and to manage their contacts and their social distancing.

I ask people to be considerate when they are out. It is a tough time for people who have to work over Christmas, whether in hospitals, restaurants or any other job. It will be harder this year. I request that people respect those workers and treat them with the dignity they deserve.

On a personal note, it has been a tough, busy year for the Minister, his family, the HSE, NPHET and all the groups he has worked with. Even though we might not always agree on anything, I wish the Minister and all those around him a happy and hopefully safe Christmas.

Minister of State at the Department of Foreign Affairs (Deputy Thomas Byrne)

Tá mé buíoch den Dáil gur glacadh leis an díospóireacht seo anocht. Tá sé an-tábhachtach ní hamháin go bhfuil díospóireacht againn ach freisin go bhfuil guth aontaithe sa Dáil anocht ag tacú leis an vacsaín, leis na heolaithe, le muintir na tíre seo agus leis na daoine ar fud an domhain a ghlac páirt sna trialacha cliniciúla.

I would like to speak about the EU's co-ordination efforts to secure a vaccine for Covid-19. A safe and effective vaccine is our best chance to beat the coronavirus and return to our normal lives. As I have said repeatedly, I join the vast majority of colleagues in this House in saying that when a vaccine is available to me, I will take it, and I look forward to that day very much. The European Commission has provided an unprecedented response to the pandemic. The European Commission and member states have agreed to joint action at European Union level. The Commission has planned a centralised EU approach to securing supplies and providing support for the development of a vaccine. Significant funding for this has come from Europe's emergency support instrument.

The Commission has worked tirelessly to secure doses of vaccines that can be shared with all on a fair basis. It has worked closely with pharmaceutical companies and the European Medicines Agency to ensure not just that an effective vaccine is available as soon as possible, but that a safe vaccine is available as soon as possible. As with any vaccine, the vaccine candidates have gone through and are going through rigorous scientific assessment before being made available to the public. I thank every one of the participants in the clinical trials. I am sure there are some in Ireland. Tens of thousands of people across the world have taken on these risks that some people have said they are not willing to take, so that this can be proven to work and to be safe for the rest of us, and very successfully in this case.

The European Commission has entered into advance purchase agreements with individual vaccine producers on behalf of us all. In return for the right to buy a specified number of vaccine doses in a given timeframe, at a given price, the European Commission is financing part of the up-front costs faced by vaccine producers from the emergency support instrument. The funding is considered as a down payment on vaccines that will be purchased by member states, such as Ireland. The approach decreased risk for companies and speeds up and increases manufacturing capacity. It is our European Commission, and on behalf of us all it has secured agreements with six vaccine developers, most of which are now household names, including AstraZeneca, Johnson & Johnson, Sanofi, Pfizer, CureVac and Moderna. More may come. The recent positive announcements of effective vaccines for Covid-19 and the conclusion of these arrangements is warmly welcomed by everybody in this House.

All member states of the European Union have access to vaccines at the same time and distribution will be done on a per capita basis to ensure fair access. Yesterday, the Commission's President, Ursula von der Leyen, said that the EU's 27 member countries aimed to start vaccinations at approximately the same time in a sign of unity. She had discussions with the Taoiseach about this the day before. In her statement to the European Parliament, the President of the Commission said that to get to the end of the pandemic, we need approximately 70% of the population to be vaccinated. This is a substantial task. Our medics and scientists have started the ball rolling, but it is up to all of us to work together, both as individuals and member states, to make sure that this happens.

The European Medicines Agency, which regulates the release of medicines in the EU, is bringing forward to next Monday a special meeting originally planned for a week later to discuss provisional approval for the Pfizer vaccine. It is true that European member states have the option to go before the EMA under emergency rules, but the Commission wants a co-ordinated roll-out across the European Union to ensure nobody is left behind. It is an important principle that everybody has safe access to this.

The European Council and the General Affairs Council, where I sit, have continually underlined the importance of preparation for the timely deployment and distribution of vaccines, including the development of vaccine strategies, which is the focus of the debate tonight, to ensure vaccines are available to people in the European Union in good time and in a co-ordinated manner. This is exactly what the Government has done with our own Covid-19 taskforce. I pay tribute to the Minister for Health, Deputy Stephen Donnelly, to the Taoiseach for his leadership, and to my good friend, Professor Brian MacCraith, for his public service. I think it is fair to say that he has transformed Dublin City University. It is a world-leading young university. His skills are exactly the skills that we need, with a friendly, non-confrontational approach that is grounded in scientific assessment and reality, and in the scientific method. I think we can be certain of getting that from Professor MacCraith.

