The long-awaited ramping up of the State’s vaccine programme against Covid-19 gets under way from this week, although the acceleration in supply looks set to happen more gently than originally forecast.

Up to 960,000 vaccine doses are expected to be delivered to Ireland this month, according to informed sources – about 100,000 more than was reported last week.

With about 90 per cent of supplies being used within days, this points to at least 860,000 people receiving a vaccine dose in April.

Hospital Report

These figures mark a significant improvement on the 1.18 million doses that were shipped to Ireland in the first three months of the year.

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More than 30,000 people were vaccinated on Good Friday, the first time the daily figure approached something like the intended peak capacity of the system. Overall last week, 120,000 doses were administered, up on the 100,000 recorded the week before.

Last week was also a good one for deliveries, with 100,000 doses of AstraZeneca, 80,000 doses of Pfizer/BioNTech and a small shipment of Moderna vaccine received.

Government and the HSE had consistently promised vaccine rollout would be significantly ramped up in the second quarter of the year, when the delivery of 3 million doses was expected.

Bumpy rollout

It now appears there will be some backloading of the overall supply, with deliveries increasing over time between April and June.

Given the bumpy history of the rollout so far, it would not be surprising if further setbacks were to occur. Supplies are confirmed by the drug companies for just two weeks, so everything beyond that is in the realm of forecasting.

On the ground, the rollout is still beset by a number of issues, many of them related to prioritisation.

More than two-thirds of the over-70s have received a first dose, and inoculation of this cohort is expected to be completed next month.

However, the process of identifying very high-risk patients, who are also being vaccinated at present, remains ongoing. The lack of a national disease register, and associated IT infrastructure, is being sorely felt as doctors struggle to identify qualifying patients on their lists. The HSE is even considering an advertising campaign to make contact with “hard-to-reach” patients.

The HSE originally “guesstimated” there were 150,000 people in this cohort, but it now believes there may be more than 200,000. Some doctors report coming under heavy pressure from patients to be included in this cohort, but the HSE insists there is “clear clinical guidance” on who qualifies.

It all sounds somewhat similar to the expansion of the frontline healthcare worker category, more than 244,000 of whom have been given a first dose. This is three times the number of frontline HSE workers, and no breakdown of vaccinations in the cohort has been forthcoming.

Meanwhile, there are an estimated further 500,000 patients in the “high risk” category 7, who will be inoculated after* 65- to 69-year-olds. It will be interesting to see whether the size of this category rises before then.

Age-related prioritisation

Several thousand vulnerable cohort 4 patients from all over the country were vaccinated at the Aviva Stadium over the weekend. Asked why they weren’t dealt with closer to home, a HSE spokesman explained that many were patients of the larger Dublin hospitals, which would have arranged the appointments for them. Patients were free to receive the vaccine in hospitals closer to home if they wished, the spokesman emphasised.

While the switch to age-related prioritisation has generated controversy over the past week, particularly among teacher and Garda representatives who feel their members are being overlooked, the real mystery is why this system was not adopted from the start.

Experts seem to have waited for evidence that shows particular occupations are not at increased risk due to the work they perform. Yet it was always obvious that the risk posed by the virus rises massively with age, above all other factors.

About 250,000 vaccines a week will have to be administered starting next week, if the promises of ramping up are to be kept. So far, less than half of the 37 planned mass vaccination centres are up and running. Doubts have been expressed about the ability of the HSE to delivery sufficient manpower to administer this level of doses, fanned by its failure to confirm how many vaccinators will be available to deliver doses later this month.

Despite these issues, the administration of the one millionth vaccine, likely to happen later this week, is a significant milestone for a programme that should be looking forward to better days from here on.

*This article was amended on April 7th, 2021.