Up to 40 large vaccination centres to be introduced across the State - HSE chief says

Up to 40 big vaccination centres will be put in place across the State to administer Covid-19 vaccines, according to Health Service Executive chief Paul Reid.

He said some of these facilities could have 40 to 50 lanes, or places, for people to be vaccinated while others may have 10 to 20 such bays. Significant progress had been made concerning deployment of such new centres across the country and the workforce that would be required, he added.

Mr Reid said such new facilities are being worked on in parallel with the immediate plan for administering the vaccine to several hundred thousand people over the age of 70, which will include the establishment of three GP-led centres in Dublin, Cork and Galway.

However, the HSE chief executive promised that older people who are immobile at home – and who could not get to proposed vaccination centres – "will not be left behind". He said transport could be arranged using local authorities or the Defence Forces while the HSE would also consider how vaccines could be brought to the homes of people concerned.

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Operational plans to vaccinate 483,000 people over the age of 70 across the State had to be changed last week after the Government, on expert advice , decided to use the Pfizer and Moderna vaccines rather than the AstraZeneca shot as had been envisaged originally.

However, Mr Reid told RTÉ’s This Week programme on Sunday that this would not lead to significant delays in carrying out the programme. He said people over 70 will receive their first vaccination by mid-April and their second by mid-May. He said it had been planned that originally the first doses would have been provided to those over 70 by the end of March.

He said the revised plan to administer the Pfizer and Moderna vaccines to older people would commence on Monday, February 15th, starting with those aged over 85.

Mr Reid said the majority of GPs would give the vaccines to patients in the over 70 cohort in their own practice. As part of the new system for administering the vaccines to people over that age a number of large scale vaccination clinics are to be established in Dublin, Cork and Galway.

The first of these clinics will be set up at Dublin City University (DCU) where patients attached to 121 practices across the capital will receive the Pfizer or Moderna vaccine.

Details of the new plan have been worked out following talks between the HSE and the Irish Medical Organisation.

Date of the first deliveries

However, under the new plan which was finalised on Friday night between the Department of Health/HSE and the Irish Medical Organisation (IMO) most patients over the age of 70 will still receive the vaccine from their own family-doctor practice.

There are just under 490,000 patients over the age of 70 in the Republic and within this cohort the first group to be vaccinated are 72,000 people over 85. Subsequently, people between 80 and 84, 75 to 79 and 70 to 74 will receive the vaccine.

The plan says the vaccination programme will commence with first deliveries starting on the week of February 15th and ramp up in subsequent weeks

“The deliveries will be scheduled in line with a) supply lines and b) starting with practices who have the largest number of over-85s and working down through the GP practices over the weeks of 15th February, 22nd February and 1st March during which time the objective is to vaccinate patients over 85 and then continue on with the age schedule.

“All practices with more than 200 over-70s on their list will receive deliveries through cold chain and operate their vaccination clinics within their own practice premises.”

Patients will all receive two doses of either the Pfizer or Moderna vaccines .

However, for the estimated 400 general practices around the Republic, with fewer than 200 patients over the age of 70 on their books, there will be two systems for vaccinations put in place.

The first will be through the establishment of larger-scale GP vaccination clinics and the second will involve GPs with a small number of patients over 70 “buddying up” with a larger practice.

“The vaccination clinics in urban centres will be at agreed locations . The first of these will be at Dublin City University, where patients aged over 70 attached to 121 practices across the capital will receive the vaccine. Other such centres are expected to be established in Cork and Galway.”

The plan says the new centre at DCU will operated by GPs, practice nurses and administrative staff “who will do sessions and be led by a lead GP to organise rotas and scheduling”.

“All booking, registration and payment for your own patients will be via your own practice management system – the only change is the venue at which the patient will receive the vaccine. The clinics will operate in the agreed age phases until all these patients are vaccinated and at the 28-day intervals. These clinics will operate at weekends.”

The IMO told members at the weekend: “For a small number of practices outside of Dublin, Cork and Galway we are assisting those GPs who have less than 200 patients on the over 70 age category in buddying up with a larger practice in the area.”

The IMO said it is hoped that all GPs and all practice nurses would be vaccinated prior to rollout of the programme.

What is the order of vaccination?

Separately, the HSE on Friday set out new guidelines on the sequence in which healthcare workers should be vaccinated in the weeks ahead.

It said the AstraZeneca vaccines would be administered to frontline healthcare workers as supplies arrived in the State. The HSE is to ask all frontline staff to register on an online portal, which will come into effect next Tuesday and which will be used to facilitate scheduling of your vaccination appointment

The HSE said the AstraZeneca vaccine requires two doses and the evidence demonstrated that higher efficacy was achieved with an interval of 12 weeks between the first and second for those under 65. It said the interval for those 65 to 70 would be six weeks. The guidelines set out the sequence to apply for the vaccination of healthcare workers in its own facilities or in private hospitals/clinics and other community-based not-for-profit and private-healthcare providers not directly funded by it who have not already received a vaccine.

The HSE said the sequence should be based not on where, or for who, the staff worked but on the type of work in which they were engaged as well as the setting.

“Healthcare workers from all staff groupings who work in the units, wards or services, community settings day, residential and respite services, all the time, or who attend occasionally must be included. Examples of these are support staff, agency staff, students, administration staff, volunteers and other healthcare professionals (physiotherapists, public health nurses, speech and language therapists, home support workers, radiologists, pharmacists, etc). Healthcare workers who usually work in these roles – but who are out of work due to, for example, sick leave, high- or higher-risk medical status, maternity leave etc – must be included for vaccination in the relevant groups/cohorts.”

Those in the first of several categories listed in the new sequence document are healthcare workers in a congregated care setting (unit/ward/service) in contact with a known or suspected Covid-19 patient/service user where there is potential for active transmission of the virus.

The next category includes healthcare workers who deal with unscheduled care patients/service user on a regular basis in an uncontrolled environment and includes first responders in the community and those in the emergency child-protection services.

The next group listed are healthcare workers who deal with unscheduled care patients/service users in a semi-controlled environment on a regular basis. These are those who see, in the main, patients/service users by appointment but who may from time to time need to see urgent unscheduled patients/service users. The group includes urgent care-facility clinical staff, GP practice staff, GPs/practice nurses as well as dentists and dental nurses providing urgent dental care.