It is important that we give as much clear information as possible on vaccines to counter disinformation. I sincerely hope that we do not hear disinformation in the Dáil, or insulting talk about risks. There are always risks but a greater risk has been taken on by many ordinary men and women in clinical trials. They have paved the way for the rest of us.

The Commission will put in place a common reporting framework and a platform to monitor the effectiveness of national strategies and to share best practices. The conclusions of the first review of national vaccine plans will be presented in the second half of this month. The Taoiseach would say, and I would say at the General Affairs Council and know the Minister for Health would agree, that the sharing of best practice from across the European Union and of experience is important, and plays a key role in what we are doing. It is a key benefit of our European Union membership.

The arrival of vaccines does not mean that the pandemic is over. The epidemiological situation in Europe is worrying. It is worrying in this country too. Considerable efforts are being made across the European Union. When I was in Brussels last week, there was not a soul on the streets after 10 p.m. There is a curfew. Restaurants and bars are shut. Similar measures have been introduced in Germany, the Netherlands and many other countries. There is a dire situation in Europe that can only be relieved by the production of a vaccine.

The co-ordination of efforts at EU level has been successful so far. Member states want to strengthen this as much as we can. Everybody wants to lift restrictions, to return to normal travel and to get tourism back, as the health situation allows.

Vaccination should be treated as a global public good. It is no good if we all get vaccinated if some poor country in Africa, or indeed another part of Europe, is not able to avail of the vaccine. If we are not all vaccinated or do not all have the opportunity, it loses its effectiveness. The COVAX facility is a good strategy but we need to keep working on that to make sure we live up to its ideals.

Disinformation on the coronavirus is thriving. It is important to get updated information from authoritative sources only, such as hse.ie and who.int. I encourage everyone to follow the public health advice. It is based on scientific rigour, significant experience and the successful science behind vaccines over the last century. Where has polio gone? Smallpox has also all but disappeared. Diseases that were debilitating and killers have been eliminated or much reduced because of vaccines. I was proud to stand up for the HPV vaccine throughout its history and while I certainly met concerned constituents, a quick conversation with Professor John Crown about the dangers of cervical cancer certainly corrected any misapprehensions that one may have had.

We can look forward to a future without cervical cancer and similar diseases because of the roll-out of the HPV vaccine, which at the time was sought and campaigned for by tens of thousands of Irish people. I am proud supporter, not just of vaccines, but of scientific method and scientific reality. Not all of the candidate vaccines will be approved by the European Medicines Agency but many of them will. We can rely on testing and scientific method challenging all of the assumptions and making sure the vaccines that are on the market are safe and effective and that they put an end to the pandemic.

I have great respect for the Rural Independent Group Deputies but I was surprised to learn that the motion they tabled yesterday referenced the reopening of pubs, which is undoubtedly a significant issue, but there was no mention of vaccines. We are not going to get out of this pandemic or sort out all of the issues it has brought upon us unless we can get vaccine roll-out.

I express my solidarity and support for families that have been grievously affected by Covid-19. Thousands of people in this country have died, in many cases leaving families behind and there are other people who are very sick still with ongoing issues. I know of one person who had an amputation as a result of coronavirus. It is a serious illness. We must stick together and do our best for the next few weeks and months until the vaccine becomes available in order that we can eliminate the virus.

The solidarity that we have shown together in the European Union, working together, buying medicines together and getting that medicine for a good price, sharing scientific and practical expertise, is a wonderful thing to behold. It is of immense benefit to Irish and European citizens.

Deputy Réada Cronin

I am sharing time with Deputy Ó Murchú. I welcome the Covid-19 task force and I look forward to getting the vaccine jab when it is my turn. This time last year we could not have imagined what we would be facing, not alone the deaths but the change in life as we know it. This virus has reminded us how fragile and interdependent we are.

