Covid-19 Vaccination Programme: Statements

I welcome the Minister of State to the House and thank her for taking the time out of her busy schedule to address us on this important issue.

I thank the Cathaoirleach. I am representing the Minister for Health, Deputy Stephen Donnelly.

The World Health Organization declared the prevalence of Covid-19 to be a public health emergency of international concern on 30 January 2020. Although we are now nearly a year on from that, I know that for many it now feels that it has been a lifetime. Since that day we have found ourselves living very different lives from those we would previously have expected or hoped for. We now find ourselves living what would once have seemed a surreal existence where the things we took for granted are the things that put our loved ones at risk.

However, throughout all of this we have found the best of ourselves and dogged determination, and we have worked tirelessly to care for and protect the lives of others. Public and private sectors have collaborated and innovated with a view to finding ways to save lives.

In the space of that year, we now have vaccines that are safe and effective. Two have already been approved for use in Europe and more vaccines are on the way. As a consequences, there is hope that we may be seeing the beginning of the end of this pandemic.

Acting on behalf of member states, the European Commission has negotiated six advance purchase agreements with a range of vaccine suppliers to date. The EU emergency support instrument has been leveraged to provide upfront funding to facilitate negotiations, secure production and lower costs to member states. The vaccines that have been approved are produced by Pfizer BioNTech and Moderna. They have been reviewed by the European Medicines Agency which has provided significant assurance that they are safe and effective. These vaccines are currently being administered as part of Ireland's vaccination programme. A third vaccine supplier, AstraZeneca, recently submitted its application for approval to the European Medicines Agency and may receive approval from the Commission as early as this coming Friday.

Issues have arisen, however, with regard to the vaccine supply. Reduction in the quantity of the Pfizer BioNTech vaccine supplied across the EU for one week has proved challenging. These reductions in supply were required to allow the company to make necessary changes to expand its production. Pfizer BioNTech has provided assurances that this reduction will be resolved speedily.

Of more significant concern is the recent indication that AstraZeneca will not be available to meet its initial delivery commitments once it has received market authorisation. It is estimated that the deliveries in February will be at the lower end of what was anticipated and there will be further significant impact in March. The Department of Health is monitoring this changing situation and is continually engaging with the Commission and the company. I and the Minister, Deputy Stephen Donnelly, are very concerned that this supply issue was only communicated to the member states just a week before the scheduled authorisation was to be given for the vaccine.

Subject to the regulatory approval and delivery of vaccines, the vaccination of the third group in the Government's vaccination allocation strategy, the over-70s, will start next month. It will begin with the older of those, aged 85 and other, followed by those aged between 80 and 84, before progressing to those aged 75 to 79 and 70 to 74. It is planned that those vaccines will be administered by GPs in their surgeries and the HSE is preparing a public information campaign and will ensure that everyone knows in advance when, where and how to access their vaccine.

As of 24 January, 143,000 doses of vaccine have been administered to healthcare workers and residents in long-term care facilities. Importantly, the HSE began administration of the second dose of the vaccine last week. These will be the first cohort of persons to be fully vaccinated under the programme and the progress shown is a credit to all involved. I extend many thanks to the HSE and its staff for the hard work and dedication they have shown.

Plans are being progressed to ensure vaccines can be delivered at a pace as delivery volumes increase significantly over the coming weeks. This scale-up is being progressed through partnership with GPs and pharmacists and, ultimately, delivered through mass vaccination centres. To facilitate the roll-out of this programme, I am pleased to note that the mass vaccination of 1,800 GPs recently took place in three locations across Galway, Dublin and Laois. In addition, planning is ongoing to mobilise further mass vaccination centres soon to meet the expected increase in supply. Some adjustments to the original target doses being administered by March may be necessary to take into account AstraZeneca's recent announcement. It is important that everybody is aware how dynamic the situation is with regard to the supply chains and that Ireland has to employ an agile plan to react to such changes. The Minister for Health previously stated that he expected all adult residents to be vaccinated by September and that remains our target. However, as the Minister stressed, that is contingent on existing commitments on the approval, supply and delivery of vaccines.

There are important caveats that have sometimes been missed in the national discourse. We want to give people as much clarity as we can but we must be honest about the many variables and challenges with which we are grappling. It is important to note that more research on the vaccination of children is needed. This research is ongoing. The Pfizer-BioNTech vaccine has been approved for those over the age of 16 while Moderna has been approved for those over 18 years of age. As stated, under the Government's allocation strategy, children will be vaccinated if the evidence demonstrates safety and efficiency. This is standard practice. The Government will continue to monitor and adapt its plans as data emerge.

A key challenge to be addressed as the vaccine roll-out accelerates is the presence of Covid-19 in an increasing number of care facilities. This will require follow-up vaccination visits after the initial roll-out phase. Such visits are planned to take place at the earliest opportunity.

While everyone will be entitled to vaccination under the programme, it is not possible to vaccinate everyone simultaneously. The Covid-19 vaccine allocation strategy sets out a provisional list of groups for vaccination. This was endorsed by NPHET and approved by the Government on 8 December 2020. This strategy was developed by the national immunisation advisory committee and the Department of Health. Given that limited amounts of vaccine will be available initially, it will take some time for all to receive vaccines. This necessitates an allocation strategy to ensure that those most at risk of death or serious illness receive the vaccine first. To date, more than 4,800 HSE staff have received training and now work as vaccinators. The timing of vaccination will be subject to vaccine supply, logistics and the characteristics of each vaccine. The priority is to vaccinate and protect the most vulnerable among us first, and to use vaccines directly to save lives, reduce serious illness and protect our healthcare workers.

The roll-out of the largest vaccination programme ever seen in Ireland gives rise to a set of complex and difficult challenges, some of which have yet to be resolved. The promise of a return to some sort of normality which the vaccines represent gives rise to public expectation that cannot be met in the short term. The existence and roll-out of the programme, however, undoubtedly represents a good news story. In the space of less than a year, we have also seen the benefits of unprecedented collaboration between the public and the private spheres, between the initial spur of invention and the channelling of investment to foster it. The end result is that we now have vaccines, which are currently being administered. They will continue to be administered for free and will be available to all.

I welcome the Minister of State, Deputy Rabbitte, to the Chamber. I thank her very much for her informative address. I am very glad to hear that there will shortly be a public information campaign on the schedule for the roll-out of vaccination because my office is getting a lot of queries from people who are concerned about how to get the vaccination. They wonder where they should go, whether they have to register and what they should do. It is therefore great that there will be a campaign. Will the Minister of State speak to those in her Department to ensure this information will also be available in Irish? A lot of the regulations and public health information so far have only been provided in the English language while the information that has been provided in Irish is incorrect and completely insufficient. I want to see a very comprehensive campaign in Irish rolled out at the exact same time as the campaign in English. Irish is the first language of our country and it is only right and proper that people's language rights are respected in that regard.

I understand that the vaccination schedule is a moveable feast because the Government is not fully aware of the supplies that will be available but people need to be given as much certainty as possible. I know that the Minister of State will endeavour to give that certainty.

The Minister of State referred to the independently devised vaccination strategy which was approved by NPHET and then by the Government. While the strategy is outside of the political sphere and it is not open to people to lobby to change it, priority should really be given to people in category 9, that is to say, people aged 18 to 65 who are living or working in overcrowded settings.

My colleague, Senator Flynn, spoke this morning about the difficulties facing the Traveller community right across Ireland at the moment. Priority should be given to these vulnerable communities, who are living in dire conditions without electricity or running water and who already suffer from health inequalities. Extra support should be granted to them. I am sure Senator Flynn will talk about that but I just wanted to relay my support and that of the Fianna Fáil group on that issue. Senator Flynn spoke about isolation facilities that should be made available for people who are doing their absolute utmost to stay safe and stay away from this deadly virus. In countries such as Canada, communities like the First Nations peoples were prioritised and similar prioritisation should be given here.

The Minister of State is doing an awful lot of work around the clock in the Department of Health. It is perhaps the busiest Department and the busiest period it has ever had. We completely support what is being done with the vaccine roll-out; it just needs to be clearly communicated. I wish the Minister of State the best of luck over the coming months.

I thank the Minister of State for coming to the House today to represent the Minister for Health at this important debate. The HSE is being overstretched in the responsibilities that have been placed on it by the Government. It is responsible for the general healthcare of the public as well as testing and tracing and now it is responsible for the roll-out of the vaccine. There should be a single person reporting directly to the Taoiseach who is responsible for the roll-out of the vaccine and that person should have the Taoiseach's authority to cut through any red tape or any blockages that may be in the system in order to get the vaccine out as fast as possible.

With respect to the vaccine, why is the Government not giving the numbers? Every evening on RTÉ we get the bad news at 6 o'clock. It has become a feature in all the households with which I am engaged that at 6 o'clock every evening they wonder what the numbers will be that evening. Would it not be great to hear that we rolled out 1,000 vaccines today, or that we had 1,000 infections but rolled out 2,000 vaccines? Would that not be an important PR message to get out there for the Government? More important, it would give hope to the people who are depending on these vaccines. Once the vaccines were approved, a sort of euphoria ran through society and people thought it was great because there was a vaccine on the way and they were covered. They thought it was great stuff and that we would all be able to get back to normal. That was until they looked at the ready reckoner that was put on the Internet some time ago. I looked at it and if someone is 40 years of age and healthy, he or she is not likely to be vaccinated until some time between November 2021 and May 2022. We need to make people aware that this is a slow and extremely arduous programme to roll out. Not only that, we must make them aware that the manufacturers themselves can run into problems as it goes along. The Government has to be honest with people and say that AstraZeneca or others may run into production difficulties and if they do, it is going to set back our programme. People need to be aware of that and comfortable with it.

