Covid-19 Vaccine Roll-out: Statements

I am pleased to be able to update the House on the vaccine roll-out programme as it relates to people with disabilities. The national vaccine programme is unprecedented in its scale and will grow to become the largest immunisation programme in the history of the State. It is important to me and to people with disabilities and their families that the appropriate priorities are made in the national roll out, which I have spoken out about a number of times. It is also important for me to acknowledge how hard it has been on people with disabilities and their families over the course of this pandemic. It has not been easy, of that there is no doubt but we are turning a corner now and there are brighter days ahead.

Covid-19 has affected people with disabilities significantly and there have been 155 outbreaks in disability settings this year. Around 1,250 staff and residents in disability services have been infected since the start of 2021. Tragically, I have been notified of 20 deaths in disability settings since the start of this year. To those families who have lost loved ones, I pass on my sincere condolences. It is important to acknowledge and thank the healthcare workers and disability service providers for their hard work over the last 14 months. Collectively, they have done their utmost to keep people safe. I am pleased to report that all but four of the disability outbreaks in 2021 have now been declared closed and I am glad to be able to inform the House that there have been no Covid-19 outbreaks recorded in disability services since 19 April. This situation held until 13 May when the cyberattack halted receipt of detailed Health Protection Surveillance Centre, HSPC, data on outbreaks and cases. This certainly suggests that the vaccination programme is successful in suppressing the outbreak of Covid-19 in disability services. I would like to take this opportunity to thank all of our healthcare workers and disability service providers for their hard work and dedication which has gotten us to this point. As Covid-19 has disproportionately affected people with disabilities, I have sought to ensure that they and the staff in disability services are prioritised in the vaccine roll-out programme. The focus has been on ensuring those who face the greatest risk of severe disease and death, the oldest and most vulnerable in society, as well as those who care for them, are prioritised for vaccines. I am pleased to inform the House that the HSE has ensured that people who live in disability residential settings and those who attend day services have been vaccinated as part of the 271,000 people included in cohort 4, that is, people who are aged 16 to 69 years and at very high risk of severe Covid-19 disease. Access to Covid-19 vaccination has also been made available to individuals with a disability through the GP pathway and within HSE vaccination settings. The administration of the second vaccine dose for this group began in the week beginning 10 May and, to date, 11% of this group are now fully vaccinated. The first dose roll-out is mostly complete and the second dose inoculation will continue through June 2021.

Many people in receipt of health-funded disability services have complex co-morbid health conditions but might not be attending a day or residential service. They are largely included in cohort 7 which comprises people aged 16 to 59 years with medical conditions at high risk of severe Covid-19 disease. There are 250,000 people in this cohort and vaccinations for them began in May and are being delivered primarily through GPs. The first dose for all of these individuals is expected to be completed by mid June. Administration of the second dose of the vaccine for this group commenced this week, with 715 second-dose vaccinations scheduled. Both first and second dose administration will continue over the coming weeks.

Community clinical teams have offered Covid-19 vaccinations within their community clinics or through central vaccination clinics for individuals from cohorts 4 and 7 who can be identified as eligible for a vaccine because of their disability. In the context of disability services, this is all being done while the provision of services continues. I must stress how grateful we all are to the staff working on the front line who are continuing to deliver services for people with disabilities and their families, day in and day out. Disability services continued to operate during level 5 restrictions, providing vital supports to service users and their families during difficult times. There is no doubt that there will continue to be challenges but the vaccine roll-out programme has already demonstrated its agility in responding to unpredictable changes in delivery schedules.

I welcome the opportunity to update the House on our Covid-19 vaccination programme. The programme has continued uninterrupted since our last session despite the cyberattack on both the HSE and the Department of Health, although this criminal attack on our IT systems has had an impact on the programme, as the validation of data and daily reporting of vaccination figures have not been possible.

Ireland's vaccination programme represents one of the greatest public health and logistical challenges that our health services have ever faced. It is a testament to the commitment and quality of character of those working for our health services that they have met this challenge and we are seeing such significant progress with the roll-out despite the attack on our systems. We have made major inroads into the vaccination of people all over Ireland, with vaccination of the most vulnerable in our society now largely completed.

I will outline for the House insofar as possible the latest information on the vaccination programme. Yesterday afternoon, Mr. Des O'Grady from Castleknock in Dublin received the 100,000th vaccine dose administered at the Citywest vaccination centre. This was a remarkable achievement for a single centre. Mr. O'Grady received one of approximately 280,000 vaccine doses being administered this week. By the end of this week, that number may be higher. It follows on from a record week in our vaccination programme last week when more than 300,000 vaccine doses were administered, including almost 40,000 of the single dose Janssen vaccine.

As of last evening, it is estimated that we have administered in excess of 2.5 million vaccine doses. Colleagues will be aware that the exact number is not possible to provide, as data from GP practices across the country cannot be reported back to the central system. I spoke with the HSE, the task force and the Department this morning to get the latest estimates, though, and I am delighted to be able to say that, by the end of this week, we believe that half of the adult population will have received at least one vaccine dose. What a wonderful figure for us to be able to share and discuss this morning. Colleagues will join me in expressing on behalf of the Government and the Oireachtas our great thanks to the thousands of men and women in every county in the vaccination centres, GP practices, vaccination teams and nursing homes, including therapists, nurses, doctors and clinicians from across the healthcare family as well as students, volunteers and people who have come out of retirement. The National Ambulance Service, NAS, and the Defence Forces have played an extraordinary role and we have been helped by other Departments and Government agencies. This has been a truly national effort. Is it not wonderful to think that, after the dark and brutal year this country has faced, half our adult population will have received at least one dose of a Covid-19 vaccine by the end of this weekend?

I am delighted to be able to share that registration on the online system is open for all those aged 45 to 69 years. Uptake is going from strength to strength. I will share some of our figures as of last night. Among those aged 60 to 69 years, nearly 89% have started vaccination. Among those aged 50 to 59 years, we have a registration rate in excess of 86% and growing all the time, of whom more than 70% have started vaccination. Encouragingly, of those aged 40 to 49 years, more than 45% have registered or started vaccination. These are the people aged 45 to 49 years for whom the portal is open. Nearly 100% of those aged 70 years and above have been fully vaccinated. What a wonderful set of figures for us to be able to discuss.

The vaccination programme has recently been extended to encompass pregnant women, with pregnancies of 34 weeks and above being prioritised. An operational plan for vaccination of pregnant women between 14 and 36 weeks has been implemented. All 19 maternity services have a pathway in place for these vaccinations. We have extended the vaccination programme to those in socially vulnerable groups, such as those in homeless services. A vaccination pathway has also been provided to those in the Traveller and Roma communities. This pathway was extended to a number of community health organisations at the beginning of this week. Thirty-seven vaccination centres are in operation around the country and another will open soon in UCD.

The Government is taking measures to secure the future immunity of the public from Covid-19 and providing a robust framework against variants of the disease, which we are all watching closely. Ireland has opted into a new purchase agreement at an EU level for up to 1.8 billion mRNA-based vaccine doses, which has been negotiated by the Commission with Pfizer-BioNTech on behalf of member states. While the basket of vaccines will be broadened for the future, this is a significant advance purchase by Ireland and the rest of the EU of the Pfizer vaccine, which has proven reliable and effective. The purpose of this agreement is to ensure that member states have access to a vaccine that can be used to provide booster doses where required but can also be adjusted to protect against emerging variants, which is an important part of the agreement, can be safely administered to children, is linked to a dependable and secure supply chain - we know how important that is - and will be easier to store and more portable than its predecessor, in which regard there have been encouraging advances in technology. This will serve as the backbone of our vaccination strategy for the next two years. We will be directly contributing to the manufacture of this vaccine. The announcement that Pfizer's Grange Castle plant will play a role, with 75 new jobs being created, is something that I warmly welcome. Subject to regulatory approval, production at the plant could commence as early as the end of this year, which would be fantastic.

Through our participation in various EU forums and COVAX, we are taking steps to plan access to vaccines for countries less fortunate than ours. Recent events, including those in India, point again to the global nature and impact of the pandemic and highlight our moral obligations. Recent discussions at national, EU and international level have focused on the need for clear and robust actions to be taken, with countries being called upon to contribute generously to global vaccine sharing. Ireland will not be found wanting in this regard.

Pfizer-BioNTech has requested that the European Medicines Agency, EMA, consider whether administration of its vaccine may be extended to 12-to-15-year-olds, which opens up the potential for the vaccine to be administered through a paediatric programme, providing an additional pathway. We are seeking for the EMA to make a decision or give a view on this soon.

The cyberattack on the IT systems in the HSE and the Department was solely for the purpose of criminal gain. It was an attempt to prey upon the fears and vulnerabilities of everyone who relies on our health and social care services. It is particularly abhorrent that the cyberattack has arisen during the course of the Covid-19 pandemic and the roll-out of our vaccination programme. Fortunately, the attack has not compromised the roll-out. The resilience already shown by management and staff in the HSE and my Department during the course of the pandemic is being shown again in the face of this new challenge.