Across the world, vaccines have changed lives, virtually eradicating diseases that devastated earlier generations. It is a medical fact that some people will not be able to get the vaccine. Everyone who can be vaccinated against Covid-19 should be vaccinated. We do it for ourselves and for others too. There has been too much suffering and too much death for people to prevaricate. I think of the people, men and women, who died in north Kildare in nursing homes. We paid a heavy toll in Kildare in comparison with the rest of the country. Each one of those people was unique and loved, as stated by our wonderful Kildare coroner, Dr. Denis Cusack. Tonight, I pay tribute to them, their families and the staff who put their own lives at risk to look after those people. Many of those staff are highly skilled but poorly paid.

This pandemic has shown us what Governments can achieve when they work together and with experts for the common cause of public health and the chequebook is open. The chequebook was open because this coronavirus affects the economies of the developed world. If we can apply the same level of global mutual co-operation towards eradicating poverty and promoting rights, one can only imagine what we could achieve. I hope and pray that will happen. We could and should do that.

It will be some time before the vaccine is rolled out to everybody. I urge people to take extra care this Christmas. I heard a HSE official say earlier that people should only meet other people they would trust with their lives. That is good advice. Christmas time is about the birth of a baby. It is a time of hope. Next year will be the year of hope. I welcome the Covid-19 task force and I wish it well. I also wish the Minister well and I thank him for the help he gave me throughout the year with various issues in north Kildare.

Let us roll up our sleeves, literally and metaphorically, and get this done.

Deputy Ruairí Ó Murchú

I want to add my voice to much of what has been said. I wish the Minister, the HSE and all of our front-line healthcare workers, some of whom have been through a gruelling year, a safe Christmas. I thank them for all they have done. Like others, my thoughts are with those who have lost people during this pandemic.

It is vital that we are having this discussion. There was a point when we would not have thought it possible that we would be here in December talking about possibility of the vaccine being rolled out across Europe on 27, 28 and 29 December. Like others, when it is my time I will be only too delighted to take the vaccine. I accept that there are people with views to the contrary. We need to ensure the experts are front and centre in ensuring the truth is out there in regard to the vaccines. Vaccines save lives.

I wish Professor Brian MacCraith the best of luck. Alongside the Minister, he and his team have a huge job to do in the roll-out of the vaccine to those on the priority list, which will need to be reviewed into the future. There will also be need for a review of the structures and processes to ensure vaccination is rolled-out to everybody. We need to make it as accessible as possible and we need to ensure that this happens on a global basis.

Deputy Cathal Berry

I welcome the Minister and the Minister of State, Deputy Rabbitte. I am happy to be here on this very auspicious occasion. It is an historic event for the country. I welcome the opportunity to contribute to the debate on the Covid-19 task force and the national Covid-19 vaccination programme.

I would like to make six points. First, I welcome the publication of the high level strategy document and the more operationally focused implementation plan. In the short timeframe of four weeks, Professor Brian MacCraith and his team have come up with two comprehensive pathways that are hugely important. They deserve a lot of credit.

I welcome that the European Medicines Agency, EMA, is on the cusp of approving, provisionally, the use of one of the candidate vaccines, the Pfizer-BioNTech vaccine. As we have heard, this may happen on Monday. This is a positive step. More important, it is likely that before year end people in Ireland will be vaccinated. Even three months ago, that was unthinkable in this jurisdiction. It is full marks so far in terms of my first point.

Second, it is important that vaccination is completely voluntary. There will be no mandatory vaccination, which is positive. That is important. Coupled with that, the vaccine will be free for recipients at the point of administration. This is essential. A person's financial means should never be a factor in determining whether he or she should or should not get a vaccine. Again, this is a very positive development.

Third, I want to focus on the vaccine allocation strategy. It is correct and appropriate that those who are most likely to contract the illness or those who are most vulnerable if they contract it, should be at the front of the queue. It is correct that those who are 65 and over in residential care settings are the first priority. I have no issue with that. I agree that the second priority should be our front-line healthcare workers and that the third priority should be those over 70 in the general public. There is one group of workers I would like to highlight. I know there are many sectoral interests competing in regard to the identify of key workers but the group of people I am speaking about are regularly forgotten about. They are loyal, they rarely grumble and they just soldier on. This group is peacekeeping troops overseas, of whom there are approximately 600.