I cannot for the life of me understand why we are not rolling out antigen testing. It is being rolled out in every school in Austria and in other European countries. For some reason, we seem to have a mental block when it comes to antigen testing, which would give a test result in 30 minutes. It would put us in a situation where we could open our schools, retail and restaurants by testing staff at the point of entry every morning. I am no medic but from the little knowledge I have, I understand that an antigen test will give a result within 30 minutes and that it is particularly good where there is a heavy infection. There have been some moves recently to do that.

We had a discussion this morning about the leaving certificate, which should be postponed.

It should be scrapped this year. We should either set the year back or put ourselves in a situation where we will deal with the same system as we had in 2020. This is a matter that is of concern to me.

We have a two-stage roll-out of the vaccine on the island of Ireland. Northern Ireland is being rolled out in one particular way and the Republic is being rolled out in a different way.

The issue of quarantine has come up. I heard the Minister for Justice saying on Sunday that we are not going to control the Border and that she did not intend to discuss it any further. We controlled the Border for foot and mouth disease in 2001 to protect sheep and cattle. We cannot cull humans so surely to God we should control the Border. The problem with controlling the Border is that countless Governments have disinvested in the Defence Forces and in the Garda presence on the Border, with the result that we would have great difficulty in doing it, but we should do it in co-operation with the PSNI in Northern Ireland, where people crossing from this side over would also be stopped. If we cannot get agreement with the Northern Executive on an exactly similar system, a facsimile of both sides, we must seal the Border and allow our vaccination programme to go ahead independent of what is going on elsewhere in the world. I ask the Minister of State - it may be unfair to do so - to set out precisely what has been discussed that is stopping the control of the Border.

On the original plan for the roll-out of the vaccine, nobody would deny those who are in long-term care facilities and who are 65 years of age or over from having the vaccine. I would like to know how far we are with that process and how many nursing homes are left in the country that need to have the vaccine. I have no difficulty with that at all.

The title of front-line healthcare workers is a title which is fraught with all sorts of argument. Who is on the front line? I had surgery two weeks ago in hospital and I have to say that the staff and front-line people who looked after me were marvellous. I was tested on the way in, while I was in there, and on the way out. It was fantastic. Everyone will agree that people working in medical institutions should be administered the vaccine. We want to open schools, however. I do not want to be told today that children do not transmit the Covid-19 infection or that they are not susceptible to it. My three-year-old granddaughter tested positive for Covid-19 and locked us all up for a fortnight. If she can test positive, at just three years of age, any child can. From that point of view, we should be looking after our teachers. They are as important a part of front-line work in this country as the hospitals are if we want to get our children back into the schools.

The same point applies to the Defence Forces and the Garda Síochána. I compliment the Garda. Every day over the weekend where I live close to the Dublin Mountains there were Garda checkpoints all over the place turning people back. These personnel were doing the job that they are being asked to do by the Government. They should have been vaccinated by now in order to protect them.

The policy in respect of 65- to 69-year-olds with medical conditions is seriously flawed. I am also thinking of the children over 16 years of age with cystic fibrosis or who have suffered with cancer and whose immune system is seriously threatened. Why have we not included them in one of the top levels of the roll-out so that they would be protected from the earliest possible date?

When we talk about key workers, for me - and I do not know how my colleagues feel about this - the key worker is the young lady or man who is sitting at the cash register in Dunnes Stores and the bus driver who is met every day by the few people who have to travel to work. I have tremendous respect for Professor MacCraith but at the end of the day we have to go back to look at who the real key workers are.

There are many other things I would like to say. Where the vaccine is concerned, I ask the anti-vaxxers is to get off my back. I do not want to hear from them.

If I need to, I will have my vaccine given to me out on the plinth in full public view. These clowns are causing serious problems, particularly for elderly people who are wondering whether they are right and whether there is something wrong with the vaccines.

I congratulate the Minister of State on the good job the Government is doing, but we need to ramp up PR in this regard.

I welcome the Minister of State to the House on this important issue. I agree with my colleague, Senator Clifford-Lee, about the Irish language. To add to that, the information should also be available in Braille so that the blind community has full access to it. I do not doubt that the Minister of State will send this message to the officials to ensure that happens.

There have been many discussions on vaccines down the years. It is correct to say that, in this country, many lives have been saved by vaccines. Outside of clean water, a vaccine is the single best medical intervention we can make to keep our population safe and healthy. The Covid-19 vaccine will do exactly that.

When the virus became a reality this time last year, it was in my parish that some of the first cases of Covid-19 in Ireland were discovered. Since then, it has been an incredibly difficult journey for everyone. Families that have lost loved ones are grieving, but they have not been able to grieve in the traditional and appropriate way. People who have got sick with Covid, some with long-term Covid, have had an horrendous time. People who have lost their jobs and are now in receipt of the pandemic unemployment payment, PUP, because of the disease have also been through an horrendous time.

The good news is that the vaccination programme has started and vaccines are being rolled out. Of course it will be difficult and there will be challenges along the way. We are a small country, but we are fortunate to be part of the EU. The European Medicines Agency, EMA, will give a green light to the AstraZeneca vaccine when it is correct to do so and when the agency can stand over it. There will be no rushing into this. It will be done with the safety and health of the citizens of Europe in mind. I have no time for the vaccine nationalisation and anti-Europe talk that seems to be taking place. Were it not for Europe, we would not have the purchasing power to get the vaccines we have already received and those we will receive. Talk of going it alone at this time is unhelpful.

We have a task force that is responsible for the roll-out of the vaccination programme. I have every confidence that the prioritisation list it has devised is correct and has the best interests of public health in mind. It is not helpful for politicians to lobby for one sector over another. We all know the unique roles and commitment of the various front-line workers, from those working at checkouts to those working in Covid wards. I have confidence that the national immunisation task force has done the best it can with the medical expertise and advice available to it to get the prioritisation correct.

We are disappointed to hear about a reduction in the supply of the AstraZeneca vaccine. I understand there are high-level discussions under way between AstraZeneca and the European Commission. I do not doubt that our best interests, just like Europe's, will be served by the Commission and that we will resolve the problem.

This will not be the first problem we have with the vaccine. To that degree, I believe communication is critical. We need to have as much communication and information available as is possible. It may not be possible to give a daily update on the number of people vaccinated, but if it were possible then it would certainly be helpful.

I agree with Senator Craughwell that anti-vaxxers have done an injustice to the vaccination programmes in this country over the years, and they continue to do so. I look to the other side and the great work being done by so many people promoting vaccines. I think of the late Laura Brennan from County Clare and the heroic work she did before she died to promote the taking of vaccines. In her memory, and in the memory of all the other people we have lost, we have a duty to get out there and sell and promote the vaccine.

I have no doubt the commitment is there to deliver the clarity that I have called for in terms of the provision of information. I do not necessarily think that anything will be achieved by having a specific Minister with responsibility for the vaccine. The vaccine is the number one priority for the Government at this stage. The little bumps that we have experienced along the way, particularly in terms of what happened in the Coombe and the Rotunda, were regrettable but significant lessons have been learned from them.

Perhaps the Minister of State does not have the answer to this, but he may come back to me at a later stage. I would like to know the logic behind not permitting pharmacists to vaccinate the over-70s when it comes to the Covid-19 vaccine? They have been providing the flu jab for years. What is the rationale or reasoning behind not allowing pharmacists to inject the over-70s? Speaking of pharmacists, I think the actions of a former colleague of this House, Kate O’Connell, were commendable. She was on national radio on Sunday saying she did not necessarily believe that pharmacist should get the vaccine quicker than other people in the medical sphere. She outlined her reasons and reasoning for that. It was a very selfless contribution, and a very logical and mature contribution.

What we need with this vaccine roll-out is clear communication and cool heads. If we all did our level best to promote it among our family, friends, neighbours, communities and, in our case, our constituents, eventually we would turn the corner and have much brighter days ahead. The sooner the better, but we can only go at the pace the vaccine becomes available to us because at our end there cannot be, and I know there will not be, any delays.

I thank the Cathaoirleach. I thank the Minister for coming into the House to talk about this issue. We are all talking about the same things and thinking about how AstraZeneca is going to impact on us. It is important, as was outlined, that the Government needs to turn its attention to the plan it has for our own vaccination programme. I know that the existence of the vaccine has provided an enormous amount of comfort and certainty for many people. This is at a time when an awful lot of things have occurred outside of our control. Right now, the public needs certainty and reassurance that our national vaccination programme will continue at pace.

The Minister did outline a bit of news on AstraZeneca and how this is going to affect the national vaccination programme. Does he envisage any major delays in the roll-out? Are there contingency plans in place to acquire the vaccine from other sources, such as Pfizer-BioNTech, to make up for the lag in numbers? When people heard that news, a shock and a jolt was felt. People are looking to the Government for comfort and certainty, to know that there is a plan B and that things will not spiral completely out of control.

