Covid-19 vaccine: HSE extends interval between first and second jabs in move to vaccinate more people

The HSE is extending the interval between the first and second doses of the Covid-19 vaccine from 21 to 28 days in a move that will spread the benefit of the vaccine to more people.

In a letter on Thursday, HSE management was told that the interval was being extended to 28 days for “anyone who has their first dose of this vaccine from Monday, January 18th, 2021.”

The Pfizer-BioNTech vaccine, the only Covid-19 vaccine being administered in the State, is about 52 per cent effective after the first dose, according to data published by Pfizer last month.

The extension of the dose interval will mean that there will be more vaccine first doses available to be given to frontline healthcare workers in hospitals and to residents and staff in nursing homes who are all being inoculated in the early stages of the vaccination programme.

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Tánaiste Leo Varadkar on Friday said the only constraint on the speed of rolling out the vaccine is supply.

“There are unfortunately two things that are not under our control. The first is when the vaccine gets apprived by the EU. Secondly, it is the rate which manufacturers can supply it.

“I heard news today that Pfizer might be closing down its speed and that is something that is not under our control.”

The HSE said that the National Immunisation Advisory Committee updated their advice on the dose interval for the vaccine in guidelines published on Wednesday. The guidelines show that the vaccine course consists of two doses between 21 and 28 days apart.

“If the interval between doses is longer than 28 days, the second dose should still be given as soon as possible. The course does not need to be restarted,” the guidelines state.

All long-term care facilities will be sent new information leaflets to allow them to inform residents and staff of the change and aftercare leaflets are being updated with the changes.

"It is vitally important that all stocks of old information materials and aftercare leaflets are removed from circulation so that they cannot be used from 18th January," says the HSE letter from senior manager David Walsh to management across the health service.

“The vaccinator should confirm to the recipient at the time of vaccination that their second dose is due 28 days after the first dose. Schedules for second dose of vaccinations should be updated accordingly.”

Nursing home management, staff and relatives of residents have been calling for an acceleration of the vaccination programme to 24 hours a day, seven days a week as the high level of virus in the community is leading to an increase in the number of outbreaks in care facilities.

The HSE said this week there were 142 nursing home outbreaks and that it was monitoring 103 closely. Including all long-term care facilities, there are 279 open outbreaks.

The number of new nursing home outbreaks more than doubled to 52 last week.

Concerns have been expressed by nursing home managers and advocates for nursing home residents that the vaccine may not be administered in long-term care facilities that are battling outbreaks where there are 50 residents and more than 80 per cent have Covid.

The vaccine cannot be given to anyone who has a Covid infection or who has had an infection, shown symptoms or tested positive in the previous four weeks.

Protection from a first dose of the vaccine does not kick in until at least 12 days and the single does is significantly less protective than two. There is 95 per cent protection from two doses.

The HSE said this week that more than 77,000 Covid-19 vaccines have been administered, including 69,378 vaccinations going to frontline healthcare staff.

A further 47,600 vaccinations are planned for next week, of whom about 3,900 will be receiving their second vaccination under the previous 21-day interval.

First dose

As of January 13th, 77,303 people had received the first dose of the Covid-19 vaccine, according to the Government's Covid-19 data hub website, which states the page will be "regularly updated".

It emerged on Thursday that vaccine roll-out in nursing homes is being recorded with pen and paper as the IT system to deal with the inoculation programme is not in place. Independent TD Cathal Berry, who is also a medical doctor, told the Dáil that "in effect, we are combining 21st century cutting-edge vaccine medicine with a 13th century means of recording it, which is simply a pencil and paper". Tánaiste Leo Varadkar acknowledged that vaccinating in nursing homes and in healthcare settings was "a pen and paper exercise at the moment". He said an information technology (IT) system had been delivered to the HSE at the end of December. "We will very much need the IT system when we go out to the GPs and pharmacies. I am told that we will be ready for when it is required, which is, most likely, next month sometime."

At a briefing on Thursday afternoon, HSE Chief Executive Paul Reid said 69,378 of the vaccines were received by frontline healthcare workers and 7,925 were received by people in long-term care facilities.

The Government expects that at least four million people in the State will be vaccinated against Covid-19 by the end of September.

Updated projections sent by Minister for Health Stephen Donnelly to TDs on Wednesday night say that while 700,000 people will be vaccinated by the end of March, the State now expects to receive some 3.7 million doses between April and the end of June and a further 3.8 million between July and the end of September. This would mean that at least 4 million people could be vaccinated by that time.

It is expected, however, that most adults will be vaccinated by the end of the summer once additional vaccines are approved by the European Medicines Agency in the coming weeks.

Ireland began vaccinating its population at the end of December using the Pfizer/BioNTech vaccine.

On Tuesday afternoon, the first delivery of the Moderna Covid-19 vaccine arrived in the country . Ireland has pre-ordered 875,000 doses of the vaccine.

On Twitter Minister for Health Stephen Donnelly said the first delivery was a small one, but that “every vaccine counts”.

The Oxford/ AstraZeneca vaccine entered the final phase of the approval process during the week, according to the European Medicines Agency. A statement by the agency said an opinion on the marketing authorisation could be issued by January 29th.