The numbers fluctuate over the year. The next large contingent to deploy will go to Syria at the end of March next year. The reason these personnel are so important from a vaccination perspective is that, first, they are deployed to very remote and very hostile countries, including countries which have a much higher prevalence of Covid-19 than we do in Ireland. Second, they are deployed to resource-poor countries that have a much-reduced medical capacity compared with what we have in this country. If our troops get ill overseas, they are at much higher risk. Third, and most important, they are the only group of workers in the State who, before they deploy on a six-month tour of duty overseas, must spend two weeks in strict, mandatory, supervised quarantine in a military installation in Ireland. This means they are away from their families for six and a half months in total. If we could shave those initial two weeks off by giving them a vaccination, it would be hugely appreciated by the military community. Anything the Minister can do from that perspective would be greatly appreciated.

The fourth point I wish to raise relates to workforce planning. I am aware that Professor MacCraith has done a lot of work in this regard already. If there was one bit of advice I could give the Minister, it would be to try, if he can at all, not to redeploy front-line staff from the health services to the vaccination programme. There is no point in robbing Peter to pay Paul. We are only going to store up further problems downstream if we do so. Our waiting lists are long enough as it is without adding to the problem. I respectfully suggest that retired healthcare professionals should be used as well as locum agencies. There are many doctors, nurses and other healthcare professionals who are not working full-time in the sector and would appreciate being part of the national effort to get the vaccination programme over the line. I welcome that the deployment of pharmacists is being seriously considered. It is a very progressive and modernising thing to do.

My fifth point is in regard to the ICT system, which has been mentioned by other speakers. We are looking at an off-the-shelf purchase and that makes a lot of sense. One point I would raise is that we have an unfortunate tradition in this country of patients being lost to follow-up as they move through a very complicated pathway system. We need a sophisticated ICT system to track, monitor and evaluate how things are proceeding, particularly in light of the fact that we are going to have at least five different types of vaccines and perhaps even a sixth one. We need an ICT system that is fit for purpose and in respect of which proper training is provided for the people using it.

My final point concerns the public engagement and communication plan, which is absolutely critical. It is essential that people be made aware that a rigorous and robust testing system has been put in place, that the vaccines are safe and that the chances of an adverse reaction are minuscule. If a person gets an adverse reaction, it can be managed satisfactorily. I am very happy to get the vaccine when my turn comes. I am in the unusual position that I am also happy to add my name to the list to administer the vaccine, should that become necessary.

This is a wonderful day for the country. Throughout the crisis, we have embraced science and enlightenment and now we can reap our just rewards. There should be a collective sense of achievement in this. It was the ultimate team performance. As this is my last contribution in the House in 2020, I wish the Minister and Minister of State and their families the very best over Christmas, and the same to the Leas-Cheann Comhairle and all Deputies and staff present. We have been through a very rough year and I wish everybody a very peaceful and happy Christmas, particularly the front-line healthcare workers who have protected and supported the population over the past nine months. It has been a fantastic achievement. Here is to a much better 2021.

Deputy Jennifer Murnane O'Connor

I thank the Minister and Minister of State for their statements. We have long talked about needing tools to live with Covid. Now we can begin to look forward to using vaccination as another tool in the Covid-19 battle. It really has been a battle, and 2020 will go down in the history books as such. It has been a battle for all the people who have gone through so much, between sickness, bereavement and losing jobs. It really has been an horrific year.

I welcome the news that work is well under way by the task force to develop plans to ensure that once we have the appropriate authorisation from the European Medicines Agency, we can commence the vaccination programme in line with the expected availability of the vaccines in 2021. The impact of the vaccines has been overwhelming in terms of the protection they offer from a wide variety of very significant diseases. It is important that people get the correct information from their GPs and other healthcare professionals. The success of the campaign requires exceptional logistical and communications planning. GPs and pharmacists must be included in the planning and roll-out. It is very reassuring that Ireland is actively involved in the EU procurement exercise being operated by the European Commission on behalf of member states to procure suitable, safe and effective vaccines in sufficient quantities to combat Covid-19.

We need the public to know that we will only be using Covid-19 vaccines that comply with all the requirements of quality and safety set out in the EU pharmaceutical legislation. It is most welcome that things are moving very quickly in this regard, with dates moving forward all the time. We need timely implementation of a Covid-19 immunisation programme as soon as one or more vaccines in the EU portfolio are approved for use. I have a concern about the policies being developed regarding the order in which people should be offered vaccination. I welcome that priority groups will be vaccinated first, including front-line healthcare workers and people who are most at risk from serious infection if they catch Covid-19. However, I am very concerned that the current provisional vaccine allocation group document does not include people with Down's syndrome in the group of people aged between 18 and 64 with certain medical conditions. I got a telephone call about that the other day and I ask the Minister to come back to me on it. It may already have been highlighted to him.