Major inroads have been made in a number of important population cohorts and the number of persons who have been fully vaccinated continues to increase. We are moving ever closer to meeting our goal of offering vaccinations to all those seeking them. We are vaccinating those at the margins of our society, those bringing new life into our communities and those living in the most vulnerable parts of the global community. These are significant achievements for our nation, illustrating what is best about our country and public service in Ireland.

I wish to conclude by acknowledging all those who are making our vaccination programme so successful: Corporal Thomas Carew, who gave that 100,000th vaccine dose in Citywest yesterday, and all his colleagues in the Defence Forces; the NAS; all our vaccinators, GPs and staff in general practice administering vaccines across the country; all in the HSE; and all of our healthcare workers who have stood up time and again when we needed them most.

I am sharing my speaking slot with my colleague.

My time is short and as the Minister knows, I like to use it by putting questions directly to him. I acknowledge and welcome the fact that half the adult population will have received its first dose of a vaccine by the end of this weekend. It is good news. There was a Government target of 80% of the adult population having received its first dose by the end of June. Will that target be achieved? What is the target for ensuring 80% of the adult population will have received its second dose of the vaccination?

With regard to the Government target, as the Deputy will be aware, I have consistently said our target is getting the vaccines out as quickly as they arrive. The latest data I have show over 96% of vaccines are being administered within seven days of arriving in the country. I would reframe the Deputy's question to ask whether sufficient supply is going to have arrived here by the end of June to have reached 80% with dose one. It is unclear if that is the case. I was on the phone to the task force this morning in order to be able to provide the most up-to-date information and there are serious concerns with the supply of the Janssen vaccine. I can give the Deputy the exact details but we have been provided with best-case and worst-case scenarios. We were due to receive in excess of 600,000 vaccines to the end of June. The worst-case scenario would see us receiving very significantly less than that and even the best-case scenario I have been given would unfortunately see us receiving considerably less. There are questions around AstraZeneca and we do not have the exact numbers. Moderna looks to be coming in on time. There has been a slight adjustment with Pfizer but the company assures us that by the end of June we will have the contracted amount. In short, it looks like we are going to get substantial under-delivery with Janssen and there are question marks as to what is going to come in from AstraZeneca.

I acknowledge it is good news that by the end of the weekend 50% of the adult population will have received its first dose. However, the Government target was very clear. It was repeated time and again by the Taoiseach and Tánaiste that 80% of the adult population would have received its first dose by the end of June. Here we go again with more problems on the supply side. Can the Minister outline to the House why we are now seeing difficulties with the Janssen supply, as well as ongoing problems with the AstraZeneca supply? The Minister is saying there is a best guess at this point, as well as best-case and worst-case scenarios. Will he explain to us what that means in real terms and what is the reasoning behind it? What is Janssen saying, what excuses is it giving as to why the agreed targets are not being met?

Absolutely, I will give the Deputy the latest figures I got this morning. On the target, Deputy Cullinane, the others in this Chamber and I have had this conversation week after week for months and months. Members of the Oireachtas have quite rightly said they want the forecasts and we have tried to provide them but as the Deputy will be aware, we have always done so with the heavy caveat that the Government target is to get them out the door and that provided they arrived, this then would be the number of people who would be seen. I ask that this spirit still be honoured now because that is how we have always operated. In respect of the Janssen vaccine, the issue involves manufacture in the US. We, together with the EMA, are waiting on a decision from the Food and Drug Administration, FDA, on a manufacturing plant in the US, which manufactures the Janssen vaccine. The EMA is waiting on it. We have been waiting for quite some time and the issue has been live for quite some time now. If the FDA approves, the EMA then needs to make a decision and that will inform the best and worst-case scenarios. I will give the Deputy some specifics as of this morning. We are contracted to receive approximately 600,000 doses; I will get the Deputy the exact numbers. For June, we were contracted to receive about 470,000 doses of Janssen. The best case I have as of this morning is that we would receive about half of that, about 235,000 doses. In the worst case, which the Deputy was looking for as well, believe it or not, it could be as low as approximately 60,000 in June.

I thank the Minister for that update. I ask that he provide us with a full written report on those figures. It is not good news that we are seeing problems on the supply side again. It is unacceptable that the Janssen targets will not be met and that at best it is only going to be half, and there are problems with AstraZeneca as well. Of course, while we can celebrate the 50% number being achieved by the weekend, it was a Government target, repeated time and again by the Taoiseach and Tánaiste, that 80% of the adult population would have received its first dose by the end of June.

I have two quick questions for the Minister on the impact of the cyberattack, which I gave him prior notice of yesterday. The first concerns medical cardholders whose cards are due to expire. Due to the fact they cannot get the cards renewed as a consequence of the cyberattack, pharmacists are not dispensing the drugs, which is obviously a real difficulty. Second, is there any update on patient or staff data breaches yet? Is there any update from those who are examining the systems as to the level of compromise of either patient or staff data?

I thank the Deputy for raising this with me. On the situation whereby the medical cards cannot be updated right now, I am discussing it with the Department and we will discuss it with the HSE. My position is that essentially, anyone who has a medical card that needs to be renewed should not have services cut off. We need to roll that access through until they have them renewed. We cannot have people being denied access because of the cyberattack and we will be continuing these conversations. I thank the Deputy for raising it with me.

On the patient data, there is a forensic piece of work going on, server by server, laptop by laptop, to establish what level of data have been taken. As Members will be aware, there were some suggestions that there might be a big dump of sensitive data on Monday. We did not find one but it does not mean nothing is going to happen. The advice I have from the Garda side and the criminal investigation, but also from the technical experts-----

I thank the Minister.

-----is that anyone who is approached by someone who looks to have data they should not is not to engage but immediately to contact the Garda at the local station in the first instance and then through the confidential line on 1800 666 111.

We are over time. I am sorry but if Members are going to divide it like this other Deputies are going to suffer. There are ten minutes. I am sorry for interrupting the Minister but I had to.

I raise the vaccine roll-out in County Meath. Everyone wants the roll-out to be a success and I welcome the comments commending those involved in the roll-out. I of course encourage people to take their appointment when they get it. However, in County Meath there is an acknowledged capacity issue at the testing centre in Simonstown. This is in part because County Meath has suffered from years of under-resourcing in public health and primary care, which I know from my time working in the health service and from the regional health forum. Vaccination of the 60-to-69-year-old cohort is not yet finished in the county and in its roll-out there were discrepancies in respect of age and geography; a type of postcode lottery for want of a better phrase. Unfortunately, people voted with their feet in some cases and went directly on spec to the Helix. Now for the 50-to-59-year-old age cohort, people on the County Dublin border, in Ashbourne, Ratoath, Dunshaughlin and Dunboyne are receiving appointments not at the Helix, nor Citywest or Simonstown, but in Mullingar. I fear what this will mean for uptake and confidence in the roll-out. All the staff are doing their very best but there is an acknowledged capacity issue. I heard my colleague, Deputy Paul Donnelly, raise the same issue yesterday in respect of the neighbouring area of Dublin 15. These capacity constraints are acknowledged by the HSE. Is the Minister aware of them? Bearing in mind we are not yet into the younger, larger age cohorts in County Meath, can he confirm whether there are plans for a second vaccination centre in the county? He mentioned UCD but nowhere in County Meath. Fairyhouse, for example, might be a good location. If there are such plans, when will that vaccination centre open?

I thank the Deputy for his questions. I am aware that there was some frustration in Meath and, quite frankly, it was taking longer to access the vaccine in Meath than it was in other parts of the country, which we do not want. The Minister of State, Deputy Thomas Byrne, and I, along with others from the area, have had detailed discussions on the matter. I raised the issue with the representatives of the HSE and encouraged them to secure additional resources to ensure that the people in the area were vaccinated as quickly as possible. I am happy to share with the Deputy that significant efforts were made. Some of the other vaccination centres, including the centre at the Helix, were used where they had capacity and that helped much of the population of Meath. Additional volume and capacity were provided in Meath. The issue of a second vaccination centre has been looked at and I am happy to share the details with the Deputy. I thank him for raising the matter. It was a real issue-----

Thank you, Minister. We are moving on.

Will there be a second vaccination centre?

-----and I hope at this point it is being resolved.

I welcome the fact that the Minister has put on record that half of all adults in this country will have received a vaccination by the end of this week. However, as the previous contributor said, vaccinations in Louth and Meath have been something of a postcode lottery. Dublin and the rest of the country have streaked ahead in terms of the vaccination of those aged between 50 and 69 years of age. The cohorts of 50 to 59-year-olds and 60 to 69-year-olds in Louth and Meath have been left behind.