In opposition, we like to blame the Government for many things, but I do not think we will hold it responsible for something that has happened at a European level.

What people want to see from the Government is how it will respond to what has happened at a European level with AstraZeneca and the potential reduction in the number of vaccines rolling out. That is within the Government's responsibility, as is the communication for same.

On the roll-out of the vaccine here at home, I want to raise concerns about the pace of the roll-out for some healthcare workers. I listened at the weekend to Phil Ní Sheaghdha of the Irish Nurses and Midwives Organisations, INMO, on RTÉ. She raised most concerning issues about nurses and healthcare assistants in some hospitals being told they would not be likely to receive vaccinations until mid-February. At the same time, they do not have access to enough PPE in some settings. I am sure I am not alone, even in this Chamber, in being concerned that healthcare providers on wards, who are bravely facing this virus every day, are still waiting for vaccination or indeed a date for vaccination. For goodness sake, we are still in January and mid-February seems quite a while away for people who are dealing with Covid patients in healthcare settings, especially given the high infection rate in hospital settings. The idea that it might take another three weeks for a nurse in a hospital setting to get a vaccine is unacceptable. Does the Minister of State, Deputy Rabbitte, have any response to that? Will she explain why we could be halfway through February before a nurse might receive the first dose of the vaccine? Does this have anything to do with the potential shortages coming down the line? What contingency plans are being put in place for those nurses and front-line workers who have been told they will have a longer wait?

I was at a meeting last night with a group of women and we inevitably got around to discussing the virus and vaccines. It was interesting to hear that many of the women in the group, some of whom were more than 60 years of age, said they would rather stay cocooning at home for a while longer to ensure that front-line workers got the vaccine. I am not saying that is reflective of all people of that age group, but I thought it was interesting that they would not object to sitting tight for another couple of weeks, as their priority is for healthcare workers to be vaccinated. Perhaps they know healthcare workers or they see the value of their work. I thought it was interesting that they were so selfless that they wanted healthcare workers to be safe, well and vaccinated.

I am pleased the Minister of State spoke about an information campaign. Last night at the meeting, we talked a lot about communication and information. I think people know that there is no real rhyme or reason to this virus, that there are things that are simply out of the Government's control, my control and everyone else's control, but there is a need to believe the Minister of State and her colleagues have things in hand, insofar as that is possible. That belief will come from clear, honest communication and from people feeling they trust that there is leadership in steering us through what has been an extraordinary situation. None of us thought the pandemic would go on for this long and I do not think any of us thought we would see something like this in our lifetime.

We also need clear and honest information about the reality of the virus, actions that the Government is taking and the safety of the vaccines. I do not want to give the conspiracy people any airtime. They have more than enough it in my inbox, in my direct messages and online, but it is a challenge for all of us to go up against this misinformation campaign, which seems to be spreading. I have been surprised to hear people I know say they have been sent information by friends while playing Words with Friends - who knew it? - about this crazy thing that is happening. I was astonished that this information is being sent around to people who would have been lining up to get vaccines and talking about vaccinating their children for everything else except for this virus. It is interesting how the misinformation has got around. It is incumbent on the Government and all of us not only to challenge this misinformation but also to simply shut down some of the nonsense that is hurtling around the place and clogging up the inbox of everyone else in this Chamber as well.

I want to discuss the need to make sure that the arrival of the vaccine and its roll-out are bolstered and not countered by the public health advice of the day. The vaccine's arrival is not a silver bullet and for as long as we have a plan to roll it out, we must also still have a plan to manage community infection. No one wanted the surge in infection rates that we saw in December 2020, which has led us to facing two or even three more months of complete national lockdown.

It could have been avoided had we all decided to keep the country under tighter restrictions in December.

I do not want to go too much into accusations on people coming into and going out of the country. At last week's meeting of the Joint Committee on Health, when discussing mandatory quarantines, Dr. Ronan Glynn said that no one thing is a panacea to dealing with this virus, but that does not mean we cannot take a combination of all sorts of things and hope that, with a strategic patchwork of actions, we can try to eradicate this virus insofar as possible. We cannot make the same mistake again. The big challenge is to learn from what has happened in recent months to try to steer us to the end point where it is hoped we will all have the vaccine.

We need a firm commitment from Government to do everything we can to reduce the spread of the virus through further and tougher restrictions, including the introduction of mandatory quarantine for those travelling into Ireland. I know that the subcommittee met yesterday and recommended that quarantine be introduced for anyone travelling without a negative PCR test. That does not take into account that someone could have contracted Covid following on from that result. I am somewhat sceptical about the negative PCR test for allowing somebody to travel.

The Labour Party calls for the introduction of mandatory quarantine and a ban on all non-essential travel into Ireland. It is never too late to begin introducing measures to reduce the spread of this virus and it is never too late to start saving lives. A number of measures could help on our way towards the full availability of the vaccine.

We face an emergency. Covid-19 is rampant in the country and could get worse if we do not act now. Our health, economy and social lives are suffering immensely. We have had more fatalities from Covid in less than a year than we had in the dreadful times of the Troubles in Northern Ireland. The people have made enormous sacrifices.

I regret to say that if we are to be objective about it, the current strategy is not working effectively. What can be done? A number of experts in Ireland and beyond have called for a zero Covid strategy. I encourage the Government to consider adopting such an approach. The Independent Scientific Advocacy Group has many respected academics and other persons involved, including Dr. Tomás Ryan, who was very impressive on television last night, Dr. Julien Mercille and Professor Anthony Staines. At the very least it is worth consideration.

The Independent Scientific Advocacy Group will point out that a zero Covid strategy is simply doing what is possible to suppress this virus towards elimination. Despite what the name might imply, it is not a utopian goal of perfection; it is an unfortunate name. The group's viewpoint has been labelled as being unrealistic. It is realistic but it has not been realised because of the reality that the Government will not give this proper and due consideration.

I am a Senator from a Government party which not only tolerates but encourages diverse opinions. We should put them all on the table and explore them fully. We should not be afraid of them and should test them forensically. What is the harm in failure? We get knocked down; we get up again; you're never going to keep us down. It is worth consideration. I hope the Government will give it detailed discussion and countenance that as a possibility.

In the world today, there are two types of countries: those that have beaten Covid; and those still struggling with Covid. The good thing is that all those that have beaten Covid have all done essentially the same thing.

They have pursued a strategy of aggressive suppression, which is what a zero Covid approach entails. We need only to copy what has been done successfully elsewhere.

In terms of key interventions that can be made by the Government, it boils down to three which must be executed with discipline. First, we need a lockdown to end all lockdowns. This will bring massive rewards for our people. The current restrictions will drive the case numbers to a level manageable by our contact tracing teams. Let me be clear, everyone hates lockdowns, but they lead to huge rewards and allow us to start living again soon. With discipline and an effective lockdown, we can go back to pubs, sports, socialising, singing, shopping, hugging and everything else.

As a former schoolteacher, I am particularly concerned for the mental wellness of young people. They have been deprived of interaction in our schools. They have also been deprived of sport, which is an essential platform and outlet for young people. They have held the line to date. I pray they will continue to do that. They need to know there is light at the end of the tunnel, even if it involves short-term pain to achieve long-term gain. We hope that the young people will continue to play the brilliant role they have played to date. Schools reopening is very important. We can debate at what specific level of cases they can reopen, but it must be a low level. This is also dependent on the school type and the area where it is located. Again, a lot depends on community involvement.

Second, there is no point driving down case numbers if we allow travel to reseed the country with more infections. To a certain extent, this is what happened in the summer, although I am not placing all of the blame in this area. I do think this has been overhyped by some people, but it is undoubtedly a contributing factor. Had the situation been managed properly, we were two weeks from zero Covid at that point. A few international travellers at that time formed part of the cocktail that reseeded the virus in the country and it then grew exponentially. We all know where we are now. We need mandatory hotel quarantine and border checkpoints and management. The virus knows no boundaries, be they borders between counties or jurisdictions. We need proper management. There is no question that these actions, if done well, will bring sufficient results.

The countries that have controlled Covid insist on some form of tight quarantine for travel. There is no other way around it. If we choose to pursue a zero Covid strategy, east-west is key to it because the parties in the Six Counties cannot agree on this. I know the issue should not be politicised, but an east-west approach and two islands working together on implementation of a zero Covid strategy would provide us all with incredible freedom, liberation and protection. In regard to the Border region, we manage it in the same way as we would manage any other county. Where there are high case numbers, they must be contained. We follow the science and the data. There is nothing political about it, we need only follow the data. We already have a border management plan and a restriction around travel beyond a 5 km radius. The Independent Scientific Advocacy Group plans show us how red zones and buffer zones can be used to relax the 5 km radius limit in the country.

Third, we must invest in public health. Test, trace and isolate is vital. After a few weeks of lockdown, case numbers will be down to a manageable level. At that point our testing and tracing infrastructure will be key to keeping it that way. The problem is that Ireland has underinvested in its public health infrastructure and staff.

I implore the Government to consider these actions. The Minister of State, Deputy Rabbitte, who I know is very open-minded, does not need to make any decision today.

