People aged under 50 years and who are not immunocompromised and who have had a Covid-19 infection in the last six months should receive just one dose of a vaccine, at which point they should be considered fully vaccinated, the Cabinet agreed on Tuesday.
In addition, pregnant women are to be offered faster access to vaccines after the Cabinet approved a series of recommendations from National Immunisation Advisory Committee (Niac).
The Cabinet heard that there is good evidence that those with prior Covid-19 infection who subsequently received a single dose of an mRNA vaccine have a similar antibody response to those who have never had Covid-19 and who had received two doses of an mRNA vaccine.
“Further, a second dose of an mRNA vaccine in those who have previously had a Covid-19 infection does not appear to increase the power of this immune response,” the Government said in a statement on Tuesday afternoon.
The mRNA (messenger RNA) vaccines are Pfizer and Moderna. The AstraZeneca and Johnson & Johnson (J&J) vaccines are made using a different process.
“There is some evidence that those aged older than 50 years have a less robust immune response than those under 50 years old. On that basis, Niac have recommended that, for those individuals who have had a laboratory confirmed Covid-19 infection within the previous six months: those aged 50 years and older should receive a full Covid-19 vaccine schedule,” the Government said.
“Those aged under 50 years and immunocompromised should receive a full Covid-19 vaccine schedule.
“Those aged under 50 years and who are not immunocompromised and who have had a Covid-19 infection in the previous six months should receive a single dose of Covid-19 vaccine, at which point they should be considered fully vaccinated.”
The statement does not specify whether or not the first dose needs to be an mRNA vaccine.
Pregnant women
Regarding pregnancy, Niac’s advice will see pregnant women offered an mRNA vaccine between 14 and 36 weeks gestation, after consulting with their doctor.
The decision to prioritise pregnant women for vaccination comes after seven cases of Covid-related placentitis were reported in Ireland, six of which led to a stillbirth.
The Cabinet also approved the use of the Johnson and Johnson (J&J) vaccine in Ireland for the over-50s and relaxed its restrictions on the AstraZeneca shot.
Previously the recommendation on AstraZeneca was it was only to be used for the over 60s but Niac recommendation to reduce this to over 50s was approved by Ministers on Tuesday.
Minister for Health Stephen Donnelly said this afternoon it was now “full steam ahead” for the vaccination programme.
He said Ireland was on course to administer between 160,000 to 180,000 vaccinations this week and more than 700,000 for the month of April.
Following Cabinet approval of changes is expected the HSE could begin administering the single-dose Johnson & Johnson shot this week.
The Cabinet has also accepted another Niac recommendation that there should no change in the gap between doses of Pfizer or Moderna’s vaccine, which Mr Donnelly had asked it to examine amid fears of supply shortfalls to other shots.
The Minister said earlier this month that there was a case to be made for spacing out the doses, and that data internationally and in Ireland showed “incredibly positive signs” in the reduction of cases and hospitalisations from the first dose alone.
However, senior medics and experts had urged caution on the step, saying a significant benefit to the vaccination programme would be needed to justify it. Mr Donnelly had sought the advice of the Deputy Chief Medical Officer Dr Ronan Glynn and Niac on the issue.
However, it also emerged today that deliveries of the J&J vaccine will be halved this week after a shipment of around 26,000 doses of the vaccine for the Republic was caught up in the fallout from an incident at a US factory producing the vaccine.
Delivery shortfalls
It is unclear if the deliveries impacted are only those due this month, which are of lower volumes, or if larger consignments scheduled for the weeks ahead, will also be impacted.
The delivery shortfalls arise from an audit by the US regulator, the Food and Drug Administration (FDA), of a factory where 15 million doses of the vaccine were ruined due to a production error earlier this year.
As a result, Ireland’s second delivery of this vaccine, due this week, will be reduced to around 12,000 doses.
It is unclear if the production issues will impact on deliveries of this vaccine next month next month, when 132,000 doses of the vaccine are expected.
Taoiseach Micheál Martin has said that while there will be a reduction in a coming shipment of J&J vaccines, he is still expecting further large deliveries to come in May and June.
“There has been some reduction in the J&J 12,000 shipment. But the bulk of the Johnson and Johnson vaccine was due in late May and June. The bulk of it is still to come.
“ We already have some in the country. There is a reduction in the second shipment but it was low enough anyway to begin with. They key for the Johnson and Johnson is the 600,000 (figure) over the quarter two period which gives us well in excess of four million vaccines due in that period.”
Mr Martin also said it was “full steam ahead” for the vaccination programme although some time has been lost in between the various changes made to the use of vaccines and scheduling.
The Taoiseach said that last week there was a significant increase in vaccine administration and “this week is looking very good as well and there will be high volume coming in towards the end of the week.”
Meanwhile, the chairman of the Irish Medical Organisation’s GP Committee believes the Government’s vaccination targets of having more than 80 per cent of adults vaccinated with at least one shot by the end of June are still achievable, following Niac’s recommendation.
Dr Denis McCauley was optimistic that 80 per cent of the adult population could be vaccinated by the end of June with the expected approval of the use of the single-shot Johnson & Johnson and AstraZeneca in adults aged 50 and over.
The availability of the two vaccines meant there could be in excess of four million doses in the next quarter which was the primary thing, Dr McCauley said. He said he believes the population of people aged 50 to 69 would “easily be able to absorb” Ireland’s supply of about 600,000 J&J vaccines.