I have worked day and night, particularly over the past few days, to persuade the HSE to get on top of this. I got a call on Tuesday evening from local HSE officials telling me that an additional 10,000 Johnson & Johnson jabs would be made available and that those who have been left hanging over the past couple of weeks, some of whom registered in April or early May, will be vaccinated by the middle of next week. However, it is scandalous that almost 1,000 of them are over 60 and some of them have been waiting for a vaccination since the middle of April. This is basic planning. We know how many 50- to 69-year-olds there are in Louth and east Meath. We know what the fix is. Can the Minister put on the record precisely what went wrong? Is it because the centre I had to secure in the Drogheda Institute of Further Education is understaffed and only operating three days a week? I must add that Drogheda is Ireland's largest town. Is it a staffing problem? We welcome the belated solution but can the Minister guarantee that the people who the HSE has stated will be vaccinated by the middle of next week will be vaccinated? Can he also guarantee that the 40- to 49-year-olds in the area who are now registering will be vaccinated at the same time as everybody else their age in this country?

I acknowledge that the Deputy raised the issue of Louth with me previously. We have looked into it. As he will be aware, the Drogheda centre opened late last week and is operating as an additional centre as required. That will help with many of the issues the Deputy has raised. The latest information I got when I looked into this matter for the Deputy was that, as of Tuesday, 25 May, vaccination was broadly complete for the 50- to 69-year-old group. That was their first dose. As per my response to the previous contributor, I concede that the delivery of the vaccination programme has not been perfectly even throughout the country, which is something we would always like to see. It is important, however, that when the Deputy and others raised the issue, we flagged it with the HSE, which responded with additional doses, capacity and centres.

I acknowledge the work the Deputy has done. It is very welcome and the issue is obviously important. The Deputy's constituents will see there has been a good response and the vaccination programme is moving quickly through the age cohorts.

I have been contacted by a considerable number of people who have accessed the vaccination training programme and because of the cyberattack, it seems they cannot complete the final anaphylaxis module. Is the Minister working on a workaround for that? It is an issue because the vaccination programme is only as successful as the number of people we train to engage in it and deliver vaccinations.

Where are we at with the advice from the national immunisation advisory committee, NIAC, on the over-60s? We are all being inundated with queries on that issue by our constituents. My colleague, the Labour Party leader and health spokesperson, Deputy Kelly, is particularly anxious to see this matter addressed. What are the views of the Minister and NIAC about following the lead of the UK on narrowing the gap between doses of the AstraZeneca vaccine?

The UK has reduced the interval between AstraZeneca vaccines from 12 weeks to eight for people aged 50 and above. I discussed the matter with public health officials last night and it was pointed out that, logistically, pretty much all of our AstraZeneca volume is already committed to second doses. For some cohorts, the interval between jabs had gone from 12 to 16 weeks. NIAC put that in place to be able to gather further information and, having had that extra time, the interval has gone back to 12 weeks. With all of our AstraZeneca doses now fully committed to the administration of a second dose after 12 weeks, it will probably leave some people waiting for 16 weeks. The best thing to do from an operational perspective is to stick with the 12-week interval because that is how the doses have been programmed. That way, we get as many vaccines as possible out the door and will be holding only enough to ensure we can get everyone a second dose within the 12 weeks. As I discussed with Deputy Cullinane earlier, there are ongoing uncertainties about what is going to arrive from AstraZeneca in the coming weeks so we must leave a bit of room for safety. I will revert to the Deputy in writing on his other questions.

I thank the Minister and the Ministers of State, Deputies Butler and Rabbitte, for everything they and the Department are doing. I also thank our front-line staff. The pace of the vaccination programme is incredible. More than 80% of our adult population is expected to be vaccinated by early July. That is a success and the programme is going well. More power to everyone at the front line who is helping to deliver that.

There will still be a small percentage of people, probably younger adults, who will not have been vaccinated before the autumn period. In order that they can go back to their college and university campuses and have a decent third-level experience, one that has been cruelty denied to them by Covid, it is important that we give a place to regular antigen testing so those students can go in and out to lectures and enjoy the after-hours life of college that has been taken from them. There is a role for antigen testing. We will eventually get to full vaccination, I hope, or as close to it as possible, but in that interim period while we are waiting to get down into the young adult category, it is essential that in educational settings, we plan for antigen testing.

It looks like we will have surplus vaccines. Some 18.3 million doses of vaccines have been ordered by the State and many of them will leave Ireland and go to countries that do not have very good vaccination programmes. That makes sense because Covid is a global problem and if we do not address it globally, it will come back in new variants in wave after wave. Supply chains are now functioning well, although they were not a few months ago. With that in mind, it is important that we keep some vaccine in reserve. The epidemiological situation is good now but scientific findings change, month on month. There may be a need to go into a second phase of the vaccination programme next year and we need to keep a reserve of vaccines so we do not find ourselves going back into those pools of supplies and looking for more. We should keep a reasonable amount in reserve.

The Minister will not have time to respond to everything I am saying but I would like him to respond to the following point about vaccination portals. A number of people who hold dual citizenship have contacted me. These individuals are Irish-Americans and hold Irish and US passports. They have had one vaccine in America but the portal of registration in Ireland does not pick that up. Those people have no way of saying they were vaccinated in New York three weeks ago and need to register for a second dose in Ennis. There is no mechanism on the portal to account for people who received a vaccine in the United State in phase 1 and hope to receive a second vaccine during phase 2 in Ireland. That is a small thing but it is catching out a number of people who are falling off the edge of the system. I ask the Minister to speak to his officials after this session and, I hope, tighten up that loophole.

I thank the Deputy. I agree with him about rapid testing in third level institutions and we are looking at that option. With regard to surplus vaccine, keeping a reserve for next year and booster shots, we will potentially do that. At the same time, we will make sure we contribute as much as we can globally. It is important that we do that. I will look into the final issue the Deputy raised.

I thank the Minister and all those who are involved in the roll-out of the vaccine. It has been most successful.

First, I have received quite a number of emails from pregnant women who are attending Cork University Maternity Hospital, some of whom have been advised that it will be at least six to eight weeks before they receive the vaccine. I understand that those who are 32 weeks' pregnant are currently being vaccinated and the programme is working backwards. It is a great concern for those women, who are going through an anxious time and who have been told they must wait six to eight weeks for the vaccine. I ask the Minister for clarification on that issue.

The Minister may not be in a position to respond to my second point. It concerns undocumented migrants in this country. I refer to those who applied for asylum but were unsuccessful and who remain here. My understanding is there are more than 30,000 such people. What is being done to include them in the vaccination programme?

I thank the Deputy for his questions. In respect of Cork University Hospital, I will take the issue up with the HSE this week. A lot of effort has been put into making the vaccines available to pregnant women according to the stipulations of NIAC. Certainly, no one would wish to see a six to eight-week delay before women receive the first dose of the vaccine. I fully appreciate the Deputy's comments regarding concern and I will pick that up this week.

As for direct provision, those in direct provision are included in one of the categories in the vaccination programme, as with other groups in congregated settings. That is being looked at and they will be scheduled into the programme. I will revert to the Deputy with more details as to exactly how that is being done.

The question was about people who are not on any list. Has contact been made with the various agencies that provide support to such people? They are undocumented migrants. I seek clarification in this regard.

I wish to raise another issue concerning the case of a person who is working with the blood transfusion service. That person registered for a vaccination appointment in February 2021 and still has not received an appointment date. There does not appear to be a mechanism available to try to get such people vaccinated. They cannot register again because they are already on the system, even though the age at which they can register has been reached. Perhaps the Minister could provide clarification on that issue.

It is difficult for me to comment on individual cases. If the Deputy provides me with details of the case, I will make sure it is looked into.

I thank the Minister and Ministers of State for taking questions this morning. Recent indications suggest that the roll-out is continuing at pace, with more than 2.5 million vaccinations now having been administered and with more than 45% of all adults having received their first jab. Hopefully, that figure will have reached 50% by next week. It is most encouraging. As the Minister stated, it is a testament to doctors, nurses, GPs and all those involved in this great national effort to bring us out of the Covid pandemic.

While all the indications are positive, we should be careful to note that only 15% of adults have received their second dose and are therefore fully vaccinated. We should be cautious over the next few short weeks until the majority of people have been fully vaccinated. This will allow us to accelerate the reopening, while being reassured that people who have been fully vaccinated are well protected against all known variants. I understand that almost 300,000 people were vaccinated last week and a similar number are expected to be vaccinated this week. I heard what the Minister said about being cautious around the delivery of supply. We have been here before, unfortunately, and it is out of our control. Hopefully, we will see the target of 400,000 vaccinations administered being hit in June and July, dependent on deliveries, of course.

In the time remaining, I have three short questions for the Minister. The first concerns the opening of the vaccine booking portal for those aged 40 to 44. I heard this morning that a choice may be offered to those in that cohort. I ask the Minister to elaborate on that.