I commend the Government. I am not having a go at it. Government members are doing their level best, day and night. The Seanad as the Upper House has a famous tradition of allowing for different viewpoints, which we can ventilate in the Chamber while testing and challenging ourselves. I hope the Minister of State will take my points on board and bring them back to the Government. I will do the same as I do in the parliamentary party, An Comhaontas Glas, so at least people can be assured that it was absolutely fully considered and explored. To date, however, I do not believe it has been given the full forensic examination and the realistic appraisal, critique and approach it deserves.

Cuirim fáilte roimh an Aire Stáit. Tréaslaím leis an méid a bhí le rá ag an Seanadóir Clifford-Lee agus Conway i dtaca le straitéis chumarsáide trí mheán na Gaeilge agus trí mheán Braille chomh maith.

I thank the Minister of State, Deputy Rabbitte, and welcome her to the House for this very important debate and statements. I will make a few points at the start before I get to the substantive part of my remarks. I am sure it will be unsurprising to Senator Craughwell that I disagree with him on this. I do not quite understand the psychology, the politics or even the effectiveness of suggesting boots on the Border to deal with this. I do not believe that is helpful. I believe it is inflammatory and it causes worry and concern in an already uncertain time for people. We need to work to give practical effect to the memorandum of understanding that was agreed between both chief medical officers in what seems a lifetime ago. I do not say this to be political, glib, cliched or lazy about this. It is not political because it is science and we need to work on the basis that Ireland is one epidemiological unit. We all share this big lump of rock. That is the reality.

When I travelled down here before Christmas, as people crossed the Border towards the Carrickdale Hotel, they were was asked to divert off and there was a Garda checkpoint, which was no big deal. It was right and proper. This was replicated throughout this State and in the North. That is how we deal with this. We have spent years talking about the fact that no one wanted a return to a hard border and that the Border could not be policed. Nobody knows better than my colleagues from Border constituencies that it would be an absolute waste of time and resources, including An Garda Síochána and other resources, to put them on particular roads. I am aware this is not what Senator Martin had suggested in his remarks, but I do not believe it to be helpful, in the first instance for that very reason and because I do not believe there is any point in arguing for that.

We need not to operate in silos and our health departments need not to turn their faces away from each other. We need to be sure in our information and we need to co-ordinate cohesive all-Ireland communication strategies that speak to and reassure people, and which give fact to what are meant to be our shared plans for dealing with the emergency we face collectively, no matter where we are. This is where our focus should be if we talk about a North-South response to the pandemic and not reactionary reflex towards putting people on the Border.

I put it to the Minister of State that the people are facing into what is, potentially, the worst phase of the pandemic so far. Case numbers are in their thousands compared with a few months ago. The State now has the fastest growing crisis in the world and the Government still has not got testing and tracing right. Testing and tracing was not used effectively to hunt down the virus. There is still no enforcement of mandatory quarantine for people who come into the State. The all-Ireland response to fighting the virus is still not right.

I mention this bleak lead-in to this debate about the roll-out of the vaccine to ensure the Government approaches its inoculation plans with much more rigour and certitude than it has in its handling of the transmission of the virus. There was a huge sigh of relief across the State when the respective states began the vaccination programmes. People are keen to be vaccinated and keen to play their part in eliminating this virus and not just living with it. The Government needs to seize this moment of popular expectation and hope that has arrived with the vaccine. Yet, the early signs are not good that the Government and its numerous systems are match ready, to borrow a phrase, for the challenge and opportunity offered by the inoculation plan for the Government and the people.

The Government must harness the resources that the State has and incorporate them into the vaccination plans. As it rolls out the plans it should work in conjunction with the Northern Ireland Executive's plans, as I have said, and both administrations must be joined at the hip, so to speak, to protect and vaccinate the people of this country, no matter where they happen to reside.

The more people are vaccinated, the safer hospitals become on wards and in intensive care units. The more people are vaccinated, the safer the rest of the population is as they await their jab. There is a caveat and just because a person has been vaccinated, it does not mean he or she cannot transmit it. When people get the vaccine, they should still be careful around those who do not have it.

It is crucial that the Government instils confidence in the public as it follows through its mass vaccination programme. That confidence will come from information that reflects the Government being on top of that plan. A lack of information from the Government in this most important of projects will create a vacuum, and into this vacuum will step misinformation and rumour, some of it deliberate, as colleagues have said.

I do not doubt for a minute that this is a massive undertaking, the biggest in the history of this State. What are the Government's key objectives and what is its pathway to achieving these objectives? Trained people are essential to the success of the programme and the Government has correctly set an ambitious target of 700,000 people to be vaccinated by the end of March. How did the Government arrive at that figure? Set against that figure is the information that the Minister has given us today about reductions and delays in the delivery of some of the vaccines, with some parties not able to meet their delivery commitments. If there is a shortfall in numbers or serum - and that seems to be the case - is the Government in a position to speedily ensure nobody will miss out on being vaccinated in a safe and timely manner? Does it have the personnel trained to achieve this target? Does it have the required dosage of serum to meet the March target and the information technology system in place to register and record vaccinations or to ultimately guide this unprecedented operation? Has it identified the mass vaccination centres yet and what about the staff and expertise needed to run these centres?

There is also a concern about the accuracy of the designation of people to be vaccinated from those most vulnerable to those most needed to protect the most vulnerable in residential care homes, in wards and intensive care units in hospitals and in childcare centres, pharmacies and GP surgeries. Is the Government satisfied the vaccination programme it is overseeing is capable of successfully covering all the various categories of people? Colleagues have told me that elected representatives are understandably being lobbied about the timeline of the vaccination programme, and when they write to the relevant Minister seeking answers and reassurance for constituents, there is an unacceptable delay in the response.

I appreciate and understand that this is a busy time but elected representatives, regardless of their level, need to be responded to. They need the information, as we have all said, to assist in having a proper communications strategy. People are genuinely worried that the speed of the Government's vaccination programme is too slow. It is fair to say there has been a collective effort from the Members of the Oireachtas to support the Government in its plans to deal with the consequences of the virus for people on many fronts. The Government must listen, respond and change its strategy when necessary. We want to see the virus extinguished and not just contained. The measures taken by the Government across the board, particularly in the roll-out of the vaccination plan, will be judged on whether we are moving towards extinction or containment.

There has been a reduction in Seanad sittings for understandable reasons so the Minister of State might indulge me while I have her. On the Order of Business we referred to the upsurge in domestic violence as people are isolating at home. There is a scheme that I want to flag where people in pharmacy outlets can quietly seek assistance by asking trained staff, who will in turn provide those people with the ability to contact the Garda. That initiative has been rolled out in pharmacies here in the South for some months and Boots in the North has recently announced an "Ask for ANI" initiative. If somebody asks a member of staff for this, that person will be brought to a private space where the police can be contacted. At this point we need to look at building on that initiative and encouraging more pharmacies and other trusted places to roll out similar programmes so that people can find engagement.

I have written to the Minister for Justice, Deputy McEntee, and the Minister for Health, Deputy Donnelly, on the issue and I am not trying to catch the Minister of State, Deputy Rabbitte, who is present, on the hop. Rather, I just wish to reaffirm that ask.

Given the gravity of the issue, I indulged Senator Ó Donnghaile. I call Senator Flynn.

I thank the Minister of State for coming to the House. It is remarkable and a positive good news story that a vaccine is being rolled out. I am delighted. I did not imagine that only a few short months after becoming a Member of the Seanad I would be able to speak on the roll-out of a vaccine. I very much welcome that it is being rolled out. I welcome the significant amount of work that has been done to date with regard to long-term residents and front-line healthcare. There are several long-term residences in County Donegal, such as St. Shanaghan House. The youngest person in that facility is in their mid-50s, while the oldest resident is in her 90s. They share a corridor and the laundry room. It is very tough for older people and others to self-isolate and cocoon. If they get a few minutes to speak to one another, many of them will do so even though it is against the advice of the management. When we speak about care residents, we need to keep older people who are long-term residents in mind as well.

Although I welcome the roll-out of the vaccine, I wish to raise an issue relating to special needs assistants, SNAs. I used to be an SNA and I know the level of work that comes with the job, such as bringing children to the toilet, washing their hands and working with very vulnerable children and children with behavioural issues. One cannot practise social distancing while working as an SNA. I recommend that SNAs be moved into the category of care workers. Although SNAs stated last year that they are not care workers and we cannot expect them to be care workers, they do a lot of care work in their job and they help young and vulnerable children and children with special needs to reach their full potential in school. I do not think there is a single person in this House who would stand up and tell me that I am wrong and that they are not essential workers.

Teachers are key workers. Every child in this State has the right to an education. At present, the unions and the Department are discussing issues around teachers being vaccinated. I believe teachers should be moved up to the category of key workers. In that way, we would not be taking people out of categories but, rather, adding teachers and SNAs into those categories. All that is doing is valuing the work that SNAs and teachers do with children. We must remember that teachers and SNAs are not robots. Many of them have young children or loved ones at home who may be at risk. The sooner we get young children with additional needs back to school, the better. One way of doing that is to put teachers and SNAs further up the list for vaccination.

The Seanad Civil Engagement Group, of which I am a member, yesterday discussed the issue of developing countries. Although the vaccine is being rolled out here in Ireland, we need to be seen internationally to support developing countries. Senators are aware that Ireland has provided funding to the World Health Organization in respect of the COVAX initiative but I and my colleagues in the Civil Engagement Group hope that we can do more as a nation.

