Is it sensible to delay vaccines if we are at risk of a fourth wave of the virus?

Coming five days after European regulators indicated a link between very rare bold clots and use of the AstraZeneca vaccine, the recommendation on Monday night to restrict its use here was not a surprise in Government. However, there was still some shock over the implications for the rollout of the vaccination programme.

Hours later phones buzzed around Dublin 2 with the news that Johnson & Johnson, whose single-shot, “one-and-done”, vaccine was due to begin arriving in Ireland this week, is to pause its European deliveries after US regulators advised the vaccine be halted. It too was hit by concerns of very rare clotting events.

Suddenly the Government was reeling after a double-whammy to its already stuttering vaccination programme – just as the much-anticipated and hoped-for acceleration of the programme was supposed to be swinging into gear.

The programme strained to administer one million vaccinations in the first quarter of the year. But in the second quarter, during the months of April, May and June, increased supplies are due to facilitate almost four million further vaccines, facilitating a summer reopening, restarting the economy and delivering some political relief to a Government punch-drunk from criticism of its management of the pandemic.

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Now, with question marks over two of the four vaccines, that salvation – personal, political, social and economic – is also in doubt.

The Government immediately scrambled for answers from health officials, demanding to know what the pause in supplies would mean for the programme. They were not immediately available, and a high degree of impatience was evident in Government Buildings on Monday night and Tuesday morning. There were demands for emergency meetings.

Overreaction

Meanwhile, several high-ranking sources suggested that the decision was an overreaction which would damage the State’s vaccination programme, leading to more infections and deaths in the coming weeks.

“How can you insist on an ‘abundance of caution’ when you’re in a race against time with the virus?” one source asked.

A further question was raised: How it was sensible to delay vaccines if, as the deputy chief medical officer Dr Ronan Glynn suggested at an Oireachtas committee, the country was at risk of a fourth wave of the virus?

Several people in Government suggested that the ultra-cautious approach advocated by the National Immunisation Advisory Committee and accepted by Minister for Health Stephen Donnelly and the HSE was an overreaction to a minimal risk.

“You’re more at risk of a blood clot on a flight or using the pill, and I’m not hearing any plans to ban them,” said a Government source.

Other senior figures complained that the recommendations were being made without any regard to their consequences for the vaccination rollout. This point was made by several people across Government.

To many people outside, the jostling is slightly incomprehensible: Aren’t they all on the same side?

Yes and no. Differences between public health experts and politicians are probably to be expected and can even be productive, as the ultimate decision-makers – the elected politicians – gauge the effects of the measures on the wider society.

Degree of risk

No life can function without a degree of risk – it is up to politicians to decide on behalf of society how much risk it has an appetite for.

For some people one death in a million might seem an acceptable risk for society to continue with the vaccine given that more deaths from Covid are certain if the vaccine rollout is hampered. Others would have a different view. But those are political decisions to be made.

That is not, however, how the system is currently working. Still scarred by the third wave over Christmas and the new year, politicians remain terrified to deviate in any way from the public health advice. In reality, the key decision-makers remain the doctors and the senior health officials. Politicians just carry the can for them. They can expect a torrid few days.