The Minister mentioned the 38th vaccination centre being located in UCD, which I welcome. I thank the Minister for listening to the concerns of those in the south-east Dublin region. I ask the Minister to indicate when that centre is due to open.

Finally, I wish to raise a point that I have raised with the Minister previously. It concerns the statutory instruments and restrictions on safe events such as drive-in movies and drive-in bingo. I see that the Minister of State, Deputy Butler is present in the Chamber. I thank her for attendance. Another issue about which I am passionate is the opening of day care centres. Many of the staff of these centres have been vaccinated, as have certain cohorts who work there in other capacities. Perhaps the Minister will elaborate on when those centres will reopen.

In relation to the day care centres, we all understand the important role that day centres play. Our elderly population has not been able to access day care centres since March 2020. An announcement will be made in respect of the reopening of those centres tomorrow, and a timeline will be included.

On the Deputy's question in respect of vaccinations for those aged 40 to 44, it is still being looked at. We hope to have an exact date for the commencement of vaccinations in the coming days. One of the challenges in sequencing the programme and providing these exact dates is the considerable uncertainty that has arisen with regard to the Johnson & Johnson vaccine deliveries for the month of June, as well as for May.

Bhí roinnt daoine ó Chonamara i dteagmháil liom le déanaí ag rá nach bhfuil an vacsaín ar fáil óna ndochtúir teaghlaigh. Ag an am céanna, níl bealach ar bith isteach acu chuig an ionad vacsaíne i mBaile an Bhriotaigh i gcathair na Gaillimhe, mar níl bus nó traein a théann isteach ann agus muna bhfuil carr acu níl bealach ar bith acu an vacsaín seo a fháil. Dúirt an tAire níos luaithe go bhfuil sé chun athbhreithniú a dhéanamh ar na hathruithe ar an mbealach stórála don vacsaín AstraZeneca. An mbeidh impleachtaí aige sin ar dhaoine cosúil leo seo? An bhfuil an tAire chun réiteach a fháil ar an bhfadhb seo i gcomhair daoine i gceantair iargúlta ar nós Conamara agus Gaeltachtaí eile?

I wish to raise with the Minister the following issue. A number of people from Connemara have contacted me. They have reported that their GP is not providing them with the vaccine and they are having difficulties in getting to Ballybrit, where the vaccination centre is located for Galway city. There is no bus or train service available to take these people into Ballybrit.

I missed some of the Minister's earlier contribution because I was travelling here. I am aware that he mentioned that issue of storage methods will be looked into in light of the updated advice in respect of the AstraZeneca vaccine. Will the Minister be looking into some way of accommodating people living in more isolated rural areas like Connemara and other Gaeltacht areas?

I also wish to raise another issue with the Minister. It concerns cohort 7 of the vaccination programme. When will those in cohort 7, whose GPs have opted out of vaccinating patients, be vaccinated? Currently, it appears that some teenagers in cohort 7 may not be vaccinated until the end of the summer. The HSE had stated that the vaccination booking portal would be open for that cohort nearly two weeks ago. Since the cyberattack there has been little or no access to information for the people in cohort 7. Last week, only 1% of those in cohort 7 had been vaccinated, despite the fact that vaccinations were due to commence for that cohort from 1 May 2021. There are over 300,000 people in cohort 7 and only 2,785 of them had been vaccinated by last week. They are being told to wait until vaccination booking opens for their age group. How is that fair for 17-year-old girls who have been cocooning for the last year and a half? I ask the Minister to confirm when the portal will be open for those whose GPs have opted out of administering vaccinations.

I thank the Deputy for her questions. I thank her for raising the issue of access to vaccinations for those in Connemara. Deputy Ó Cuív has also informed me that there has been some concern in the area that the drive to the vaccination centre is simply too long. I have raised the issue with the HSE. There are a few areas in Mayo, Connemara and in parts of Donegal, where people are located outside of the desired length of travel to the vaccination centre. It is absolutely the case that Connemara is one of the areas furthest away from the nearest centre. We have raised the issue with the HSE with a view to finding a local solution. For example, I know that in the community to which Deputy Farrell referred, there is a community centre that people are interested in using as a satellite vaccination centre. That option can be looked at. In addition, we are looking into whether clusters of GPs could be used to administer greater numbers of vaccinations because for some people, the trip to the centre is too long. The issue is being into and I thank the Deputy for raising it.

On the issue of cohort 7, I note the Deputy's point. I am aware that there is a frustration amongst some who are waiting to get vaccinated. The cyberattack has caused a few problems around data flow. It is worth stating, in respect of cohort 7, that the numbers on the portal are lower than reality. Actually, quite a number of these people have been done.

I will revert in writing with the remainder.

While that 50% figure is welcome, I appeal to the Minister to publish an updated supply projection or forecast table. He has already expressed concern about the supply of the Janssen vaccine. Can he put on record the expectations regarding the AstraZeneca vaccine over the coming weeks, and give us the worst-case and best-case scenarios?

As the Deputy is aware, the supply forecast moves around. If everything arrives as we want it to for June, we will receive approximately 2.44 million doses. That would be 365,000 AstraZeneca, 1.42 million Pfizer, approximately 176,000 Moderna and approximately 476,000 or 477,000 Janssen vaccine doses.

I gave Deputy Cullinane the figures earlier in terms of best-case and worst-case scenarios for Janssen. Essentially, as of this morning, Janssen believes best-case is approximately half and worst-case is very low. It would be approximately 60,000 out of a contracted 476,000 vaccines.

With regard to AstraZeneca, unfortunately, we do not know yet. It has not been able to give us a line of sight on what exactly it believes is going to come in week by week. I spoke to Professor MacCraith before I came into the Chamber this morning to make sure I had the latest information available. Right now, we cannot give the level of accuracy, or even a range, which we are able to give on Janssen. AstraZeneca has not able to provide it to us. The task force pointed out to me that as we know, unfortunately, the supplies from AstraZeneca have been consistently under. The company has not been able to give detail as to how much it will be under for June. As soon as I have that information I will make it available, however.

What is the level of concern on that at the moment?

It is an ongoing concern. The concern is as per the AstraZeneca deliveries for this month and previous months.

Okay. With regard to cohorts that have received the first dose of AstraZeneca, there is a wide range of concern about the recent evidence showing that there is only 33% protection against the Indian variant. Even with the second dose, it is still only 60%.

Many people aged over 60 and under 60 are concerned about the implications of that. Generally, we should be concerned about that into the coming critical months when many people will be moving around more and because of the existence of the Indian variant. The Minister confirmed that he is sticking with the 12-week interval. Has consideration been given to using an alternative vaccine for the second dose, which would provide a greater level of protection to all those cohorts over and under 60 years of age?

The figures cited by the Deputy in terms of first and second doses are from the Public Health England study. An important additional point to make is that while those figures are around individual protection, a much wider protection is afforded at a population level, and therefore, the chance and the risks fall. It is, therefore, very important from that perspective.

There has been no suggestion that we would switch out the second AstraZeneca dose for one of the mRNA vaccines, for instance. At this point, all the vaccines we have are committed to the various age cohorts that have opened up, with a first dose scheduled and then a second dose planned afterwards. We discussed 12 weeks versus eight weeks, as per as per the UK. As I said earlier, the second doses are already committed, having moved from 16 weeks to 12 weeks.

Okay. I ask the Minister to raise the possibility of provider the Pfizer vaccine as the second dose for certain of the cohort, bearing in mind the principle of vaccinating the older cohorts first. I ask him to consider the possibility of using Pfizer as the second dose. He might come back to us on that.

I want to pick up on those points made about cohort 7, which is a real issue. There is much concern about it on the part of people who have very much limited their lives over the past year. There is a real issue here about people in cohort 7, and still with some in cohort 4, whose GPs have opted out of doing the vaccinations in their practices and are moving to the centres. They are only getting one day per month, however. It means there is a long wait for people to access that vaccine, which is not acceptable. Why is the Minister not using pharmacists at this point? It seems that this would be the ideal arrangement for cohort 4. Is the Minister doing anything about that?

I have posed the same question frequently myself. The answer is that between the GPs and the vaccination centres, there is more than enough capacity-----

-----for the volume we already have.

There is not if people have to wait a month.

There is, in terms of the capacity.

Unfortunately, we have run out of time. Perhaps the Minister will get a chance before the end of the session to come back on the issue.

I am happy to discuss it later with the Deputy.

The Minister might send me a note.

I have a number of questions. Will the Minister advise the House on how many over-70s who have registered for the vaccine have not, as yet, been reached? I have come across a number of those cases in my constituency. I would appreciate if the Minister could update the House on the reasons why those people have not been reached at this stage.

A number of weeks ago, I raised the issue of delivering the vaccine to housebound people. Could the Minister perhaps give a further update on that? I know that additional resources were being put on stream. I believe it is very important.

