Donnelly: We’re going to vaccinate 4 million by September, mark my words

The population of the Republic of Ireland, these days, is about four million, nine hundred and four thousand.

So, vaccinating four million people by September means vaccinating in excess of 80% of the population. Given that vaccinated people, in theory, at least, don’t get Covid symptoms, or need to go to hospital, that should mean a return to normal life, with schools open as usual, and no more lockdowns.

But of course, it’s a major hostage to fortune. Here’s what he says:

Updated projections sent by Minister for Health Stephen Donnelly to TDs on Wednesday night say that while 700,000 people will be vaccinated by the end of March, the State now expects to receive some 3.7 million doses between April and the end of June and a further 3.8 million between July and the end of September. This would mean that at least 4 million people could be vaccinated by that time.

Meanwhile, sources have said plans are currently being drawn up to designate the locations of new mass vaccination centres around the country which will be used when the programme of immunisations ramps up in the spring and summer.

Officials in the Health Service Executive (HSE) are drawing up a list of both potential drive-through vaccination locations as well as large premises such as stadia or hotels that could be used. It is understood offers from business owners to use their grounds or premises are being collated at present before final decisions are made.

There are a few things that jump out here, which raise questions, and those questions should probably be answered. Here they are:

First, “drive-thru” vaccination centres? It sounds like a great idea. And in an ideal world, that’s exactly how you’d do it.

The problem is, of course, that the HSE’s own clinical guidance for the administration of the vaccine, which can be read in full here, requires a 15 minute observation period, at minimum, after the vaccine has been given to people. This is in case they develop anaphylactic shock. In cases where people have previously had a poor reaction to a vaccine, this rises to 30 minutes, or more.

How do you run a drive-thru vaccination clinic when every single car must remain parked up for at least 15 minutes? And how do you observe people sitting in their cars? The limits of capacity, for parking, observation, and all the rest of it, are likely to slow the process down considerably. There’s no question of waiving the observation period, obviously, because if somebody was to lose their life as a result of anaphylactic shock, and the Government had waived the observation period that’s presently in their guidelines, the legal exposure would be massive.

Second: How is it proposed to call people to receive their vaccinations? In theory, the Government wants to do this according to a strict hierarchy of criteria: The oldest and most vulnerable first, and the youngest and healthiest last. That makes sense. The problem is that the oldest and most vulnerable are relatively easy to identify, and contact. But once you get down into people in their 40s and 50s, prioritisation schemes become harder and harder to manage. Is the state aware of everyone with a health issue? Do they all have to get letters, inviting them to a vaccination centre? Can people just show up on a given day and request a vaccine?

There’s the potential here for a logistical nightmare. You can’t, obviously, just tell people that they’re now entitled to be vaccinated, and can turn up whenever they’d like. The problem there would be that there would be traffic jams, and chaos, as people rushed to a vaccination centre.

No, people will have to be called individually. Managing and identifying the people to be called is going to be a huge issue.

Third: Where are the staff coming from?

This isn’t an insignificant issue. The logical thing to do, of course, would be to turn the present testing sites into vaccination sites. The HSE already has these sites open, most of them have drive-thru facilities, and experienced staff who’ve been doing their thing for nearly a year now.

The problem with that plan is that people who’ve been trained to test for Covid have not, necessarily, been trained to vaccinate for Covid. The other problem is that while, over time, as vaccinations increase, demand for testing should fall, that won’t be the case straight away. So who is going to physically administer four million doses of the vaccine between now and September?

It can’t be GPs and nurses and hospital staff – they’re all accounted for, already. Every mass vaccination site will, of course, require a doctor and an ambulance on standby, in case somebody goes into shock, or has another unforeseen reaction.

So where are the people coming from to staff these centres?

All of these are fair questions. If they could be convincingly answered, one might have more confidence in the vaccination programme. Anyway, 4 million by September is what they’ve said. Let’s see if they make it.

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