As many other Senators stated, when we talk about vaccines, we automatically think about them in a negative context, such as chicken pox, tuberculosis, polio and other serious illnesses that had significant impacts in the past. That is especially so for members of the Traveller community. Last night, a young Traveller man asked me whether the Traveller community will be used as guinea pigs in the vaccination programme. That actually makes me very sad because the Traveller community has been treated so badly by the State for many years. I know we are moving in a positive direction in terms of equality for the Traveller community.

This young man told me he believes that members of the Traveller community are to be used as guinea pigs for the vaccination process. He believes that because of the misleading information that is circulating. Vulnerable groups take in this kind of information. I do not have to tell the Minister of State that Facebook, Twitter, etc. are all making billions of dollars a year in facilitating anti-vaccine promoters. We can get ahead of this situation with good advertising and Government investment in positive communications, especially for young people, those who are older and people from vulnerable communities.

Earlier, as Senator Clifford-Lee pointed out, I spoke about outbreaks of Covid-19 in halting sites and working-class areas, as well as in the migrant and homeless communities. Regarding the roll-out of the vaccine, I am sure the Minister of State has heard of the organisation Safetynet Primary Care. Last Wednesday, representatives of the organisation came out to a halting site in Ballyfermot and were able to kill two birds with the one stone. It was brilliant to have that service from Safetynet Primary Care, and its representatives were able to swab people to test for Covid-19 infections and give people a jab at the same time for hepatitis A. We must invest in these services provided by organisations such as Safetynet Primary Care to roll out the vaccine in the disadvantaged, migrant, homeless and Traveller communities.

One of my colleagues, Senator Ruane, works closely with Safetynet Primary Care and I know how vital that organisation is to marginalised communities. I also think, however, that we need political will and good, positive energy supporting this roll-out of the vaccine. We must get everybody involved, and this vaccination process is so important that we must start it at a community level and work from there. I have seen first-hand the type of work carried out and the services provided by the organisations I have referred to. They had built up relationships with people from marginalised communities even before the pandemic. We must value their work. The Department should invest in Safetynet Primary Care to enable the roll-out of the vaccine in all communities as soon as possible. That is one way of doing this.

Another point to note is that some areas do not have GPs. There is much we will need to discuss in the days ahead. I will not have enough time to discuss everything today, but one aspect is that some areas do not have a GP and people may have to go outside of their town to seek medical advice from a GP. When we talk about the roll-out of the vaccine, we must of course ensure that it is an equal process and that every person from every community will have an equal chance of getting vaccinated. We must also, before it grows any bigger, break down all the nonsense on social media from those who are anti-vaccination.

It is important that we all pay tribute to the HSE, as we have done, and to the task force, the Covid-19 vaccination people and their teams. However, I want to spare a thought for people such as the Minister of State, Deputy Rabbitte, the Minister of State, Deputy Butler, and the Minister for Health, Deputy Stephen Donnelly. I say that because I am sure it is not easy going to bed at night with this burden on their shoulders and then getting up the next morning not knowing what situation they will face. That is particularly the case for people who have responsibility as a Minister.

We must all have unity of purpose here, and, in general, I am glad to see that is prevailing. I state that because, ultimately, we will only be able to vaccinate people according to the amount of vaccine we get.

That is the reality. People sometimes ask when they can have their vaccinations. I get that question every day, and several times a day, as does the Minister of State. Most Irish people have been fantastic. However, one or two people, whom I know have not been following the regulations, to be blunt about it, have asked me when they will get their vaccinations.

I simply ask them when they are going to wash their hands, keep their distance and do what they are supposed to do. That is 50% of this debate and it is very important. A minority of people have been responsible for the pandemic getting out of control.

Why in the name of God, when we have a 5 km limit on travel, do we have four or five flights per week coming from the Canary Islands? These are not people from the Canary Islands coming to holiday in Ireland but Irish people, some of whom will ask me when they can be vaccinated. At the same time, overburdened nurses, doctors and helpers in our hospitals, some of whom work double shifts to help their friends, are holding the hands of relatives and friends dying from Covid. I stress again that it is a minority who are involved, as the Minister of State knows, but it is treachery by some of our fellow citizens. No matter what any politician, health expert or government does, it will all be in vain if we cannot get our people, even if it is a minority, to follow what we have been asked to do by the medical experts. For all of my life, my view has been that I am not in a position to challenge a medical expert. As much as 99.9% of what people like Dr. Holohan and others have told us has been right. We might not like to admit it but they have been very accurate all along. Again, I beg the small minority who are at this behaviour to stop and to follow the rules.

The carry-on of AstraZeneca has been extraordinary considering that it received more than €60 million from the European Union to proceed with its vaccine. The company is now telling us it will have to reduce by 60% the number of vaccines it provides to Europe, yet it will supply vaccines to other countries. That demands answers. I applaud Commission President, Ursula von der Leyen, for challenging the company because it needs to answer questions. I hope there are no dirty tricks or trickery going on with this British-Swedish company. I would like to say more but I will not do so. AstraZeneca has serious questions to answer. If, in good faith, it takes an advance order from Ireland or any other country in Europe and then suddenly says it cannot honour it, having received taxpayers' money from EU member states to develop the vaccine, it must be challenged and give answers without delay.

When Ireland faces such challenges, it is sometimes hard for the Government to deliver on its promises. However, I am optimistic for the future as I believe more vaccines will come on stream and we will get rid of the virus. I am sure we will all be delighted and thrilled when that happens, although that is a number of months away. When we get rid of the virus we will look back and say it was tough, hard and challenging but we have done it.

I have two short questions for the Minister of State, which she may have clarified already. When will people in residential care homes be vaccinated? When will young adults who attend special needs centres be vaccinated? If she cannot give me the answers today, I ask her to revert to me.

I welcome the Minister of State. I thank all healthcare staff for their work on the front line on behalf of all our citizens. These staff work long hours in difficult circumstances and have made huge sacrifices in their private lives to ensure they are in a position to continue to look after those in need.

I welcome that by Sunday last, 143,000 people had received the vaccine, all of our nursing homes had completed the first series of vaccinations and we had started on the second dose in those homes.

This will be a comfort to families who have loved ones in those homes and who have been unable to visit them. It is important to note that we cannot let our guard down with regard to the simple message of washing our hands, wearing our face masks and keeping our distance, as both the Pfizer-BioNTech and Moderna vaccines protect at 94% and 95%, respectively.

Will I take the vaccine when my turn comes? I will, and I advise everybody to do so. However, I am concerned that a recent MRBI poll for the Irish Pharmaceutical Healthcare Association, IPHA, showed that 75% of the respondents said they would take the vaccine, 18% are unsure and 7% said they will not. We must ensure we get close to 100%, if possible, to save lives, help our healthcare system and get back to some form of normality. I agree with Senator Flynn about a comprehensive campaign across all social media platforms to dismiss the myth being put forward by the anti-vaxxers. It is also important that Moderna laboratory studies have shown that its vaccine is protective against the new UK and South African variants.

I welcome the provision of the timeline for vaccinations which has been proposed by NPHET, subsequent to receiving our doses based on EU agreements. It is important that it is adhered to when rolled out through GPs and pharmacies in the coming months. There have been reports of office staff receiving the vaccination ahead of front-line healthcare workers, family members and so forth. This cannot happen. People must have confidence in our programme. I do not believe that we, as politicians, should seek to adjust the timeline, but I wish to make a few points.

I am personally very annoyed with the decision by Fórsa which meant that the special needs schools and classes have not reopened. I am aware this is a priority for the Ministers of State, Deputies Rabbitte and Madigan. We do not want children, whether they are in special needs schools or mainstream school classes, to be out of school for a moment longer than necessary. Many people support the policy that schools should not reopen while numbers are high, and I understand the concerns of special needs assistants, SNAs, about social distancing while in class. However, we have a responsibility to the children and their parents, because these children are regressing and are in danger of losing previously developed skills. Many of these children might never regain what they have lost. We must recognise the strain that the closures have placed each day on the families, guardians and carers of children with additional needs. Have we chosen to prioritise the needs of those who are vocal and strong over those of the most vulnerable in our community? Should we consider a vaccination programme for SNAs of children with special needs? Whatever needs to be done to reopen special classes must be done.

I wrote previously to the Minister for Health to request that he ensure that Covid-19 vaccines are made a priority for the principal carers of elderly people and people with medical needs. Over the past month I have been contacted by several families who are angry and frustrated that vaccines are not being made a priority for carers who are looking after elderly parents or persons with medical needs. Even though these carers work in the home, they should still be viewed as front-line healthcare workers because their work of giving full-time care to loved ones is vital. When services were shut down family carers continued to care around the clock to ensure their loved ones stayed safe at home and out of hospital. These carers are terrified that they could get Covid-19 and transmit it to their vulnerable family members, because who will mind those family members if their principal carers get sick? While some family carers will fall into the categories outlined for priority due to age or their own health conditions, many will not. Family carers and home helps cannot be allowed to be forgotten.

I will conclude with a simple message and one we must continue to reiterate. For people to stay safe they must wash their hands, wear a mask and keep their distance.

Cuirim fáilte roimh an Aire Stáit. The Minister of State has heard many important contributions. I will start with some words of appreciation to all the front-line workers who are working so hard in our healthcare services and, in particular, all the people who are working hard to get people vaccinated as soon as possible. We very much appreciate their efforts.