Can the Minister also give clarity with regard to the space between the first second dose? Is the ambition that the programme will remain at 12 weeks? Has he given consideration to that?

Finally, the Sinopharm vaccine is widely used in other parts of the world, including the United Arab Emirates, UAE, which has a large contingent of Irish people who live there. I understand the World Health Organization has recognised this vaccine now. Will the Minister update the House on our stance in Ireland? Do we recognise its use?

The programme for vaccination for those who are housebound began in March 2021. To date, there have been 3,900 referrals. The portal closed for referrals in mid-April. The National Ambulance Service is currently operating a seven-day service to ensure all individuals are vaccinated as quickly as possible.

To date, it has administered 2,700 dose one vaccines scenes and 1,400 dose two vaccines. There are currently 240 people awaiting their first dose. The programme continues and the National Ambulance Service is very busy going from house to house. I will point out an example of the logistics in this regard. The requirement for each vaccine is, at minimum, 30 minutes at each residence. In respect of 10% of cases, however, extra observation time is necessary due to medical reasons and visits can take up to an hour.

I will be very brief as I only have two questions. The temporary assistance payment scheme, TAPS, is supporting the nursing home sector. With the onset of Covid-19, TAPS has proven to be integral in supporting our nursing homes and providing effective infection prevention, which has enhanced the safety of nursing home residents. TAPS is due to expire on 30 June and nursing homes are waiting to hear if this support will be continued. Will the Minister please clarify the status of the payment or when he is likely to announce details regarding same?

My second question is about the vaccine itself. I am not a doctor or a clinician or anything like that so I have no experience in this regard. Are there specific conditions that would allow for a consultant to make the recommendation that a patient should receive a certain vaccine over another?

The temporary assistance payment scheme was facilitated for nursing homes all over Ireland since last year. Initially, finances were made available up to June and this was extended up to December. Some €93 million was made available last year and €41 million was made available this year.

It is a temporary assistance payment to support nursing homes and it will come to its natural end at the end of June this year.

With regard to whether clinicians have the latitude to recommend different vaccines for their patients, the short answer is "No". The allocation is based on the NIAC recommendations.

I will start on a positive note. We fought hard to get two vaccination centres in west Cork. There is one in the GAA grounds in Clonakilty and one in Bantry. The staff, volunteers and everybody involved are doing an incredible job. They have ramped up the vaccinations to five days a week in both Clonakilty and Bantry and they are now down to the cohort below the age group in their 50s, which is brilliant. I commend all the staff, the Department and the HSE on getting those centres up and running as effectively as they are.

My first question follows up on Deputy Carey's question on the Sinopharm vaccine. It has been recommended by the WHO as a safe vaccine. I understand the EU has also taken steps to approve its efficacy. A lot of people in the United Arab Emirates and Dubai who have been administered the Sinopharm vaccine are looking to come home but cannot because it is not on our approved list. I ask the Minister to come back to me quickly on that.

I presume the Deputy is referring to those people being exempted from mandatory hotel quarantine.

With regard to the exemption, the current policy is that it applies to the four EMA-approved vaccines. Sinopharm is currently under a rolling review by the EMA. The last time I checked, which was earlier this week, my understanding was that Sinopharm had not applied for authorisation from the EMA, although there may have been an update since. The Deputy makes a very fair point. For the digital green certificate, the European Commission is looking at a slightly wider group which would include Sinopharm. It is certainly something we can take under consideration but right now the policy position, which is that only the four EMA-approved vaccines are exempted, is unchanged.

I would like to follow up with the Minister of State on the question regarding TAPS. Many local nursing homes have contacted me about this issue. The TAPS was vital to them in keeping their staff safe but, most important, in keeping residents safe. They were able to invest in extra PPE and additional safety measures. The date of 30 June is too much of a cliff edge. All we are looking for is an extension beyond 30 June and a phasing out of the scheme. It is important for nursing homes in order to keep their residents and staff safe.

I agree that it is very important that we keep our residents in nursing homes safe. There are approximately 30,000 nursing home residents in the country. I am glad to have an opportunity to respond on this issue. This was always a temporary assistance payment to support nursing homes when they needed extra staff and preventative measures like infection prevention and control, IPC. This payment has been extended twice already. Over €133 million has been made available and significant money has been drawn down. To be clear, all the other supports for PPE, Covid teams on the ground and IPC will be retained. Full support from the HSE will be retained.

I am one of the many very lucky people who have received their first dose of the vaccine. On the day of my visit, the efficiency of the staff was outstanding and I would like to recognise that and thank them here in their Dáil. Maith sibh.

Last week, the WHO said that vaccines may be the light at the end of the tunnel but that it is important we do not get blinded by that light. It said that too many of us in Europe are not vaccinated and that caution is vital. We are all dying to see our families, get back to normal and reclaim some of our social lives but it is important that we stick to the public health advice and proceed with caution. It is important for our public health and for the economy in the long term. Most important, doing so respects the work our magnificent healthcare workers have put into this. They have been to hell and back to mind us.

I thank the Minister for his responses on vaccines for pregnant women. I am little concerned about his reply to Deputy Colm Burke but I might talk to him about that again.

I raise the plan to tackle vaccine hesitancy in younger people. Every time one of us gets the vaccine, every one of us is a little safer. I am concerned about vaccine hesitancy in young people. Almost one in ten people in the 25 to 34 age group will not take the vaccine, which is concerning. What are we doing about that?

The second issue I wish to raise is Community Call. A constituent of mine in his 60s has had to turn down the vaccine four times because Community Call was not available to drive him to the vaccination centre. It is an excellent volunteer service in the main but when he gets an appointment it is not able to bring him along to it. It is exasperating for this lovely man. I ask the Minister to examine that service and resource it. We need something like a click and collect service and it must be properly resourced. I also thank the volunteers. I am happy to arrange transport for this gentleman but if the Minister has any ideas, I ask his people to get in touch with my staff.

I thank the Deputy for her comments about everyone involved in the vaccine programme. It is not just our healthcare workers but so many others as well. I agree with her wholeheartedly. The programme is moving at pace. I am delighted to hear she got her first vaccine. I have registered for mine but have not been given a date yet. What I am hearing again and again is that it is running very efficiently on the ground and people are being taken care of, which we always want to see. I thank the Deputy for those comments.

With regard to Community Call, maybe this is a conversation we could have after the debate. We do not want people to be in a situation where they cannot get access so if we can help, we absolutely will.

Vaccine hesitancy is something we are constantly working on. There has been very little of it online compared with some other countries and that is because we have people who have been constantly calling out much of the false information that has been circulated. We are doing well by European and international standards but I fully take on board the Deputy's points that we need to keep engaging, particularly with younger populations. I have figures on the uptake for cohorts to date that I can share with the House. It has been very positive.

I welcome the Minister's statement. Every time he makes a statement on the roll-out of the vaccine it is positive and we have this terrible pandemic on the retreat. I got my vaccine yesterday. It was a great experience in Citywest. I was a little emotional about it because the last 15 months have been extremely difficult for a lot of people in this country. There is a huge collective effort to vaccinate people and I commend everybody involved in the programme. We are all so grateful for the roll-out of the vaccine and I hope it is a great success. Hopefully, in the next few months, the vast majority of people will have taken the vaccine if they want it.

I have a number of questions about things happening outside Ireland. A study done by the People's Vaccine Alliance showed that in the last 15 months, nine individuals have become billionaires because of the roll-out of the vaccine. Oxfam, which is a very respected NGO, also commented that pharmaceutical firms are creating a monopoly with the control of vaccines during the pandemic. Five of those individuals are from a company called Moderna. The vast majority of the moneys given to Moderna were public funds. It is sickening that companies and individuals are making huge amounts of money from this vaccine.

The combined wealth of those five individuals would vaccinate 800 million people. There is a disparity and inequality between the vaccine roll-outs throughout the world.

The Government recently gave allocations of money to the Covid-19 Vaccines Global Access programme, COVAX. Can that be reviewed to give substantially more money? If we have access to vaccines in future can we give them to the programme? Would the Government consider putting a special solidarity tax on the profits of some of the companies that have greatly benefited from the Covid vaccine and are based in Ireland?

I thank the Deputy for his ongoing advocacy for global justice and global fair distribution, with which I fully agree. There are various mechanisms by which Ireland can help. Ireland must help and we must do everything that we can. As was pointed out earlier, we have advance purchased a significant amount of vaccine doses, more than we would need. We can see with some of the supply issues why we and other European member states did so.

At the moment we are working on how we can be of as much use as possible. There are various ways we can do that. As the Deputy said, one is with cash. We are contributing, and have contributed, money via the EU to COVAX and the Gavi initiative. As the Deputy rightly pointed out, we can also contribute vaccine doses because we have advance purchased millions of doses of vaccines, which will still be there after we have fully vaccinated our entire population. As a Deputy pointed out earlier, we will take advice on whether we need to retain some of these for booster vaccinations and so forth, but we have also signed up to 2022 and 2023 beginning with an advance purchase agreement on Pfizer. It is our intention to broaden that basket out to different companies, supply chains and technology platforms.