I am also very concerned that people living with disabilities are seventh on the list. While I welcome front-line workers getting the vaccine first, which is 100% right, it is important that those with disabilities get it as early as possible. Many people with increased risk of severe disease due to Covid-19 have spent most of this year in isolation, often to the detriment of their mental health and, in some cases, causing significant regression. It is imperative that they have the opportunity to return safely to work, access services and engage in the social and recreational aspects of daily living at the earliest possible opportunity. One of the main issues I encountered during the Covid period was the telephone calls from families with children or adults with disabilities. It was all about the lack of services and respite. It is important that people with disabilities get the vaccine as soon as possible, as well as front-line workers, the elderly and so on. If we are all in it together and we get a proper programme in place, we can do this and maybe even do it more quickly than is currently planned. I hope we can look at the plan carefully as we move forward.

I commend the pharmaceutical, science and research sectors as well as our health sector on their hard work during this crisis. Due to the urgency posed by the pandemic, exceptional efforts are ongoing to develop Covid-19 vaccines and make them available as soon as possible. Unprecedented levels of scientific research and collaboration, investment and early proactive engagement between vaccine developers and regulators have helped to speed up development and ensure that quality, safety and effectiveness are not compromised. That is most welcome.

When my turn comes to avail of the vaccine, I will take it. I would say to everyone that this is really a good news story. There is not a family in Ireland that has not been affected by Covid-19. I have been at some of the funerals and it has been horrific for people. We need to make sure the vaccination programme is rolled out with proper information in order that people can access it as soon as possible. I wish everyone here a happy Christmas. It has been a hard year and things will be different in 2021, please God, in the sense that we hope to be back on track with employment and there will not be the same amount of sickness as we have seen this year. I wish those who get the first vaccinations the very best as they offer hope to us all. I wish the Minister and Minister of State a happy Christmas.

Deputy Michael Collins

I am sharing time with Deputy Mattie McGrath. This is my last contribution in the Dáil in 2020. I wish the Leas-Cheann Comhairle, the Ceann Comhairle all the staff and all my colleagues the very best for the Christmas period. It will be a well-earned break for many people following a very difficult time for us all.

On the vaccine, I am delighted to get the opportunity to have a discussion about it. I wish we had a little bit more time but we have something here and we must avail of the opportunity that we have. I have been asked by the media as to whether I was taking the vaccine. My answer was that I was not until I knew what I was taking and I am still strongly of that view. I would advise anybody before they take any medication, especially something as big as this in our lives, that they look at all options and ensure that they are happy. I know that 70% of people are happy to take the vaccine and I will certainly never stop anybody from taking anything like a vaccine of this sort if they are comfortable with it. It would be totally wrong of me to do so.

I am concerned, however, and have conveyed this concern to every media outlet but they have forgotten to run that piece, about the 25% to 30% who are saying that they are either fearful or will not take the vaccine. Some of that 25% to 30% will never be convinced, but we certainly need to spend time addressing their concerns. It would be very wrong of us if we did not allay those fears. I was listening to the initial talk about the vaccine probably three weeks ago when it was very much coming under discussion in Ireland and there was a strong concentration on the 70% and the 30% were forgotten. I am convinced that if we can explain this issue and allay some of the fears that are out there, if it is humanly possible to do that, then that 30% could be 20% or 15%.

My worry is where I have listened to some of the Deputies here tonight who were forceful, such as Deputy O’Connor, and were flippant about the whole thing. That is the wrong attitude to have and that is what happened last weekend. We are all well used to being harassed a bit on social media, but there was a concerted effort by an Oireachtas Member in west Cork and by his political party, together many councillors who were criticising me. They did not know my circumstances and I have an underlying health condition. I cannot just walk in there and take this vaccine and think that it is okay for me. I certainly have to take very strong advice as to whether it is suitable for me. I was talking about the 25% or 30% who have worries and that we work towards bringing that percentage down, if it is humanly possible, but they were rubbishing all of that.

