Health staff say they are getting ‘least efficacious vaccine’

Health service workers have expressed concern to the Health Service Executive (HSE) that they are receiving the “least efficacious vaccine” available.

In a letter to HSE management earlier this week the group of unions – known as the staff panel – said members were dissatisfied that they were receiving the AstraZeneca vaccine which it said had "only 60 per cent efficacy".

The unions said the Pfizer-BioNTech vaccine had an efficacy of 95 per cent and the Moderna vaccine 94.5 per cent.

The HSE decided to use the Astra Zeneca vaccine for health staff after the Government changed policy earlier this month, on public health advice, not to use this product for those aged over 70 in the community.

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Three vaccines are currently authorised for use in the EU; Astra Zeneca, Pfizer-BioNTech and Moderna.

The Pfizer-BioNTech has a stated efficacy of 95 per cent while the Moderna vaccine clocks in at 94.1 per cent. AstraZeneca say their jab has an efficacy of between 76 per cent and 82 per cent but the European Medicines Agency has stated its efficacy is 60 per cent.

The HSE will sit down with any group of workers to discuss vaccine concerns, according to chief executive Paul Reid.

Any doubts about the AstraZeneca vaccine related only to the lack of data for older people and, from a limited study, to the South African variant, HSE chief clinical officer Dr Colm Henry said.

The efficacy of all three vaccines being used was very good, he pointed out.

The HSE is working on the assumption that the AstraZeneca vaccine will be approved for 65 to 69 year olds, Dr Henry said. Ultimately, Government will decide on this, based on a recommendation by the National Immunisation Advisory Committee.

‘Legitimate concerns’

The unions also said healthcare workers were "raising legitimate concerns that they will not be protected by a vaccine until May/June 2021, as the gap for the AstraZeneca first and second dose is longer than the timeframe for the Pfizer Biontec 21-28 days".

The staff panel letter said that the period where health care workers remained at risk of becoming infected with Covid-19 would be lengthened.

Health service trade unions are also seeking that sick leave taken by healthcare workers due to adverse reactions to Covid-19 vaccination should be categorised as special leave and should not be deducted from their standard entitlements.

The unions said they were aware from engagement with the HSE that “several staff have become unwell and absent from work, directly relating to receipt of the vaccine”.

In their letter to the HSE, the unions said a small number of staff had been hospitalised post vaccine dose.

On the selection of vaccine, the letter said: “The unions and staff associations are experiencing a significant increase in contact from members in recent days, complaining that the HSE are making available the least efficacious vaccine, namely AstraZeneca to frontline health care workers.

"Also, members are pointing out that National Immunisation Advisory Committee (NIAC) and the HSE made the decision to utilise Pfizer Biontec for over 65s and in the intervening time the World Health Organisation guidance with regards to same has changed."

“ The legitimate question being raised by health care workers is that they are dissatisfied that that least efficacious vaccine available is being made available to them with only 60 per cent efficacy. As you are aware this is in the context of more than 26 000 health care workers have been infected with Covid-19, which is 12.5 per cent of all infections in the state. Also, it is worth noting that the 26,000 figure is the rate of those detected with Covid-19 and the HSE will be aware of the high levels of asymptomatic infection and spread. Furthermore, the antibody testing process conducted at several acute hospitals have indicated that the number of those infected by Covid-19 exceeds the numbers that have been detected via the PCR testing process.”

In the letter which was first reported on Thursday by Industrial Relations News and which has been seen by The Irish Times, the group of unions sought explanations on a number of issues:

(1) Can the HSE set out its clinical reasoning why it is making available to health care workers the less effective AstraZeneca vaccine (60 per cent) rather than the other two available vaccines at 94.5 per cent and 95 per cent?

(2) Is the HSE and NIAC reviewing its decision considering the amended WHO advice with regards to the use of Pfizer Biontec for over 65s?

(3) Is the HSE satisfied that it is compliant with the Biological Agents Directive, implemented since the 24th of November 2020, with regards to ensuring the availability of a vaccine to healthcare workers?

(4) What arrangements have the HSE in place to accommodate the requests from health care workers for an alternative vaccine to AstraZeneca?

(5) Has the HSE considered the implications of utilising a vaccine for health care workers that has only 60 per cent efficacy in regard to the maintenance and provision to health services in the short to medium term?

In a statement, the HSE said: “The Covid-19 vaccine AstraZeneca has been approved for use from 18 years of age by the European Medicines Agency (EMA), the National Immunisation Advisory Committee and the World Health Organisation.

“The EMA reported 60 per cent reduction in cases of symptomatic Covid-19 disease from this vaccine and therefore above its threshold for authorisation.

“Further details in studies of the Covid-19 Vaccine AstraZeneca show 70% effectiveness, with no cases of hospitalisation or severe Covid-19 at least 21 days after the first dose of the vaccine.

“Data just released shows 76 per cent vaccine efficacy and no decrease in immunity for the first 90 days after the first dose. Vaccine efficacy was 82 per cent after the second dose with a 12 week interval between doses and this longer interval resulted in the highest vaccine efficacy, which is why this interval has been chosen to ensure the highest and longest immune response.”