The Covid-19 vaccine booster programme of third doses is well under way with more than 200,000 already administered, but hundreds of thousands more people are still to be jabbed.
Why is the State 'boosting' people with jabs?
Scientific evidence has shown that waning immunity from the primary two-dose Pfizer, Moderna and AstraZeneca jabs and the one-dose Janssen vaccine starts within months. Breakthrough infection in vaccinated people is higher three to six months after initial vaccination. The Health Service Executive has said that currently about 45 per cent of new infections are among vaccinated people, with older and medically vulnerable at higher risk of severe illness, hospitalisation and death. The fact that some parts of the country have both the highest vaccination rates and the highest infection rates – Waterford, for example – shows that boosters are required. The higher proportion of older people with Covid-19 ending up in hospital is another reason to 'boost' this group.
Which groups are receiving the booster jabs?
The Government started last month with the most at-risk groups: people aged 80 and over living in the community, those aged 65 and over living in residential care facilities and people with compromised immune systems and underlying health issues. The National Immunisation Advisory Committee (NIAC) subsequently recommended extending the booster programme to all people aged 60 and over, and last Monday it added healthcare workers to this list.
When should people get boosters?
The recommendation being followed is that third jabs – a dose of Pfizer mRNA vaccine – should be given at least six months after primary vaccination, though NIAC has said that a minimum interval of five months can be followed for operational reasons.
How many people have received boosters so far?
About 142,000 people among the 161,000 people aged 80 and over have received their doses through GPs and the HSE aims to reach the remainder this month. Booster doses for the over-65s in long-term care facilities is substantially complete with about 23,000 doses being administered to the estimated 25,000 to 30,000 in this group. About 48,000 people among the 100,000-strong immunocompromised group have received third doses. Boosters for people in their 70s just started this week and there are about 336,000 in this group. They are being vaccinated through GPs.
The HSE expects them to be substantially completed within four to five weeks. People in their 60s, estimated to number about 475,000, are being offered their third doses from this week and will be called to appointments by text message. This group is receiving doses through vaccination centres and will be completed by the end of December. About 305,000 healthcare workers will start getting their third jabs from this weekend and the vast majority will receive theirs over the next four to six weeks, starting with patient-facing staff. The HSE is using existing vaccination centres for healthcare workers but plans to administer them through pharmacies as well over the coming weeks.
Are boosters working?
It is early days but initial evidence suggests that they are. Infection rates are not as high among people aged over 75 who were among the first to receive third doses. The National Public Health Emergency Team (Nphet) has said that this may be due to boosters. Israel managed to suppress a fourth wave of coronavirus infections last summer, driven by the more transmissible Delta variant, by giving a third booster dose to people aged 12 and older along with public-health measures.
Could that happen here?
For now, Nphet is not in favour of this. Chief medical officer Dr Tony Holohan said this week Nphet sees boosters as a way of protecting older and vulnerable people from severe disease and does not consider them "a protective control measure" to reduce transmission, preferring basic public-health measures such as mask-wearing, hand-washing and avoiding crowded indoor spaces. Prof Philip Nolan, chair of Nphet's modelling group, said it was "a very big policy question" whether it was appropriate to boost the whole population as a substitute for basic health measures.
Does the HSE have the doses if the Government decides to go this route?
Thankfully, the State is not struggling with the shortages that slowed the rollout of the vaccination programme in the first half of the year. The HSE has a stock of about two million doses available, which is enough to cover all the groups currently earmarked for booster doses, but it can reactivate deliveries if the booster programme is extended.