It became a political football by immature politicians. This is not a political football but a very serious vaccine. We desperately need to come out of the position that we are in with Covid-19. I urge every politician who is in the Oireachtas or who is a county councillor to consider everybody. If someone comes before me on the street and says that they are taking the vaccine I will say well done to them. Equally, if someone says he or she is worried about it, I will work with that person to try to allay his or her worries. We have to be sure to act in a very mature way here because some have acted in a very immature way. We need to work with the people and not work against them.

Deputy Mattie McGrath

I, too, am happy to speak on this issue tonight although I am very critical that we did not have a question and answer session or a debate and had to fight tooth and nail to have this debate, albeit it is just statements with no answers from the Minister. I am glad that the Minister has stayed for this debate. It is the first debate where he and his group have waited to hear our own group. It is very important that all voices are heard.

We have not had great success but I compliment everyone and all front-line workers in the community, including An Garda Síochána, the fire service and the community groups who have worked so hard to try to reduce the impact of the Covid-19 pandemic. I sympathise with all the businesses in the leisure area and all of the musicians who cannot perform.

I have a significant issue with the HSE and the way in which it handled this pandemic. I am not happy that there has been no airport testing or that countries like Canada do not let anybody in or out except family or someone very close to them. We have no real follow-up protocols but have weaknesses. We have railed against the antigen testing which could be quite simply done. We have seen people who have tried to use that and are not allowed to do so. We have seen the force of the law - I am not criticising An Garda Síochána here - used to prevent people going on their way, like the public in Galway. We have paid significant moneys to Chinese companies also for faulty PPE equipment. These are significant areas.

The Taoiseach informed us that he has indemnified all of the vaccine companies, which I know is common practice, but we had no discussion on that. We live in a democracy and have not had any debate or discussion about a no-fault compensation scheme for people if they become ill or have repercussions from the vaccine.

We are also lucky to be part of a powerful Europe that could buy the vaccines, but what about the Third World countries? Where is our respect for all human beings? They are not going to get it, or how long will they be waiting for it?

The nursing homes have been mentioned here as being first for the vaccine. The nursing homes have been treated appallingly. People were sent in by the HSE who had the vaccine.

We are told that there were 2 million doses of the flu vaccine. Some 1.4 million doses have been accounted for, which means that 600,000 doses are missing. The HSE has been asked to make a statement in response to these different reports. There are now between 8.5 million and 9 million doses of this vaccine. How can we have faith in a HSE that is so dysfunctional, it was unable to administer the flu vaccine this year with the result that 600,000 doses are unaccounted for? I have many questions about the roll-out of this vaccine and about how people might have confidence in it. We must win over the people who have concerns. We must talk to them and engage with them. It is a matter for each person, with his or her GP or consultant, if necessary, if he or she has an underlying condition, whether to take this vaccine.

A practice has crept in here, used by Deputy Kelly and others, of writing to all of our colleagues, and demanding that we provide an answer within a week. That is bullying. This is a democracy and we are all elected here with individual rights to represent our people and ourselves without being intimidated and being shouted down. Some people are nice and most people are very respectful, but some are dismissive of anybody who has any issues. We must bring the people with us. Ní neart go cur le chéile.

Mar fhocal scoir, I wish the Leas-Cheann Comhairle, the Ceann Comhairle, the Minister, every Deputy and Senator, all the staff of the Oireachtas, na gardaí out on the street, and everybody else a happy, holy and peaceful Christmas and we look forward to the new year with hope.

An Leas-Cheann Comhairle

Go raibh míle maith agat, a Theachta. Glaoim ar an Teachta Harkin.

Deputy Stephen Donnelly

Given the importance that the public have correct and not false information on the vaccines, can I correct the record of the Dáil because Deputy McGrath has just put misleading and false information on the record?

An Leas-Cheann Comhairle

I ask the Minister to allow me to speak, please.

Deputy Stephen Donnelly

I beg the indulgence of the Leas-Cheann Comhairle.

An Leas-Cheann Comhairle

I ask for just one minute, please, Minister. There is plenty of time. I am going to allow Deputy Harkin to speak now and there is ten minutes then for the Minister to-----

Deputy Stephen Donnelly

There is no more time for me, unfortunately, because the Minister of State, Deputy Rabbitte, is speaking in that slot.

An Leas-Cheann Comhairle

That can be decided between the Minister and the Minister of State.

