A “critical window of opportunity” was missed by not initiating widespread vaccinations of nursing homes immediately after shots arrived in the country, an Oireachtas committee will hear on Tuesday.

Nursing Homes Ireland (NHI), which represents the sector, will tell the Health Committee that despite nursing home residents and staff being designated the top priority for vaccination, “just 10 per cent of the initial 77,000 vaccinations administered by mid-January were within nursing homes”.

NHI chief executive Tadhg Daly will say “the first vaccines arrived in Ireland on December 26th, yet the first was only administered in a private or voluntary nursing home on January 7th, 2021. Every day is vital for our nursing home residents and staff.”

Hospital Report

HSE figures show that on January 13th, 7,925 vaccinations had been administered in long-term residential care facilities, while 69,378 had been given to healthcare workers.

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Nursing home residents accounted for 37 per cent of more than 1,000 Covid-19 deaths in January.

In December, The Irish Times reported the plan to vaccinate nursing homes was slightly delayed after reports of anaphylaxis emerged in some individuals elsewhere.

Based on these reports, the National Immunisation Advisory Committee (NIAC) said it would prefer if the first tranches of vaccines be given in hospitals, where expert medical support would be available in case of adverse reactions. Nursing home vaccinations were accelerated on January 8th.

Sources said on Monday night that NIAC had indicated the AstraZeneca vaccine could be used as an option for the over 65s, but sources said that other factors would be considered and that there may be some nuances relating to its administration.

The committee met on Saturday and again on Monday and was to issue advice yesterday evening to the Department. The European Medicines Agency (EMA) last week approved the vaccine for use in all adults, although German health authorities have limited its use in older cohorts.

First sweep

NHI will also tell the health committee that a system should be outlined for vaccinating residents and staff who missed the first sweep of nursing homes.

HSE “mop-up” guidelines for this process, seen by The Irish Times, state that vaccinators will only visit nursing homes which had Covid outbreaks where there are at least six residents, or three residents and a minimum of nine staff members, to be vaccinated.

The guidelines state that where there are fewer than this number to be vaccinated in care facilities with outbreaks or where residents missed the first dose due to being sick with Covid-19, the residents will be vaccinated at a weekly “vaccination hub” outside the nursing home between day 21 and 28 after the first dose.

The guidelines state that first doses for nursing home residents who missed them should only take place on the day of second-dose vaccinations if there is excess vaccine available.

“Dose wastage must be minimised, so any mop-up done on site must ensure that the maximum number of doses can be extracted from the vial,” state the guidelines, which are designed to maximise doses and resources.