We are in very positive discussions with the European Commission right now, literally this week and through into next week, on how Europe can contribute in a meaningful way to global vaccination. The preferred method is through Gavi. The Deputy will agree this is probably the best way, certainly one of the best ways, that Ireland and Europe can contribute to make sure there is an expert group with no political or state affiliations that can direct these vaccines to where they can be of most use.

I propose to use the time for questions and answers. I will deal with the unfolding situation in Limerick regarding Covid cases. I note the phenomenal work done on the roll-out at the Radisson vaccination centre. I welcome the shuttle bus running from the city centre will be transferred when the centre moves to Limerick Racecourse in Patrickswell.

We have seen a rise in Covid cases in Limerick. There have been nearly 260 cases in the last ten days, peaking at 59 cases on Tuesday. We have also seen the cyberattack. I welcome the new testing centres in St. Joseph's Hospital on Mulgrave Street and the Ballysimon Road, but I ask the Minister to update us on where we are with the numbers of Covid cases. Is the matter being brought under control? Where are we at regarding the number of tests and cases in intensive care units, ICU, in hospitals? Where does the Minister see that progressing in bringing it under control over the next number of days? In the context of the whole cyberattack, where does he see the situation developing in terms of getting back to normality with appointments for patients in all the hospitals in Limerick?

I thank the Deputy for his questions and his acknowledgement of the shuttle bus. The Deputy raised this issue. He and I discussed it with the Minister of State at the Department of Further and Higher Education, Research, Innovation and Science, Deputy Niall Collins, Deputy Willie O'Dea and various people. I committed to Deputy O'Donnell that we would do it if it could be done. I thank him for acknowledging that and I hope it is of use.

I am sure the Deputy had a smile on his face when he saw that the Limerick vaccination centre, which he pointed out was not in fact geographically in the county of Limerick, will now be there. I am sure the Deputy is much relieved that has happened.

I am sure it is a great relief. Regarding the cases, we had a serious situation. From the public health reports I received a combination of things were happening, including end-of-term parties, indoor family events and various other things. We also had reports of people who had been infected going into workplaces when they possibly did not need to be there and thereby becoming vectors of transmission. Essentially, what appears to have happened, and this is the public health view on the ground, is that a significant number of quite diverse indoor activities led to this, which are currently not provided for in the public health measures and, in other words, should not have happened. Public health is very active on the ground. I have spoken to Deputy O'Donnell, Minister of State, Deputy Niall Collins, and the other Deputies in the area. We are looking to see if pop-up PCR testing and other measures would be useful.

On a point of order, are the cases being brought under control?

There is not a point of order. We are in the middle of questions. There are two and a half minutes left for Deputy James O'Connor, which we are eating into.

I will get the Deputy the data.

On a point of order, Deputy Ó Cathasaigh is not here so can I perhaps use-----

There is not a point of order. The Deputy has two and half minutes. Deputy Ó Cathasaigh is sitting in front of us. The time is being used up and the Deputy now has less time.

It has to be stated in the House that the vaccination roll-out has been an enormous success in recent times. I am delighted to see the progress that has been made with the HSE and other partners that are working on it. I fully commend the officials working on the vaccination roll-out. I am very glad to see there are plans to ramp up weekly vaccinations to more than 400,000 per week in the very near future.

I will make a point to the Minister and the Ministers of State at the Department of Health, Deputies Anne Rabbitte and Mary Butler, who are with him today in the Chamber, around the vaccination bonuses that may come in the next number of weeks. The Cabinet will meet later in the week to make many important decisions on how we move into the next phase, perhaps the final phase before a full reopening of society, to get back to some degree of the normality we enjoyed up until the start of 2020.

I encourage Government to be very proactive in how they will implement such measures. As we know, in June we will definitely reach the tipping point in the level of the population that will be inoculated against the Covid-19 virus after receiving their first jab, which is very exciting and I am delighted to be able to say it. It is expected that more than 80% of the Irish adult population will have received their first dose by the end of June, which will make a remarkable difference to the level of hospitalisations and to those who have developed severe illnesses from Covid-19. It will, hopefully, help to reduce drastically the level of transmission as well.

I have a very simple question for the Minister about the vaccination bonus. Does he plan at any stage over the next month or two to alter that, when we arrive at a situation where we have met the targets that have been supplied, which is in excess of 80% being vaccinated?

I will have to make myself more evident to Deputy O'Connor in future. I praise the success of the vaccine roll-out. The figure of 50% by the end of the week is very exciting. There were people who said that the Irish system was not going to be able to roll it out in this time. It is right to praise everybody working within that system, including Department officials, HSE staff, GPs, doctors and vaccination centre staff.

That is an exciting number. A total of 300,000 vaccines going into people's arms last week is fantastic news.

I wish to address two specific issues. The Minister of State, Deputy Butler, will be familiar with one of them, particularly as it relates to west Waterford. People in Tallow and Ballyduff are being referred to a vaccination centre in Killarney. I believe this has to do with the postcode system. There is an irony in people being made to travel across two counties in view of the fact that we only just recently removed the restriction on inter-county travel. The second issue relates to Ferrybank, which is in Kilkenny but which is within 5 km of the vaccination centre at the Waterford Institute of Technology Arena. There is an irony, as well, in people having to travel that far to be vaccinated.

On a more general point, there is inconsistency with the speed of roll-out in the context of GP services. Many of the larger practices get access the vaccines first. It is great that people are getting the vaccines, but it creates a bit of ill feeling when people feel somebody is getting ahead of them in the queue.

On global vaccine equity, I do not agree with the Minister that Gavi and COVAX, as currently formulated, go far enough. I do not think a trade-related intellectual property rights, TRIPS, waiver is necessarily a silver bullet but we need to be part of a conversation about intellectual property and accelerating vaccine roll-out in the global south. I do not accept the 20% figure for global vaccinations. I do not think it will work for anybody. I will leave it at that to allow time for answers.

There are only 20 seconds left.

The Deputy is quite right. Over the weekend, it became obvious that people in the likes of Tallow, Ballyduff and Aglish in west Waterford were being asked to go to Killarney for their vaccine and that those living in the Ferrybank area were being asked to go to Kilkenny. I made inquiries immediately. This was a postcode error. I advise that those who received their first dose in Killarney over the weekend will receive their second dose at Waterford Institute of Technology. Those in Ferrybank and those who declined will also be facilitated in Waterford.

The way I am doing this might be most unsuitable, but that is the time limit and we will now be in trouble with questions. I am sorry but maybe Deputies can take it back to the Business Committee.

A lady contacted me who is in desperate need of gastric sleeve surgery. She saved for four years for the surgery in Turkey. She forwarded to me a letter from her surgeon which states that this surgery is time-sensitive and necessary. I contacted the Department of Health and was informed that only a liaison officer can tell her, when she returns to Dublin Airport, whether she is exempt from hotel quarantine. She cannot afford the cost or time involved with quarantining for two weeks in a hotel on her return. She desperately needs this surgery. Will the Minister establish a pre-clearance system so people who travel for medical reasons will know in advance if they have to hotel quarantine? It is a reasonable request.

Cork University Maternity Hospital currently only vaccinates pregnant women who are over 30 weeks, far behind what other maternity hospitals in the State are doing. Why is there a delay? Will the Minister commit to contacting the hospital and supporting it in fast-tracking vaccinations for pregnant women?

For the past month, I have been contacting the Minister’s office, the HSE and others to find out on behalf of a snooker hall whether it can open for business. The owners do not when they are due to reopen. They do not know if they fall under gyms or indoor hospitality. There are other businesses out there who are confused, want to follow the guidelines and adhere to restrictions but we need a dedicated phone line for businesses to ask these questions and get clarity. Where does this snooker hall, and others like it, fall? Will the Minister establish a dedicated phone line to support the business community?

If the Deputy will send me the details of the lady in question, we will have the matter looked at. There are numerous ongoing cases of people travelling. We have a clear regulation in place which sets out the criteria for medical exemption. As the Deputy said, those criteria include it being time-sensitive and verification from a treating clinician. If the Deputy contacts me, I will point him to exactly the criteria. If there are issues with a particular case, he can talk to me.

On Cork University Maternity Hospital, we discussed it earlier and another Deputy referenced that there is a six- to eight-week period from referral to vaccination. I ask the Deputy to bear with us and with the HSE. The system this and last week has been under extraordinary pressure because of the IT systems. Infant and maternity care was one of the areas particularly badly affected. We are doing everything we can to ensure there is as quick a roll-out to pregnant women within the stipulated age bands from NIAC as possible.

On the snooker hall, it is a great question. I suggest is probably does not qualify as a gym, unless the Deputy plays some type of snooker I am not familiar with. It is a fair question and I will make sure it is dealt with in Cabinet discussions on the next phase of opening. I thank the Deputy for raising it.

