Sir, – The coming months are going to bring very difficult challenges and choices for our Covid-19 vaccine roll-out programme. In your editorial "The Irish Times view on the vaccine priority list: a striking anomaly" (January 28th), you have highlighted an anomaly around vaccination for the very high-risk groups, but it does not just apply to those with cystic fibrosis. As you mention, at the moment the very high-risk groups are not being prioritised along with the over-70s, despite often having an equivalent or higher risk of hospitalisation if they get Covid-19.
We already have a clear agreed list of this very high-risk group, also called the extremely medically vulnerable group,
If we keep to the current draft prioritisation groups, this very high-risk group, which includes those post-transplant, on dialysis or having chemotherapy, should not even be vaccinated in hospital settings, where most are attending.
GPs also recognise that while they will have far fewer of these very high-risk patients in the younger age groups, it doesn’t sit well to vaccinate a healthy 65-year old ahead of them.
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A further concern relates to other very vulnerable groups, such as the homeless and Traveller communities, both of which would be relatively easy to target for priority vaccination. Emerging data from the UK vaccination programme is highlighting inequalities in vaccine with more affluent and healthier groups being more likely to be vaccinated, thus compounding the health inequalities already laid bare by the pandemic.
Our National Immunisation Advisory Group has been working tirelessly to prepare the Covid-19 vaccination programme and try and ensure fair and equitable vaccine roll-out. I hope that they can review and revise the draft prioritisation list so that other equally vulnerable groups can be prioritised alongside the over 70s. – Yours, etc,
SUSAN SMITH,
Professor of Primary
Care Medicine,
RCSI,
Dublin 2.