AstraZeneca vaccination was suspended on the advice of the National Immunisation Advisory Committee (NIAC) by the Health Products Regulatory Authority (HPRA).

Minister for Health Stephen Donnelly hailed their suspension as “decisive” and “quick”. He passively hoped it would be for a “very short period”. Newspaper editorials commended the suspension. But they were wrong.

Suspension was justified, we were told, by applying the “precautionary principle”. But it was not a valid application of that principle at all.

Hospital Report

About 120,000 people in the State have received the AstraZeneca vaccine and 30,000 more were due to receive it this week. Millions more doses have been ordered and are due to be administered here.

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Given no domestic evidence of thrombosis in Ireland, we were told that a tiny number of possible side-effects in Norway, Denmark and Italy justified suspension of Irish vaccinations until the European Medicines Agency considered the matter.

If there was a risk that justified applying the precautionary principle in favour of suspension, we surely had to model that risk against another risk – a modelled assessment of the foreseeable consequences of suspension.

Exactly what are the modelled consequences of this week-long suspension? Did the National Public Health Emergency Team (Nphet) go strangely silent out of sisterly deference to the NIAC and HPRA? Did Nphet’s Prof Philip Nolan produce a likely projection of increased transmission, infection, hospitalisation, long-Covid cases and deaths consequent on suspending 30,000 vaccinations for a week? Was he asked?

If AstraZeneca is efficacious at all, there are known and predictable consequences to suspending its administration for a week in our present circumstances.

Precautionary principle

We have an emergency Covid-19 situation in which community transmission is occurring. Immediate use of all available vaccination is a vital imperative. Suspending vaccination for 30,000 people per week had additional serious consequences – both for those whose vaccination is delayed and for the wider community – which are capable of being modelled.

While statistical modelling is not a precise science and while any particular infection, hospitalisation or death cannot be identified or predicted, there will be a serious health and mortality toll resulting from the suspension.

If thrombosis was a statistically significant side-effect of AstraZeneca, one might have expected that to become apparent in the UK by now

A true application of the precautionary principle would entail an evaluation of the known or predictable consequences of suspension against any international evidence of the risk of thrombotic side-effects. The UK has vaccinated 11 million people using AstraZeneca.

Presumably the UK vaccinations have prevented many, many infections, hospitalisations, long-Covid conditions and deaths. If thrombosis was a statistically significant side-effect of AstraZeneca, one might have expected that to become apparent in the UK by now. In Ireland, we have had a 20 per cent usage of AstraZeneca. Was there any reason to believe that the risk of the potential thrombotic side-effects (if there is any such risk at all) justified the modelled predictive consequences of suspension?

Consequences of choice

The precautionary principle assumes that avoiding unknown consequences is justified in itself. But the precautionary principle, if applicable to a choice to suspend or not to suspend vaccination, cannot justify creating a known and avoidable exposure of people to additional risk of infection, hospitalisation, long Covid or death without coming to some expert judgment about the likely consequences of making that choice.

Evaluation of consequences – properly a matter for the Minister in the final analysis – does not seem to have happened at all in Ireland. More people, as a virtual statistical certainty, will become infected, hospitalised, develop long Covid and die as a consequence of the suspension.

What does this suspension mean for early reopening of Irish society? Apart from public health infection-related consequences, there are wider social, health and economic consequences for every week of delay. They are very serious too.

The NIAC and the HPRA trumpet the maintenance of public confidence in the vaccination programme as their imperative. But has their suspension really advanced or retarded public confidence? Will more people be happy to be vaccinated this week than last week? Was this suspension justified or rational?

Suspension was not mandated by the science or the data

Or was it misguided insurance against blame? In Tuesday’s papers, some “experts” were quoted as defending the suspension on the basis of the presumed outcry and repercussions if the alleged side-effects materialised to a serious extent. That is not the basis for a proper decision on whether or not to suspend.

Suspension was not mandated by the science or the data. Yet again, an elementary blunder was made by delegating vital decision-making to the opaque complex of bodies that pass for expertise in the area of public health.

Holding down the lid on the lockdown pressure cooker is increasingly fraught and politically difficult. The younger age cohort will simply not accept being confined to their homes for spring and early summer. No amount of checkpoints or exhortatory admonition will stop their social interactions.

The Government holds the reins and must prioritise vaccination at all costs.