I wish to draw the Minister of State's attention to a particular category of people. I am hearing concerns that, with the best will in the world, a significant number of elderly or vulnerable people could fall through the cracks without anybody meaning it to happen. I refer to the almost 7,000 members of religious orders in Ireland. Not many people would know that many elderly people in religious life are living in groups in congregated settings which are not HIQA-regulated settings and may or may not come under the Nursing Homes Ireland umbrella.

I heard from one such group recently in a case involving what is effectively a care home being run with 24 elderly persons, with an average age of well over 80, within a campus of 65 people with an average age of 80. They are not, however, on the HIQA-regulated list. They do not want to jump any queue. They would like to know whether they will be forgotten. They should be in the same category as regulated nursing homes. In that context, I drew the Minister's attention to the matter, and I know they have written to the Minister. I also know that the Association of Leaders of Missionary and Religious in Ireland, AMRI, has written to the head of the vaccination task force and to the relevant authorities to draw attention to the fact that there are thousands of religious, many of whom are elderly at this stage, as we all know, and many of whom have underlying conditions, and the need to be aware of them. Certainly, at the time of the Covid outbreak there was a lack of awareness about the situation of religious who were not in regular nursing homes. We saw what happened with nursing homes earlier last year when people did not move fast enough and did not have the knowledge, the stitch in time that saves nine. I am drawing the Minister of State's attention to the fact that there may be at least one institution, and there are probably several, that would qualify as residential nursing homes but which are not HIQA-regulated. We are also talking about a situation in which there might be a wing of a convent, let us say, where there might be six or seven religious. There might be somebody coming in from Sodexo or some other care provider, multi-skilled people providing everything from nutrition to sensitive personal care.

I have two questions on two issues. Is it clear that people who are working, if one likes, as private healthcare providers, going from one place to another, are in the front line? Are they on the high tier? That is the first issue. The Minister was not terribly clear about that in the House last week. As for the situation of the religious, can something be done to make sure that people do not fall between the cracks because they are not in accommodation that is on the list of HIQA-regulated nursing homes? I will happily supply details of at least one such setting but I know there may be more. I would argue that where perhaps three or more people over 65 are gathered, where there may be underlying healthcare conditions, but even if there are not, and where there are a sufficiently large number of people gathered, it would make sense to vaccinate early. That is especially the case if there are carers coming in from an organisation or individual carers moving from one setting to another. I am really anxious that attention be given to this. I know they have written the letters, but so far there has not been the reassurance. I stress that they do not want to jump any queue; they just want to make sure they take their place with others in their category who, because they are in HIQA-regulated settings, have already been vaccinated. A date is of tremendous consolation to people. They are not saying they have to have the vaccination tomorrow, but people would be tremendously reassured if they could be given a message that we know about them and they will not be overlooked or fall down the list of tiers and they will get a vaccination probably by a certain date. That message is of tremendous importance to a person who is elderly or vulnerable, and that side of the operation needs to be minded.

I wanted to put that to the Minister of State. As I said, people are not looking for special treatment. They are actually very self-conscious these days, given the climate they are in, in that they would not want to be seen to look for special treatment. It is very important, however, that people do not fall through the cracks simply because they did not come within the bureaucratic definition, for want of a better phrase. I would be very grateful if the Minister of State could either respond to this concern today or take it away and get a Government response to me and to the Seanad as early as possible.

I thank the Minister of State for coming before the House. I commend her on her work on trying to ensure that adult respite services remain open during this difficult period and also that day care services for children with special needs are open. I agree with the sentiments Senator Flynn expressed.

It is important that we ensure that provision is made for those children and their families. I worry about the levels of regression that are happening. We must make sure that they remain a priority. I also agree with Senator Flynn on our approach to overseas aid. It is important that vaccines are made available in the developing world and are not seen as the preserve of the wealthy western world.

I echo the comments of Senator Clifford-Lee on the Irish language and the comments of Senator Conway on braille. I have asked on a number of occasions that information campaigns be conducted in other languages. I am thinking in particular of Polish and Portuguese for a variety of reasons. It is essential, given the multicultural nature of our society now, where English or Irish is not somebody's first language, that we have information campaigns available in more than one language.

The EU strategy has been correct. We need more European co-operation in the health area. If we did not have European co-operation, countries would fight against each other to get a supply of vaccines. I welcome the fact that President von der Leyen is holding AstraZeneca to account. It has to deliver on the contract that was provided.

I had the wonderful experience of an anti-vaccine protest outside my office in Gorey before Christmas. We need to take further action. I look forward to dealing with this in the context of the online safety Bill, which we will consider quite soon. As part of that, measures can be taken against disinformation concerning vaccine and health products. This is something that will be important.

We also need to take stronger action against some of those who continue to break the 5 km rule and do not travel for reasons of work, study or emergency, including some anti-vaccine protesters. I have a lot of time for gardaí and the difficulties they have faced. It is important that the House acknowledge Garda Alan Leblique who had to stand up to some of those protesters. It is important that we note his very sad passing and extend our sympathies to his husband and gardaí. These are some of the challenges that gardaí are forced to face.

For the majority of people in this country who follow the rules and try their best, it is very difficult to see a small minority who do not follow the rules. In my community in Gorey there was a funeral last night where over 50 people attended and did not care about social distancing. Gardaí tried to do their best, but a small minority do not believe that the rules apply to them. It is important for the overwhelming majority of people in this country that the rules apply to all. We need to send out a message to those who are anti-vaccine that their behaviour will no longer be tolerated. Senator Hoey talked about communications issues. I agree with the comments. One of the challenges has been consistency in messaging and the roll-out of policy between different hospital groups. I want to specifically refer to concerns I have about the roll-out of mental health services. There is evidence that while public health nurses are receiving the vaccine as part of the process, public mental health nurses are not. This has been the case in the south east. I have raised the matter with the Minister, Deputy Donnelly, who I know has raised it with the HSE. I refer to St. John's in Enniscorthy which has a geriatric building. All the staff and patients in that building received vaccinations, but not all the staff and patients in the psychiatric building beside it did. We have to ensure that those who are engaged in mental health and public mental health services are treated fairly.

A debate needs to be had on a post-vaccine context. The question of vaccine certification, in particular travel in the future, is something that requires an EU-wide response. The Government needs to start to plan for that. We also have to examine how we recover from this period in terms of rebuilding communities and continuing with our message of hope. Everyone wants the vaccine programme to do well and to contribute in a positive way. I ask that the Minister works with all sides of the House to ensure that this can happen.

Over Christmas I took a strong interest in vaccines, the history of vaccines and everything else. Let us consider smallpox, a disease that has ravaged mankind for millennia. We can go back as far as the death of Ramesses V, who died in 1,145 B.C. When his mummy was exhumed in the 1970s the experts could see evidence of smallpox legions on the mummified corpse. They identified him as being one of the first historical figures to have suffered from smallpox. Let us fast forward many centuries to 1795 and Edward Jenner. The British physician was one of the first people to discover vaccinia. He used the cowpox virus to inoculate against the disease. Thus, the word "vaccines" entered the English language and dictionary. Much of the work Edward Jenner did at the turn of that century led to the great strides we made in the 20th century to combat smallpox, leading to its eradication. The moral of my story, and the point I am raising, is that vaccines save lives and work.

Let us fast forward to the 1970s in Ireland. At that time, close to our home, many family members told stories of people dying from polio or tuberculosis. Many of the survivors who did not take vaccines were left with permanent damage, including brain damage, deafness and blindness. In 1985, 10,000 children were diagnosed with measles in Ireland. We then embarked on an ambitious vaccination programme and by 1987, only three years later, the figure fell from 10,000 to 205. As I said, vaccination works.

What really stops vaccination and hinders it is misinformation. Last night, there was almost a meltdown on Irish Twitter because of misinformation. Misinformation was put out to the effect that the new AstraZeneca vaccine would only have an 8% efficacy rate for those over 65 years. The only reference to 8% in the report in question was a comment that 8% of people studied were between the ages of 56 and 69 years. That is the only place where a figure of 8% was referenced.

There is great responsibility on the Minister of State, members of the Government and Members of the House to ensure the information we put out to the public is correct. The same goes for the media. There is a serious responsibility on those in the media. Some in the media have far bigger social media platforms than all of us in the Chamber would have put together. I am looking around and I mean no offence by that. These people have a responsibility to ensure the information they are putting out is correct.

There is a tendency to want to be the first person to tweet or get breaking news out and to be the first person to see that tweet or news. Mark Twain said a lie gets around the world seven times before the truth even has the chance to lace up its boots. I wish to put that point on the record. It is important for people throughout Irish society who have a platform to ensure the information they are putting out is correct.

I was looking at WhatsApp groups last night involving different friends with no interest in politics. Straight away, they commented on what others said about the vaccine and this and that. Regardless of whether we like it, what people see online is what they believe much of the time. This happens no matter how many times we say that people should take what they see online with a pinch of salt. It is simply what many people take as gospel.