I reiterate what many other speakers have said on the Covid vaccine roll-out. It has been a prime example of how, working together, we can get things done right. The feel-good factor around the country from everybody who has been vaccinated is palpable. It is important we continue that.

My first question was alluded to earlier. It relates to nursing homes and TAPS. I broached the question yesterday with the Taoiseach but the most important thing is that, when Covid arrived first, nursing homes were not prioritised. They have been prioritised since that. TAPS is very important. It helps them make sure that they can run their facilities in the safest way possible. There is a review being carried out and, until that review is complete, its findings published and the resources put in place, it is important that we continue to provide TAPS to nursing homes and not have a cliff-edge situation.

My second question relates to AstraZeneca and the 12-week gap between doses. Will the Government consider reducing the 12-week waiting time as, hopefully, the vaccination becomes more plentiful and more people are vaccinated? This is so we can reduce the time for people, especially in the context of AstraZeneca, in light of the spread of the Indian variant.

As a regional Deputy, the third issue I wish to raise relates to aviation. It has been discussed this week that the aviation industry is in crisis. We have had pilots from Aer Lingus protesting peacefully outside the gates of Leinster House. I ask the Government to look at being first in class in allowing people from North America, including Canada, enter this country once they have had their two vaccinations. This is important for the aviation industry, for the economy as a whole and for the regions, tourism and hospitality. If we can be first in class in announcing we will bring these people in, we will get a huge share of the people who will be travelling from America. Other regions such as Asia are looking at doing this but if Ireland could do it first, then people in America thinking about taking a trip would come to us and would reignite some of the businesses that are in trouble at the moment. I await the responses on those matters.

TAPS for nursing homes was introduced last year as a temporary support to nursing homes during the most awful time. They needed all these supports, so the supports were put in place. The temporary assistance payment has been extended twice already and is due to cease at the end of June. My understanding is that the financial payments will cease at that time. However, all other supports will remain, such as the supply of PPE and of infection prevention and control measure supports in respect of the 23 Covid teams on the ground. It is important to recognise the situation we are now in regarding nursing homes. Almost 99% of residents and in excess of 90% of staff in nursing homes have been vaccinated. Thankfully, the numbers who have Covid in nursing homes is at an all-time low. There was only one outbreak reported last week.

I remember saying in this Chamber that there were outbreaks in 195 nursing homes. We hope to hold a residual amount of money as a small buffer, so that if, for example, a nursing home was to have a significant outbreak of Covid, it would be able to apply for financial supports. TAPS, as we know it, will come to a natural conclusion at the end of June, having already been extended twice.

I thank Deputy Canney for his questions on the various issues. The short answer on the AstraZeneca vaccine is that there is no plan to shorten the interval below 12 weeks. The interval was extended from 12 weeks to 16 weeks for a significant number of people and is now being brought back to 12 weeks. All of the doses we have and all those that are coming are fully committed for second doses, so the 12-week interval is deemed to be the right one.

Regarding aviation, the Government is well aware of the enormous burden this pandemic has placed on the aviation industry. As the Deputy pointed out, other industries such as tourism are heavily reliant on aviation. The Taoiseach and the Minister for Transport, Deputy Eamon Ryan, have had numerous meetings with the industry this week. There is very close engagement at the moment.

With regard to the fully vaccinated, the current position for fully vaccinated individuals coming in from the US who have received one of the four EMA-approved vaccines, which is most likely to be the case, is that they are currently exempt from mandatory hotel quarantine. They still need to self-isolate but that can be lifted after a PCR test on day 5. However, in further progress, it is highly likely that the US will be one of the partner countries for the digital green certificate. We are looking to bring the digital green certificate in as quickly as possible. That will mean that anyone who is fully vaccinated with one of the vaccines listed by the Commission will be able to travel unimpeded, which will deal directly with the issue the Deputy raises.

In the remaining time I wish to go back to the TAPS issue. I am concerned that if we have a cliff edge scenario, bearing in mind what we have been through, and what the Minister of State described, nursing homes will be in an at-risk situation again. We have to be very careful about that. Given the work the nursing homes have done, we need to support them because they will doing a lot more work on safety measures going forward.

I welcome the Minister's comments on US travel. I hope we will be first to invite the Americans to Ireland and to get the green aeroplanes back into Shannon Airport and the regional airports as well.

I also welcome the Ministers today. It is great that we can welcome the vaccination roll-out because it is very positive. The reopening from 2 June of accommodation services such as hotels, bed and breakfast accommodation, self-catering and hostels is very important. Many pub owners in counties Carlow and Kilkenny have contacted me. I ask the Minister to look at this issue again. It is important that we are doing so well.

My understanding is that some maternity hospitals are allowing partners to accompany expectant mothers. Will the Minister provide an update in that regard?

I wish to raise a concern relating to my area. In Carlow and Kilkenny we have two excellent vaccination centres, in IT Carlow and in Cillín Hill in Kilkenny. Many people from Carlow are now going to Kilkenny for their vaccination. I compliment everyone on the excellent service being provided. I was delighted to get my vaccination last week in Kilkenny, but I am lucky as I have a car. One of the biggest issues raised with me in recent weeks has been that of people who have no transport. I was in contact with the HSE about this. There was no number for people to ring to say they had no transport or ask if they could go to Carlow instead of Kilkenny. I was trying to get some information for people, but was unable to do so. Will the Minister put something in place for people who do not have transport? It is important that people who are unable to go to Kilkenny are able to get vaccinated in their home town of Carlow. As the Minister of State, Deputy Butler, outlined, there has been confusion about Eircodes. I understand from the HSE that different age cohorts such as those aged between 60 and 70 years or those aged between 50 and 60 years have to be done at the same time. That is why Carlow people had to go to Kilkenny. That is good, but I urge the Minister to address transport as it has become an issue.

I welcome the fact that McCauley pharmacies are supporting the vaccination roll-out. The company announced that vaccinations will be given in six of its pharmacies, including in Carlow. I am delighted with that. The pharmacies will be able to vaccinate up to 200 people daily, which is very good news. The Minister spoke about pharmacies. It is great news for me and for people in all of the other centres where vaccines are being administered. I compliment McCauley pharmacies on doing this. It is great that Carlow will be one of its vaccination centres.

On rapid testing, it is important that we consider the use of antigen tests. I have received several queries about the TAPS payment and I urge the Minister of State to examine the issue. I know she said the scheme will come to a halt at the end of June, but I urge her to consider an appeal mechanism in the review as that would be important for nursing homes that may need support.

I am extremely conscious of the tremendous progress that we have made in the vaccination programme in recent weeks. It is hugely positive that we have gone ten days without a Covid-related death. I thank the three Ministers here today, as I know they have invested a huge amount of time, energy and passion in this. I commend their efforts and those of their Departments.

I look forward to what I hope will be a positive update from An Taoiseach tomorrow. It is vital that we see a meaningful pathway forward for aviation, tourism, hospitality, sport and the arts. We all agree it has been a terribly difficult 14 months for the country. Businesses have struggled and, sadly, many will not reopen. As tired as we all are of regulations and restrictions, there is still an onus on us to put public health first.

Notwithstanding the successes of the vaccination programme, we are still tracking the UK and Northern Ireland by six weeks. At this stage, businesses and communities desperately need clarity and certainty so that they can plan their recovery. I am hopeful that the Taoiseach will deliver on the need for certainty and clarity tomorrow.

Yesterday's Fáilte Ireland guidelines for the hospitality sector were confusing and, in some respects, divisive. There is a short window for the sector to recover and we must give rural communities in particular every chance to recover. We again seem to be differentiating between hotels, pubs and restaurants, seeking to impose poorly thought-out time limits and also limits on the number of people allowed on the premises. We are probably two to three months away from finally getting to grips with Covid. At this stage we should be energising, mobilising and enthusing businesses and communities but yesterday's Fáilte Ireland guidelines have left them deflated and frustrated. I believe the public health requirements must come first, but I appeal to An Taoiseach and Government colleagues to provide a clear path and, where necessary, the supports that key sectors will need to restart and recover.

All is not well in County Louth. I know people from other counties are praising the Minister but there is a serious problem in County Louth. More than 7,000 people have not received their vaccination appointments at the appropriate time. The HSE is dealing with the matter. What will happen on Monday and Tuesday is that 7,000 people from County Louth will have to go to The Helix in Dublin to get their vaccination. I welcome that because they will get the Janssen vaccination, which is a one-shot vaccine, and within 14 days of getting it they should be fine and should not need a further vaccination.

The big issue is why it happened and what the Minister is going to go about it. Will he give the HSE the support it needs to increase the vaccination roll-out in Drogheda in particular? The Drogheda Institute of Further Education, DIFE, is a vaccination centre that currently operates only three days per week. Will the Minister increase the number of vaccinators and staff to ensure the centre can operate on six or seven days a week, which is what is needed? The key point is how the Minister can ensure that this issue will not arise again with other age cohorts.