Deputy Stephen Donnelly

This will be very quick. I wish to correct the record of the Dáil if I may. Deputy McGrath has stated falsely that the HSE has mislaid 600,000 vaccines. I want to let the Dáil and the public know that that is verifiably false information. Deputy McGrath should not be spreading false information about vaccines in our national Parliament. I thank the Leas-Cheann Comhairle.

Deputy Mattie McGrath

Many media reports have carried this and the HSE has not come back with a comprehensive answer as to where the 600-----

An Leas-Cheann Comhairle

I thank the Deputy. He has raised the issue. I am moving now to Deputy Harkin.

Deputy Marian Harkin

I wish to make two main points to the Minister. I have read his vaccination strategy and implementation plan. It is impressive and I wish him, the task force, and everybody involved well because this is the most important piece of work that the Minister and his Government will undertake during its term of office. That is why I have previously called for a separate Ministry to take full and final responsibility to ensure effective, efficient, safe and timely roll-out of the vaccine. Let me assure him that in no way does this question his competence or that of his Department. The Minister already has a 24-7 job with very significant responsibilities. We cannot get this wrong.

The implementation phase, and I have read through it, is multilayered and multifaceted. There is a long vaccine supply chain starting with supply, then proper storage, and this is different for different vaccines. We need to organise distribution at both national and local levels and to ensure that adequate numbers of vaccinators are in the right place at the right time. There will be scheduling of appointments and the contacting of individuals, often more than once. We need to ensure informed consent, arrangements for arrival, check-in, vaccination and follow-up. We will then need to do that again because most of the vaccines will require a second dose. As well as that, at an overall level, there must be effective governance and data protection systems, adequate regulatory processes, proper surveillance and monitoring, and, crucially, good clear communications and public engagement.

The reason I mention all these is because the undertaking is massive. The Minister knows that. Regarding those who already have 24-7 jobs, if there is going to be no new Ministry – it does not seem that there will be – the Minister should make sure he has all the resources necessary in his Department to get the job done.

The other point I want to make is on public acceptance. Many have spoken about this here. We want to see a high take-up of the vaccine. The best explanation I have heard was made by a Sinn Féin colleague two or three weeks ago. The individual asked me to consider how I would react if I went to the doctor to get the usual prescription for a certain illness and the doctor said there was a new medication that targeted my illness very effectively and, from what could be seen, gave good results. In such circumstances, the vast majority of us, including me, would say it was great and that we were happy with it. The truth is that the position on a new vaccine is similar, but it is often viewed in a very different way.

It is crucial that we take on board and listen to people's concerns about getting vaccinated themselves or about their families getting vaccinated. It is not enough for us to play mother and say it is for their own good, or to play teacher or doctor and say we know what is best and that it is in their interest. Getting some people to take this vaccine is about hearts as well as minds. It is about how people feel as well as how they think. Many different issues can be conflated. Previous negative experiences, be they one's own or somebody else's, can have an impact on take-up. We have to avoid being judgmental, even though there is a great temptation, and at the same time strongly encourage take-up of the vaccine. A way to give a good example is by getting vaccinated oneself. Social influencers will all play an important role. Active listening matters, and active engagement is really important. We will not change some people's minds by insisting on our superior knowledge. If I do so, or anybody else does so, it only pushes people to find another reason to dig in and reject the viewpoint. We have to be careful not to fall into that trap.

We are in this together. The approach has worked to a large extent up to now. It can continue to do so. People make up their own minds on vaccination for various reasons. There is no hierarchy of reasons. Clear, simple and straightforward information on all aspects of the vaccine is critical. If there is a problem, large or small, as there will be, people should be informed. People's trust is gained by always telling them how it is. If the Minister does this, we will not spend hours in this Chamber or in other fora trying to get to the reality of the situation. "Transparency" is a lovely word but, in reality, if we practice it, it engenders trust. We can do this well. I wish the Minister and all involved in this endeavour the very best.

I listened to the Minister's speech, including his optimistic opening and his worrying conclusions. When I hear that the R number is 1.2 or more, I become very concerned. As the Minister said, we need to mind each other. To that, I add that by minding each other, we mind ourselves.

An Ceann Comhairle

I thank the Deputy for those words of wisdom.

Minister of State at the Department of Health (Deputy Anne Rabbitte)

I thank all the Deputies for their considered questions and comments. It is positive to have such a healthy conversation on this issue because there are many differing opinions. We must ensure that the discussion is given the time to happen.