My third point relates to vaccine scepticism and what we see on Facebook. I am keen to discuss this topic further, although it does not much relate to the point. Let us consider Facebook and the powerful algorithms the company uses. If I go looking for vaccine scepticism and ask whether vaccines do something to me, I get directed to a Facebook group with perhaps 1,000 people who are talking about the dangers of vaccines. It is all hogwash. Then the platform takes me down a rabbit hole. Since I am searching for these topics, Facebook and its algorithms put something else about vaccines in front of me and then something else again and so on. A person can go down a rabbit hole of conspiracy theories and misinformation and total BS, for want of a better term.

We have to hold social media companies to account. They cannot continue to undermine public health advice. No matter how much they say they are taking action, using their services responsibility or trying to delete material and tackle misinformation, it is not enough because misinformation is being allowed to spread like wildfire. The World Health Organization has been clear that vaccines save lives and misinformation costs lives. We must not allow misinformation to thrive online, whether through Facebook companies or journalists with a large social media following who want to get a tweet out first. They may realise they were completely wrong and were had or taken for a walk up the park with the information referenced. It is incumbent on all of us in Irish society to ensure key information about vaccines is available.

People should take their information from those who have spent their lives devoted to the study of vaccines and not from what they see online.

I welcome the Minister of State to the House. There are a number of items I want to bring up with her. Some of my colleagues have already asked about them but from my own experience and from the representations I have received, I would like to put them to her today as well.

We need the promised data on the roll-out of the vaccination programme on a daily basis, as has been mentioned. It is simply not good enough that we must rely on tweets from the Minister for Health to get this information. I am sure that like all other Members in this House I receive a daily briefing by email on Covid figures which unfortunately, as we all know, has included a large increase in deaths over the last couple of weeks. Therefore, it is very important that these figures are balanced with ones of hope. In fairness, our only hope at this time is to vaccinate as many of our citizens as we can in the quickest possible time. I am sure we are all very familiar with the evening announcement of the Covid figures that occupy conversations in every home. I honestly believe those conversations need to include more hope and more light at the end of the tunnel. Vaccination figures would give us all a lift each day as we would know that that light is getting closer.

I learned from the RTÉ news yesterday that the EU is seeking that 70% of all adults be vaccinated by the summer. I join other Members of the House in asking the Minister of State what effect, if any, the delays with the delivery of the AstraZeneca vaccine will have on us in Ireland. In a tweet a number of days ago the Minister, Deputy Donnelly, said it was a real setback but I would appreciate an update from the Minister of State today. Again, notwithstanding what she said in her comprehensive introduction and what other Members have asked her already, while driving to the House this morning I listened to Mr. Seán Moynihan, the chief executive of ALONE, who was speaking on my local radio station KFM. He outlined many of the concerns I have been receiving from older persons and their families regarding when they will receive the vaccination. Important in this information is also the question of who will let the older population know it is their turn to be vaccinated. Will it be their GP or will that information come from the HSE? Will it be a phone call or a letter? This information is all the more important considering the unbelievable scam that our older population in particular are facing now. Those carrying out this scam need to be brought to justice straight away. I have seen the very professional way they are contacting our most vulnerable and seeking their most private information from them. It is important that the Minister and the Minister of State clarify the procedure on how these citizens will be contacted and the approximate time for that contact. I ask the Minister of State to make people aware of that scam, which is ongoing. Others have raised it but it is something that has been very professional, from what I have seen. It has been mentioned by so many.

Like so many Members today, I want to pay tribute to our front-line workers and welcome the fact that so many have received their first vaccination. It was great to see those same front-line workers share vaccination pictures on social media and for that to be welcomed by so many in our community. However, we are all aware of those healthcare workers who, as has been mentioned, have not received the vaccination and I join with others in asking the Minister of State to give us an update on that position.

I have received a number of phone calls from those living in sheltered housing and their families. They were suggesting and indeed asking that they be vaccinated at the same time as the residents of the nursing homes and hospitals to which their homes are adjoined. It seemed to be a practical solution but unfortunately this did not happen. I wrote to the HSE on this matter and would appreciate if the Government considers vaccinating those living in those sheltered homes in the quickest possible time. They live on the grounds adjacent to facilities whose residents have had the vaccination and I would appreciate it if that could be considered.

I would also like the Minister of State to consider those on dialysis for the vaccine and indeed carers as well, as has been mentioned. Like other Members, I appreciate that the roll-out must be premised on health grounds and on the basis of those affected most, but it is very important that we as public representatives relay the large number of representations we are getting from various sectors of society.

I too believe that there should be a dedicated person in Government in charge of the vaccine roll-out. I tell the Minister of State that it is not too late to consider this. There have already been two important issues that have needed such a person. This is the most important issue for this State in many generations. So much is depending on it and as I stated about the leaving certificate families this morning, the entire country is waiting on every word from the Minister about this roll-out.

The tourism industry is, as we all know, on its knees. It welcomed the announcement from the Minister that the majority of the adult population will be vaccinated by the end of the summer. This announcement needs urgent intervention by Government. The good news of the vaccine has us all discussing holidays later in the year.

I ask the Government to assist the tourism industry now as it needs to tap into those discussions and ensure that the Irish market is the holiday of choice this year.

I will finish by thanking gardaí, as others have already, who are on the front line and protecting us from those who simply should know better. The Garda continues to protect us all. I also want to put on record my thanks to the Defence Forces who, once again, have come to the fore at this time of national crisis. They can always be relied upon. Let us ensure that this good news is promoted at every opportunity. Our country needs this programme and its roll-out as quickly as possible. I wish the Minister of State every success is getting us all vaccinated.

I welcome the Minister of State to the Chamber. It is an unenviable task to try to co-ordinate the logistics and roll out a vaccination programme with multiple vaccines in such a short time. It is quite a feat of human engineering to be able to bring these vaccines to the market in such a short time and to have them transported across the globe to vaccinate people as quickly as possible. We should not underestimate that logistical task. It is important that the effectiveness of the programme is not compromised in any way when we bring speed into the process. There should be no mistakes along the way. We must keep a track of everyone who has received the vaccine and the only way we can do that is to have proper systems and processes in place to do it. We will pay the price down the line if things are not done steadily and properly from the outset.

There are a couple of issues that I wish to raise and that have come to me through representations from various groupings. It is welcome that so many different groups are lobbying to get bumped up the list, for want of a better phrase, because the fear was that there would be a massive anti-vaccination campaign, people would be too afraid to take the vaccine and we would not reach the crucial 70% vaccination target in the country. That fear is gone now because people want this vaccine as quickly as they can get it. I am certainly in that category, although, rightly, much further down the line than many others. I am here to advocate for some of those others today.

We need to ensure that there is confidence throughout the vaccine programme. We have only started this process so there is a long way to go yet, but to ensure that confidence, we must underpin the programme with transparency and fairness. Those two things are key. People need to know what is happening and why, every step of the way. They need to know where the vaccines are coming from, how they will get here, why there is a delay if there is one, why they are going where they are going, and the rationale behind those decisions. People need to be fully informed every step of the way.

Fairness must underpin the vaccine programme, and there have been some deficiencies in that regard since the programme began. We have to give a little bit of leeway there because the programme had only just started, was still bedding in and the guidelines were still filtering across the system. We have to give people the benefit of the doubt that those mishaps at the beginning will not happen again. I am referring to the instances where those who were not on the priority list were vaccinated ahead of those who should have got the vaccine first. A number of facilities were involved in that, some of which made the media while others did not. My understanding is that those who were not top of the list were getting in ahead of others in a number of facilities and that should not happen. I hope that is the end of it.

We are going down the line of vaccinating based on age and I question that, not to be difficult but because we have to have these conversations. Age is just a number and is an arbitrary way of assessing the need for a vaccine. A 70-year-old might be in the best of health and would run rings around somebody in their 40s. Somebody in their 30s or 40s may have cystic fibrosis or chronic obstructive pulmonary disease, COPD, and may be immunosuppressed or on a transplant list. Such individuals are in greater need than the 70-year-old I mentioned. Some of them have been cocooning since March 2020 because the risk to their life is greater than somebody who is older but perfectly healthy. The easy option is to choose to roll out a vaccine programme simply based on age. I ask the Minister of State to have that conversation with the Minister, Deputy Donnelly. There is no harm is doing things differently. We can change direction on this. There is nothing wrong with putting one's hands up and saying that, having had time to assess this, we think there is a better way to tweak the programme to make it more effective and work better for our citizens. I ask for that to be considered.

I spoke earlier today to a woman in her late 30s with a six-year-old child. She had a kidney transplant 23 years ago and is already doing better than her doctors ever thought she would when she had the transplant. She is immunosuppressed and has been on drugs since the day she got that transplant. She has not left her house or seen anybody, bar her husband and her child, for ten months. Her parents came to see her in her garden at Christmas.

We all had a little bit of respite over the last ten months. We got a break at Christmas and got to see more people. That did not happen for those who are immunosuppressed because of the fear of catching Covid. The mortality rate for people in that category is between 20% and 25% as opposed to less than 1% for the rest of us. That is the general rate. I am not aware of everyone's medical history. I am assuming that, for the most part, we are all perfectly healthy. This person's biggest fear was that her child, who was going to school, might bring the virus home. Her husband has not seen his elderly mother or had a cup of tea with her for ten months because he will not go into anybody else's house for fear that he might bring the virus home to his wife. That woman should not be waiting for the vaccine. She needs it more than somebody in his or her 80s who is quite healthy and who has no underlying conditions.

