The HSE has told nursing homes that some residents who are frail and elderly should not be vaccinated against Covid-19.

HSE Chief Clinical Officer Dr Colm Henry wrote the letter to nursing homes on Sunday, telling them of the possible risk the vaccine represents to those who are very frail or not far from death.

Referencing the revised advice of the Norwegian Medicines Agency and the Norwegian National Institute of Public Health following the deaths of 23 people there, the HSE chief warned the vaccine can cause adverse reactions such as fever and nausea.

“The reports suggest that common adverse reactions to mRNA vaccines such as fever and nausea may have contributed to a fatal outcome in some very frail elderly individuals,” the letter reads.

Dr. Henry also highlighted that natural deaths from underlying causes would occur “during any vaccination campaign”, and that staff and GPs should make decisions on an individual basis in regards to who would benefit or be at risk from the injection.

“Given that the benefit from vaccination only begins about 10-14 days following the first dose and full protection is not achieved until 7-14 days following the second dose of vaccine currently in use, it is not appropriate to vaccinate people if their expected duration of life is less than that for the vaccines to take effect and if, in that context, their overall care is focused on comfort and dignity,” he said.

“All events reported as possible side effects following vaccination are being closely monitored. It is important to note that fatalities will occur from natural causes or background illnesses, and will continue to do so, during any vaccination campaign.

“The National Immunisation Advisory Committee has reviewed the available information and has advised that the vaccination rollout should continue as planned and reiterate that, as in all situations, a careful, individual assessment of the risk/benefit ratio for those receiving a Covid-19 vaccine should be carried out.”

Dr. Henry also stressed that vaccines should be delayed for those with a fever or other temporary illness.

“They should be aware of situations where vaccines are contraindicated and precautions to be taken. Vaccine should be deferred in people with acute febrile illness, those who are acutely unwell until recovery, and for four weeks following diagnosis of Covid-19,” he added.

Pfizer and BioNTech yesterday said they were aware of the Norwegian deaths associated with the vaccine.

“Norwegian Authorities have prioritised the immunisation of residents in nursing homes, most of whom are very elderly with underlying medical conditions and some which are terminally ill,” a statement from the companies read.

“NOMA confirm the number of incidents so far is not alarming, and in line with expectations. All reported deaths will be thoroughly evaluated by NOMA to determine if these incidents are related to the vaccine. Norwegian Health Authorities have now changed its recommendation in relation to vaccination of the terminally ill. Our immediate thoughts are with the bereaved families.“