It was no surprise to learn this week that "unprecedented" was chosen as the word of the year. The new decade has not got off to the start any of us expected. This year has been one of heartbreak for each and every one of us in different ways. We have had to deal with the deaths of loved ones and, in many cases, we have been unable to attend their funerals. We have seen the struggles and anguish as people lost jobs and as their businesses closed, in some cases for good. We have dealt with isolation among family, friends and communities. The simple joy of taking a walk or browsing in a shop can now put our health at risk. However, perhaps the word of the year next year will be "hope". As the Minister, Deputy Donnelly, said earlier, subject to approval the first vaccines could be administered before the end of the year. We are aware that vaccines will not be a total cure for the disease but they are a step towards normality. They are a step towards a time when we might not have to live in fear of what this disease might do to our loved ones, families or friends.

I am thankful for the tremendous amount of hard work that has gone into our response to this pandemic. People have made incredible sacrifices to help keep each other safe. We must, however, be honest about how this vaccine will shape our behaviours in 2021. While the roll-out ramps up over the next few months, we will need to stick to the public health measures that we all follow now. We will need to keep safe by keeping our number of contacts low, washing our hands, wearing face coverings and maintaining social distance.

I welcomed the announcement this week on the national Covid-19 vaccination strategy and implementation plan. A lot of hard work has gone into getting this right across government. It has involved my Department, the HSE, several agencies and experts. The strategy provides us with a clear path that we can follow for safe, effective and efficient vaccination of the population. It allows us to do this while getting the best out of our health service and continuing with service delivery. Vaccines will be administered in a range of settings that are best suited to the needs of the patient and the practical requirements of individual vaccines. Long-term care facilities, large-scale healthcare sites, mass vaccination centres, GP clinics and community pharmacy settings will all be utilised. There will be no charge for the vaccine. Each person in Ireland will be entitled to receive it free of charge. Vaccination will be carried out by registered healthcare professionals, all of whom will have received specific training in the administration of Covid-19 vaccines.

The focus initially will be on administering the vaccine to those who need it the most. As the Minister responsible for disabilities, I am aware that there have been queries on where people with disabilities stand in the vaccine allocation sequence. It is important to note that, as outlined, people with disabilities are included in the plan although not explicitly listed as a defined group. A person's age, whether he or she is in the long-term care setting and whether that person has a medical condition will dictate when he or she is vaccinated. More broadly, though, the implementation plan is a live document that will change and grow. Further subdivision of the cohorts outlined will be needed. The strategy can adapt based on further expert advice and in accordance with the data and status of evidence that emerges over time. Just as Deputy Berry said in his statement, perhaps the likes of peacekeeping troops going abroad might be considered in this regard. It will all depend on how we move through the phases of our approach and the experiences in Ireland and abroad.

The framework takes into account the current and evolving understanding of distinctive characteristics of Covid-19, its modes of transmission, the groups and individuals most at risk of severe disease or death, and the known characteristics of the candidate vaccines. Scientists and clinicians will continue to play a key role in determining the ongoing evolution of vaccination prioritisation to ensure the optimal approach from a public health perspective. Based on Ireland's experience with Covid-19 so far and the risks that the vulnerable and those in front-line roles in health and social care settings continue to face, it is essential that they be they be accorded the highest priority under the programme. In the first wave of the pandemic in Ireland, 56% of those who died were people in nursing homes and long-term care facilities who were older than 65 years.

They will be prioritised. Healthcare workers have also borne the brunt of Covid-19 infections and they will be prioritised, as will people aged 70 and over because we know that the risk of hospitalisation or death from Covid-19 significantly increases with age. The announcement that the European Medicines Agency will consider the BioNTech-Pfizer vaccine at a meeting scheduled for next week brings us closer to a new phase in our response to the pandemic. As part of the European Commission procurement exercise, Ireland has so far opted into five advance purchase agreements with pharmaceutical companies with a process in place to opt into a sixth. It is likely that early next year, we could have a number of vaccines approved. We have made a great deal of progress over the past number of months and will continue to follow the medical and public health advice in order to keep each other safe in the new year. We hope that the roll-out of the vaccines will prevent the most severe cases, hospitalisations and deaths associated with the disease and that we will be able to reopen our society and economy.

I thank all Members of the House for the questions and issues they raised here this evening. I hope that the answers provided have addressed some of their concerns.