Confidence is a big factor when it comes to mass inoculation campaigns

Every week the Department of Health asks 2,000 people a series of questions about their confidence in vaccines. They ask them how worried they are about side effects, priorities and trust. The results are tracked.

The reason is because when it comes to mass inoculation campaigns, confidence matters. It doesn’t just matter at a pharmaceutical level; it’s also about having faith in the humans giving them to you and the systems designed to ensure it’s done in a safe, efficient and fair manner.

The vaccination of teachers from a private school, done by a private hospital whose chief executive’s children happen to attend the school, risks not only undermining that confidence but detracting from the commonality of purpose that is at the heart of any successful pandemic response.

Clinicians, appalled at the goings-on revealed in the Irish Daily Mail, say at this stage of the vaccination campaign good excuses are thin on the ground.

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Strategies should be put in place, they say, given everything known about the vagaries of missed appointments, doses per vial and the importance of reserve lists that follow the logic of the vaccine prioritisation plan.

After the events uncovered at the Coombe and elsewhere, decision-makers in hospitals must be aware that departing from these strictures risks provoking public ire and associating the entire programme with a toxicity in the public mind.

The story also speaks to deeper concerns about the nature of privilege, access to vital healthcare and equity in Ireland. Bypassing patients in cohort 4 within its walls, and State national schools in closer proximity, compounds this.

It also does a great disservice to the vast majority of those involved in the vaccination programme who are putting the correct jab in the correct arm under enormous pressure.

But this happened, and shows such incidents are happening. They may not be widely representative, but neither are they fiction. And they embed themselves deeply into the public imagination.

Learning

The system – whether the HSE or the Department of Health – must show an interest in identifying these instances and learning from them.

In January, when The Irish Times broke the story of the Coombe, Minister for Health Stephen Donnelly said he had requested a report on it from the HSE – which has not yet been published, understood to be delayed while the Coombe's own review is under way.

The monetary value of the vaccination programme, many tens of millions, alone demands close oversight. But its true value is in its efficacy, measured in its impact on the collective health of the nation.

What is to stop a post-facto audit of a representative sample of vaccination centres? Individual breaches can represent systemic threats, so it’s up to the system to respond. No time like the present.