Dáil Éireann Debate, Wednesday - 21 April 2021
2189. Deputy Mary Lou McDonald asked the Minister for Health if the national immunisation advisory committee advisory group on cardiovascular patients has considered the HSE national heart programme submission which recommends that patients under 70 years of age waiting for cardiovascular surgery be placed in the vaccine allocation group four; and if he will make a statement on the matter. [20083/21]
View answerThe COVID-19 Vaccine Allocation Strategy developed by the National Immunisation Advisory Committee (NIAC) and my Department, was endorsed by the National Public Health Emergency Team (NPHET) and approved by Government on 8th December 2020.
The aims of the vaccination programme are to ensure equitable access to safe and effective vaccines with the goals of limiting severe disease and death from COVID-19, protecting healthcare capacity and enabling social and economic activity.
The NIAC is an independent expert group that provides evidence-based advice to my Department on vaccines, immunisation and related health matters to inform health policies in Ireland. The general approach taken by the NIAC for prioritisation to help with planning for vaccine implementation is based on:
- disease burden and severity in risk groups
- impact on society
- vaccine specific information
- moral equality of the person, minimising harm, fairness, and reciprocity.
Given that vaccine supplies were initially going to be limited, a number of groups were prioritised for receipt of vaccine on the basis of the epidemiology of COVID-19, preliminary information on vaccines, and in line with the ethical principles set out in my Department's Allocation Framework for Equitable Access to COVID-19 Vaccine(s).
In line with the primary objective of the vaccination programme, to reduce mortality and morbidity as a consequence of COVID-19, those aged 65 and older residing in long-term residential care facilities (LTCFs) were prioritised, as were frontline healthcare workers. Increasing age is the clearest risk factor associated with hospitalisation, ICU admission and death. This risk is amplified for older persons living in long-term residential care as they have a higher risk of exposure to infection. Frontline healthcare workers are also at high risk of exposure to SARS-CoV-2 and are vital to maintaining the delivery of healthcare services.
The provisional vaccine allocation strategy contained a commitment that the priority groups would be kept under review and would be updated and adapted where necessary considering any new evidence and/or a changing epidemiological situation. Since the publication of the provisional priority listing at the beginning of December, Ireland has experienced increasing disease incidence with extremely elevated case counts reported through late December 2020 onwards. Concurrently, there has been the emergence of SARS-CoV-2 variants of concern, including the B.1.1.7 variant which is the predominant circulating strain in Ireland currently.
In the initial vaccine allocation strategy, the NIAC listed several medical conditions associated with an increased risk of serious illness and death. In the interim, additional national and international evidence has become available which enables a more detailed examination of specific underlying medical conditions which increase the risk of developing severe disease or death following infection with SARS-CoV-2. This has allowed the NIAC to sub-divide those with specific medical conditions into those at very high-risk and those at high risk of serious disease and death. The list of conditions considered is not exhaustive and will need to be further informed by clinical discretion.
The NIAC has completed a review of the epidemiology of COVID-19 disease, as well as an extensive literature review, and deliberations have also been informed by submissions from HSE clinical programme as well as submissions from a wide variety of stakeholders. The NIAC recommendations have also been informed by my Department's Vaccine Allocation Framework for Equitable Access to COVID-19 vaccines.
The updated allocation strategy is presented below in order of priority.
|
1 |
People aged 65 years and older who are residents of long-term care facilities (likely to include all staff and residents on site) |
|
2 |
Frontline healthcare workers |
|
3 |
People aged 70 and older |
|
4 |
People aged 16-69 with a medical condition that puts them at very high risk of severe disease and death |
|
5 |
People aged 65-69 whose underlying condition puts them at a high risk of severe disease and death |
|
6 |
Other people aged 65-69 and key workers essential to the vaccine programme |
|
7 |
People aged 16-64 who have an underlying condition that puts them at high risk of severe disease and death |
|
8 |
Residents of long-term care facilities aged 16-64 |
|
9 |
People aged 64 years and younger, and people aged 16-64 living or working in crowded settings (in parallel) |
