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With coronavirus numbers spiraling out of control in Ireland and many other countries, there will inevitably be an intense focus on the progress made by governments in vaccinating their populations against Covid-19.
In 12 months, the difference between a slow and a fast launch of vaccines here will likely be measurable in terms of the loss of hundreds of lives, along with tens of thousands of jobs.
So far, Ireland has gotten off to a slow start, leaving the government and health officials exposed to accusations of slowness and delay. By the end of December, one in 2,500 people had been vaccinated, compared with one in eight in Israel and one in 80 in the US and the UK. By that date, 1,800 Irish people had been immunized, according to Our World in Data, compared with more than 40,000 in Denmark, a country with a population slightly larger than ours.
The criticism will only intensify as the number of cases increases pressure on the health service and forces much of society to remain closed. The best answer for them is to make great strides in vaccinating the population, but this depends on a sufficient supply.
This, in turn, is contingent on clearances from Irish and EU regulators, which have so far tended to lag behind other jurisdictions. Another factor is the size of the order placed by the EU on behalf of the member states for individual vaccines.
It was only after heavy pressure from Germany that the European Medicines Agency made its decision last month on the Pfizer / BionNTech vaccine, and it must now make a decision on the Moderna vaccine in the coming days.
The agency is not alone among regulators struggling with Oxford / Astra Zeneca’s application for its vaccine, and its requirement that additional data be provided has delayed a decision on the matter until February.
Workhorse Vaccine
The problem is that this vaccine was conceived as the workhorse of European vaccination programs, because it is cheap, easy to transport and works in a similar way to existing vaccines, unlike the Pfizer / BioNTech and Moderna treatments, which use novel technology.
The EU opted for a strategy of not putting all its eggs in one basket by ordering six different vaccines. You may also, with the benefit of hindsight, have spent too much time haggling over the price. Several of last year’s potential contenders were delayed and regulatory decisions moved slowly, leaving the bloc with insufficient orders for the vaccine that came out of the traps first, Pfizer / BioNTech.
As a result, it doesn’t make much sense for the Irish vaccination program to “get ahead of itself” until a broad and safe line of vaccines is put in place.
Until that happens, we will have to make the best possible use of what we have. The UK has delayed the second dose of the vaccine so that more can administer a first dose and thus enjoy the partial protection it offers. This approach has divided scientific opinion. Even drug makers are divided, Pfizer resolutely opposes any delay in delivering a second dose of its vaccine, and AstraZeneca is more sympathetic to the idea.
For now this approach has been scrapped in Ireland, but another idea we can take from the UK is to extract six doses from a vial of Pfizer / BionNTech vaccine instead of the recommended five. When the correct needle is used, the content of the dose can be divided into six ways, instead of using five times and leaving some liquid. This could potentially increase productivity by up to 20 percent.
Who is the boss?
Some countries have decided to start their vaccination program with working-age adults rather than vulnerable residents in nursing homes, but this approach is unlikely to favor Ireland.
At this point, it’s hard to tell who is running the vaccine deployment program here. Is it the Department of Health that has decided the public health response during the pandemic? Or the HSE, which administers the vaccines? Or the working group that developed an implementation plan and is still active?
While the UK began administering the Oxford / Astra Zeneca vaccine at 7.30am on Monday, the Department of Health referred Irish journalists seeking updates on Modern vaccine supplies to HSE and HSE to the department. A nursing home vaccination plan was delayed Monday, apparently for consent issues. GPs still wonder when they and their staff will get vaccinated.
At least Health Minister Stephen Donnelly was able to announce an increase in this week’s vaccination target from 20,000 to 35,000.
Hopefully none of these initial issues will matter in the long run, but greater clarity would do no harm.
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