It is unbelievable. It is not just the 7,000 in Louth but 4,000 people in County Meath have not got their vaccination appointments, and they will also be travelling outside the county to other locations, such as Mullingar, Athlone and Citywest in Dublin. Will the Minister give the commitment that people want? My office is inundated with complaints from angry constituents who are very upset that this is happening. The final insult to one person from Drogheda was yesterday, when he rang up the hotline to ask where his vaccination appointment was, only to be told, “You missed it yesterday. You failed to turn up down in Wexford, where it was there for you in a hotel.” That is unacceptable.

I thank the Deputy. It is a pity to hear his anger and frustration in what is a very positive roll-out across the country. He and I have discussed in the Chamber on several occasions the need for a vaccination centre in Drogheda. That has been delivered and it opened last week, as the Deputy will be aware. On the Deputy’s question on whether we need to open it for longer, if that is required, we absolutely can. I have raised the issues directly with those running the programme. If more needs to be done in Meath and Louth, where there was not the same volume as in some other areas, it will be done. A lot has been done now and I expect to see that issue largely resolved. I will stay in close contact with the Deputy. If additional resources are required, he can rest assured they will be provided.

I intend to use my time for questions and answers. Elderly people in my constituency of Cork South-West, especially the housebound, are concerned. I have always known that the ambulance service is flat out to the mat in the normal daily work it has to do, and it is the ambulance service that must administer vaccinations to the housebound. Has the Government looked at another mechanism for doing this? Many housebound people in my constituency are still unable to get it because the ambulance service is under too much pressure. That is the first question.

My next question concerns those aged over 60 who have been vaccinated with the AstraZeneca vaccine. Many people have contacted my office and my staff. Some of them had the first vaccine, which it is said is about 30% resistant to the Indian variant, and they are waiting 12 weeks for the second vaccine, which will make it 60% resistant. First, could Pfizer be used for these people over 60, or perhaps Johnson & Johnson, which has a bigger resistance, we have been told? Second, can the waiting time of 12 weeks be cut back? People are very frustrated and concerned that they are waiting a huge amount of time - three months or more?

I have previously raised the issue of Parkinson's patients in the House with the Ministers. Is there any movement with regard to these Parkinson's patients? I will allow the Ministers to reply.

On the Deputy's question with regard to the housebound, there were 3,900 referrals in total from GPs. To date, fewer than 10% are left to be concluded. There are 240 people awaiting their first dose, 2,700 have got one vaccine and another 1,400 have got both vaccines. If the Deputy knows of specific cases and he wants to contact me, I will happily look at them for him.

I am delighted to have the opportunity to ask some questions. Why will we not accept antigen testing here, when Europe has acknowledged it and it is acceptable everywhere else? I know of a family - a mother, a father, four children and grandchildren – who, the night before last, travelled home to see their dad, who is dying and is in palliative care. They were turned back at the port because they had the NHS test, not the PCR. Where is the humanity in turning them back? They had to travel back again, whenever they got the next ferry, and they will try to come here again when they get antigen tests, despite the associated costs. Why will we not accept the antigen test or the NHS test? They seem to be doing an awful lot better with the vaccinations and everything else than we are. That is the first question.

Ceist eile concerns St. Brigid's Hospital in Carrick-on-Suir. The Minister refused to answer on this but I will keep raising it because it is my duty for the people there, as well as the people of east and west Waterford. I refer to having that hospital returned to the status of a district hospital, with four palliative care beds and excellent staff and teams working there. Although there is fundraising and buy-in from the community, the Government closed it in the middle of a pandemic after the Minister, Deputy Stephen Donnelly, had assured Councillor Kieran Bourke, in the presence of Deputy Cahill, that it would return after the pandemic. They have rolled out all the excuses in the world about HIQA. It was a fly-by-night job, a trick-of-the-loop job just to cod the people by talking about a diabetic centre.

With regard to maternity hospitals, I want to acknowledge South Tipperary General Hospital maternity services. All of my eight children were born there, as were my eight grandchildren, and one, hopefully, in the next couple of days, making number nine. There are excellent staff and excellent antenatal and prenatal services, and we have been through all of those areas. Why is there management blockage in different hospitals so they will not allow partners, husbands, dads or siblings to go in with an expectant mother to get good news, although it can be bad news sometimes? I have written a number of times to the manager of the hospital, who told me they will examine it, and referred to the statement made by the Minister and the Department that they were easing the restrictions, but there is still no movement.

I cannot get any reply since the cyberattack - nothing at all. Even before the cyberattack, I had never got an answer from the Minister to aon ceist amháin. I will keep asking here and I will be raising it at the Business Committee again today, and the Chief Whip and the Ceann Comhairle have tried. I have never had a written answer from the Minister about anything. I have used my limited time to ask questions and I expect to get an answer. The Minister has plenty of officials with him to take the questions and answers so I can get an answer. Never in the last 12 months have I got an answer on any question I have put to the Minister here on the floor of the House. That is an insult and disrespect to the electorate in Tipperary, who, for the time being, have elected me and asked me to do a job for them. I do my best to ask the questions and we are entitled to get answers. It is an abdication of the Minister's responsibility.

The time is expired. I ask the Minister to reply in writing to the questions posed.

I thank the Ministers for their speeches today and for their work. In the short time available, I want to ask several questions and I do not know if the Ministers will have time to answer me. On a question to the Minister of State, Deputy Butler, I want to raise the issue of day centres. There will be an announcement tomorrow but respite has never resumed in Galway. It is painful to walk home at night and watch people of all ages out and enjoying themselves, with no social distancing, yet no respite centres are open in Galway. It is simply not acceptable.

Yesterday, I spoke on the draconian legislation that we are going to put through the Dáil once again, which is not evidence-based, yet we are clapping ourselves on the back for the vaccination programme. I pay tribute to the staff on the ground in the various venues but we need a full discussion at some point as to what we are doing in regard to public health vaccinations, what they are costing, the indemnity that we have given, and the pre-purchase and what it is costing. There needs to be a full discussion on that. We have completely ignored intellectual property rights. As was said by Deputy Gino Kenny, we are pushing ahead with making more billionaires on a trapped audience, and giving them an indemnity, but there is no parallel compensation system for those who might suffer.

The clock was not switched on so it is difficult for me to know what speaking time I have. As I have said before, it is not the Minister's fault that we are having a segmented discussion but we need an overall discussion in regard to what we are doing in public health. Vaccination is part of that but only part of it, so we need a proper and full discussion on all aspects in order to give us confidence.

With regard to the roll-out, I ask the Minister to come back at some stage and clarify that those in the 60-to-69 age group who, for various reasons, cannot take AstraZeneca, are not to be punished. That message is going out repeatedly. I think the Minister said today that there is no choice, although maybe I am wrong on that. Of course, there has to be a choice. Of course, there has to be a discussion between a doctor and the patient. The Minister cannot interfere with that. Sending out a message that people go to the bottom of the list and wait there is not good enough.

I am in a little trouble because I am not sure what speaking time I have.

The Deputy would be safe enough to conclude.

I will stick with the five things I was going to ask. The question on day centres and respite has been asked. In regard to Connemara, I reiterate what was said and I will not repeat it, but arrangements should be made and they cannot possibly travel into town and across town. I am not sure where pharmacists are at. I am not sure why we made an agreement with the pharmacists but have not used them.

That is another reason for the lack of trust.

Finally, I am not sure if the situation in Galway has been brought to the Minister's attention but I understand that staff have been told to go home due to the cyberattack and there being no work. It is in the hands of the unions. It is unbelievable that staff would be told to go home and take holidays in the middle of a crisis when they could be used to do so many jobs including looking at the files that are in the basement and in private storage, which are not available in digital form because of the attack.

I will ask some very quick questions if I could get "Yes" or "No" answers, it would be appreciated, as then we could have a chance of getting them done and dusted. Will all vulnerable people in cohort 7 in all counties be vaccinated by the end of June?

It would be impossible to say if everybody in cohort 7 will be done but certainly as many as possible will be done by the end of June.

Will all housebound people in rural areas be vaccinated by then too?

The short answer is "Yes", but there is one caveat. New people are being notified to us all the time. If new people are notified, we will get to them as quickly as possible. The answer is "Yes" for those known to us now.

Does the Minister receive update reports on the vaccine roll-out per county?

Is he concerned about the progress of the roll-out in any county in particular?

Yes, I am. There have been various issues raised regarding Meath and Louth, for example. We have responded to those. If there are any localised issues we are made aware of, we will do everything we can to respond. We want as even a roll-out as possible.

Will all SNAs and ancillary school staff be fully vaccinated before September so that schools can restart safely?

Yes, they will. Any of them who want a vaccine should be fully inoculated by the end of September.