The director general of the HSE, Paul Reid, has said his frustration levels with delays of deliveries of AstraZeneca would “blow the roof off.”
The ongoing difficulties – from an operational and planning point of view, were “very significant” he told RTÉ radio’s.
Mr Reid gave the example that the 165,000 doses due to be delivered next week had been pushed out another week while only 9,000 doses would be received of the 44,000 doses scheduled for this week.
The HSE chief executive said he wanted to roll out the vaccination programme as quickly as it could be, and that health officials wanted to use the Johnson & Johnson vaccine to sort out the disruption caused by the AstraZeneca deliveries.
He pointed out that of the 15 deliveries of vaccines due in the past three weeks, 14 of those had been changed.
“That’s the kind of change we’re dealing with,” he said.
The National Immunisation Advisory Council (Niac) decision on Johnston & Johnston would be an important decision for everybody, he said, particularly for the campaign to protect vulnerable groups.
“We want to get on with our vaccination programme,” said Mr Reid.
Mr Reid said he wanted to see a return to normal society and of the economy.
“We are in a better place, but we really still need to be careful,” he said.
Overall the picture was positive, he said and added there had been a reduction in hospitalisations, the numbers in ICU and the number of deaths.
As the vaccination programme progressed, more benefits would be seen.
But he cautioned that a dual approach was needed, the vaccination programme and public health measures – people needed to continue to do “what they need to do”.
There were two other priorities, he said. To administer the vaccine in an efficient manner and to give the Government the opportunity to make decisions on the easing of restrictions.
The public was responding well to the vaccination programme, with 1,750 in the 64 age group already signed up before 7am on Friday.
When asked if people in this age cohort could wait until late in the summer to get a vaccine other than AstraZeneca, he said it was the approved vaccine for that age cohort.
“There isn’t a vaccine choice that we can offer people,” he said.
The protection provided by the vaccine was really strong, he added, compared to the risks of putting off getting vaccinated.
There was no clarity given by Mr Reid about supply for Q3 and Q4.
Mr Reid said he would encourage people to come forward for their vaccine now.
“If you don’t come forward you’re putting yourself at higher risk.
“I can’t offer a choice [of vaccine]. I can’t guarantee another vaccine. To leave it to later is putting themselves at risk,” he said.
People who were in the high-risk category 4 (under the age of 60) who had their appointment cancelled because of the decision on AstraZeneca would shortly be contacted as supplies of MRNA vaccines were sourced, he said.
Mr Reid added that 95% of the over-70s had now been vaccinated, while a small number would be carried forward because of a timing issue with the Moderna vaccine.
Next week, the numbers operating the programme to bring the vaccine to the housebound would be doubled and call centres were working to validate that patients were residing at the address listed.
Mr Reid said there had been some incidents of members of the National Ambulance Service arriving to find that the person was not there – they had either moved to the home of a family member, or to a nursing home or had passed away.
“I want to restate the commitment, nobody will be left behind,” he said.
When asked if the HSE would be taking a legal case against AstraZeneca, Mr Reid said all engagements with the manufacturer were through the Department of Health, and that any decision on legal action would be through the department.
Meanwhile, the HSE's chief clinical officer has said he thinks the Johnson & Johnson vaccine should be given the green light for use by Niac.
Speaking on, Dr Colm Henry pointed out that both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) had acknowledged there were rare side effects, but he thought it should be used.
“Go ahead, it's a good vaccine, it works well, it's single-use, attractive certainly for mass vaccination centres and for certain vulnerable groups,” said Dr Henry.
Dr Henry said many hard lessons had been learned since last summer.
“In ways, it was a year of magical thinking where we all wished it would go away, we wished the virus would change – what happened instead is we got a variant that was even more transmissible – probably 30-50% more transmissible. The virus, other than that new variant, it hasn't changed what it does, it goes from person to person.
“The harm it is doing to vaccinated groups is reducing, but remember it is not just older people or vulnerable people who are admitted to hospital,” he said.
Dr Henry said everyone hated the word cautious when it came to the easing of restrictions. There was a phrase in Irish, he said, “Tá ciall ceannaithe againn” which means “we’ve bought sense” and that’s what an incremental phased opening meant. He added the vaccination programme was having an impact.
“That's good news, that's good evidence, but it's some time to come before the vaccine seeps through all those people who might be hospitalised,” he said.
The real-world evidence from Israel and particularly the UK where the AstraZeneca vaccine had been used widely, was that there was substantial protection a number of weeks after the first dose, he added.
However, he said it was not a surprise that there were a number of cases of blood clots linked to AstraZeneca in Ireland as it was a known side-effect.
“It's very rare, so it's not a surprise, we will see cases here. I have to emphasise that we're seeing strong evidence, especially from Scotland, that it has the capacity to reduce serious illness. It is much better than we wished for in the clinical trials,” said Dr Henry.
He said that Niac was working very hard to reach a decision on Johnson & Johnson.
“I know what factors into their decision are the supplies, how quickly we can get the vaccine out to people and that played into their decision on AstraZeneca when they felt there's another vaccine available that we can use, that we can get to people in good time.
“I have no doubt they will be working over the weekend and early next week to come to a decision very soon.
"There are brighter days ahead, we're not out of it yet, but we're making strides definitely," said Dr Henry.
Meanwhile, immunologist Professor Tomás Ryan has warned that any easing of restrictions will have to be cautious as numbers continue to be of concern.
“If we want to keep the schools open, then we need to be cautious how we open up,” he told.
“The reality is something has to go,” said Professor Ryan.
The spread of the virus at present is happening in the 20-50 age group, he said and while they were not likely to die, they could still spread the virus. This meant that the risk to individuals could be low, but the risk to society was high.
The vaccine rollout had “neutered” the worst effects of the virus, but hospitals and intensive care units could still be overwhelmed “if we let it rip”.
Prof Ryan said the country is in "a dangerous middle zone” and that if infections continued to rise there could be deaths in the 20-45 age category.
He said it was clear now that schools were "contributing to the story”, and that everyone wanted schools open and hated restrictions and wanted a normal summer, “but we can’t have everything in the real world”.