Although I am out of time, I will make two more very brief points. The first relates to the vaccine companies. The Minister needs to talk to the Taoiseach and the Cabinet. We need answers as to why the vaccine companies have not met their contractual obligations to deliver the amount of vaccine they signed up to deliver. The citizens of this country need an answer to that question.

Finally, while we are rightly very focused on our surroundings, our country and our people, let us not forget the world's poorest populations and the poorest countries in the world. They are not getting the same access to the vaccine that we are getting. We have a moral and ethical obligation as a First World country to lead and to ensure that people in the world's poorest countries have the same access to the vaccine as we do. Let us not rely on the drug companies to do that job; we must do it ourselves.

I thank the Minister of State for coming here this afternoon for this very important debate on the Covid-19 vaccine programme. Like many other Senators, I put on record my appreciation for our front-line workers across the health system, particularly those who have taken up roles as vaccinators over the last month and who have worked many additional hours over weekends and, in many cases, extended their shifts. We now have an initial team of 1,700 vaccinators in place and more than 4,800 people have completed the training programme. That so many are mobilised and ready to vaccinate as supplies come on stream is a testament to the work of the Minister of State's Department and the HSE.

The effectiveness of these vaccinators is, however, limited by the supply of vaccines they receive. I was concerned by the 50% reduction in the supply of the Pfizer-BioNTech vaccine, which obviously had an impact. I saw that impact in my own county of Waterford as University Hospital Waterford was unable to vaccinate over the last ten days. We should be thankful that vaccinations in the hospital resumed today as the Pfizer vaccine is once again in circulation.

As other Senators have mentioned, serious questions need to be answered by AstraZeneca. Yesterday, I heard the EU's health Commissioner state that the answers the company has given thus far are unsatisfactory. I concur with that. We need to find out whether the company has provided the vaccine not only to the UK but to many other countries in breach of its contractual obligations to the European Union, as has been widely suggested. We need clarification on that urgently. I know that Ursula von der Leyen is also trying to get to the bottom of the matter.

As other Senators have mentioned, there is an urgent need for a dashboard relating to the vaccine roll-out programme. This could be tacked on to the existing Covid-19 app which, incidentally, utilises technology developed by a Waterford company. As vaccines come into the country, it is important for people to see when and where they are being distributed and how many are being administered every day. That is doable and it should be done without delay. It is important that we present those data to give the public confidence.

Confidence feeds into tackling misinformation and the spread of misinformation.

Before Christmas I was horrified to come home from Dublin and find a glossy A4 leaflet, of which I have a copy here. That misinformation was not spread in the way my colleague, Senator McGahon, spoke of so eloquently, that is, on social media. This was the traditional form of the leaflet in the door and I understand it was distributed widely across Waterford city. It links Covid-19 to 5G, says nanochips will be implanted in people and that face masks are unsafe. While I dismissed these things as crazy, I am conscious that there are people who probably read this nonsense and believed it. There is an onus on us as a Government, on every politician, the media and anyone who has access to a social media platform to call out this nonsense for what it is when they see it. We all have people in our own network, maybe people we were in school with when growing up, who have bought into these conspiracy theories. We have seen how quickly they can spread right across our social media platforms and we need to up our game in targeting misinformation.

The utopian view that zero Covid is possible is misleading when one considers the back door that is Northern Ireland. We need to be very careful about what we wish for as regards mandatory quarantine for everybody coming into this country. While we might be lucky to have all our family here in Ireland, there are many hundreds of thousands in this country who have family abroad and so we need to be very careful. People will say in six months that this was not what they asked for. I ask the Minister of State to be careful in this consideration, and I know she is doing so, because we cannot just jump and say in one fell swoop that it is possible to solve everything.

I have enjoyed this whole conversation and thank everyone who participated in it. It was a very meaningful debate. I have taken some notes and will deal with them before I read my script.

One issue about which I am very passionate is SNAs and children with special needs, as well as special schools and special classes. A number of contributors spoke on that matter. Senator Flynn suggested that perhaps SNAs should be considered carers. Believe it or not, while SNAs are under the same union, when working in adult disability services they come under health and care but when working in education they come under education. In adult disability day services they are back and working and are seen as essential front-line workers during level 5. That is a clear thing and it is important for people to know that adult day services are open thanks to the huge work of the providers and families but, most important, the staff who are going out day in, day out, and supporting our vulnerable adults. Senator Flynn is hitting a very clear point on something that is an issue at this moment in time.

Misinformation is an important matter to address and Senators Cummins, Byrne and many others brought it up. There is an onus on all of us as public representatives to be confident enough in our beliefs to be able to speak back to this and speak out about it. Senator McGahon explained the history of vaccination, back to the very beginning, which proves it works. Misinformation is ongoing on social media, as well as through the traditional approach of coming in the letterbox.

I have heard it and could not believe the story of the chip going into one's hand where we are all being tagged. This is absolutely shocking but, as pointed out by Senator Flynn, there is a vulnerability as well in our society where people are listening to news about Covid-19 all of the time. When a different voice is heard, people wonder if there are some merits or truth in it. One would not normally expect vulnerable people to be led in this way. We need to be confident about the whole vaccination issue. It is here for a reason and the whole world wants it. We are very fortunate to be part of the EU where a schedule of vaccines has been put in place for us. At the same time, it is important that people understand why we need it and that it is safe at this time.

We should call out the social media. As I listened to the debate, I wondered if social media platforms allow issues to run so that the Government will have to come in and pay to boost or sell the other side of the story. At this stage, the social media companies themselves should be running such a campaign. There is a big sporting event taking place in the United States next weekend - the Super Bowl or something like that. Rather than being sponsored as normal by a drinks company, which I will not name, on this occasion it is sponsoring the idea that one should take one’s vaccine. That is the right way for us to go. I call on companies like Facebook and Twitter to get involved in a little sponsorship. The Government and public representatives are doing this, but maybe these companies should take the lead by providing sponsorship in support of the roll-out of vaccines. That is all I have to say on fake news.

Senator Craughwell asked a question on nursing homes, all bar four of which have now had their residents vaccinated. The Minister of State, Deputy Butler, clarified that to me yesterday evening. The strategy is agile in its approach but we must have a framework to start with. These are priority groups 1, 2 and 3 and this leads on to the question of how many vaccinations will happen and where. The Minister, Deputy Stephen Donnelly, has always stated that through priority groups 1, 2 and 3, we would have 700,000 people vaccinated by the end of March. What is the composition of those 700,000 people? To start with, and without being morbid, we have to look back at where our greatest losses took place. To be very honest, the greatest losses occurred in the congregated settings of the nursing home environment where staff were on the front line. That is where we had the greatest loss of life. We will, of course, deal with our nursing homes and congregated settings. They make up a portion of this group. Our front-line healthcare staff of 150,000 people and the 500,000 people aged 70 years and over comprise priority groups 1, 2 and 3.

The target that was set out for the end of March was based on having a supply line, or sight of line, of vaccines. This was based in the beginning on having our first two vaccines and then our third vaccine. We have to deal in facts at all times. Between the two vaccines that we had sight of line of in the beginning - in the first three weeks - we had 45,000 vaccines. They require two jabs. We have now used them to deliver 148,000 vaccinations. We are now back to the start again because we have to give the second dose of the vaccine. That is as open, clear and transparent as we can be, as nobody is hiding vaccines. We know what we have contracted to get in. One of the silver bullets, of course, was the third vaccine, which people would know as the Oxford vaccine. This was due to come on stream. We were expected to have sight of line of that. It was supposed to feed into the roll-out of the vaccine to the rest of our front-line healthcare workers, to those over the age of 85 and to those between the ages of 70 and 85. That was to bring us to the end of March.

From the end of March, 1.7 million people, across 12 different priority groups, were to be vaccinated in one go. Senator Chambers spoke about different advocacy groups. Of course, the people with the most serious underlying conditions would have to be at the head of that group, along with carers, who were raised by Senator Carrigy, and the home care assistants who are going into homes.

However, home care assistants do not fall into priority group 1, 2 or 3. It is important for people to know that if someone is a carer and over 70 years of age, he or she is in priority group 1, 2 or 3.

I take Senator Mullen's comments on board and will bring them to my colleagues, the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputy Butler, who has responsibility for older people. I do not like to assume anything, but I assume that the people in question being over 70 years of age means they would fall into priority group 1, 2 or 3.

I will ask the Acting Chairperson for a smidgin of leeway. To my Green Party colleague in government, we will differ on certain points. While I appreciate the flow and openness within the Seanad, all of us in the Government, of which his party is a member, like to stay on the one ship so that mixed messages do not go out to the general public. All of our colleagues in government are together on this point. In fact, it should be non-political and we should be delivering the one message on getting the vaccine and ensuring our healthcare workers, front-line staff and so on are covered in priority groups 1, 2 and 3. We must allow that to happen in the interests of everyone's safety. As the Acting Chairperson mentioned, the pressure we are getting, including via email, from people asking whether they can get vaccinated now is unbelievable. However, we must stick to the strategy even while Professor MacCraith, the Minister and the team in the Department of Health remain agile in their approach, which is continuously changing.

I commend the Minister of State on her response.

I was going anyway.

Second, this is an important issue and I am sure Senators did not mind.

Sitting suspended at 4.02 p.m. and resumed at 4.19 p.m.