People in their 40s to be given choice of AstraZeneca or J&J vaccine

Strict conditions will apply following advice from National Immunisation Advisory Committee

Niac made recommendations about the accines  to chief medical officer Dr Tony Holohan over the weekend. File photograph: Brian Lawless/PA Wire
Niac made recommendations about the accines to chief medical officer Dr Tony Holohan over the weekend. File photograph: Brian Lawless/PA Wire

People aged in their 40s will be given the choice of using the AstraZeneca and Johnson & Johnson vaccines, but under strict conditions.

Following advice from the National Immunisation Advisory Committee, the age limit for the two vaccines is being reduced from 50 to 40 years, HSE chief clinical officer Dr Colm Henry has confirmed.

Niac, which made recommendations to chief medical officer Dr Tony Holohan over the weekend, considered the administration of the two vaccines to people in their forties “with some conditions attached,” he said.

Dr Holohan is understood to have endorsed Niac’s recommendation in his recommendation to Government. The HSE has now been asked how to operationalise the proposals.

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Sources said that implementing the advice will be “tricky” as it is not clear whether the information on risks can be given through existing frameworks and structures in the vaccination programme, or if they will need to be modified. Other aspects, such as whether the conditions attached complicate plans to roll out the vaccine through community pharmacies, also need to be examined.

The recommended conditions would include ensuring people have full information about any potential risks and ensuring the two vaccines could be administered to younger people at a quicker pace than the Pfizer or Moderna vaccines, Dr Henry said.

People who decline to accept AstraZeneca and Johnson & Johnson will be offered mRNA vaccines (Pfizer or Moderna) as supplies come available.

Dr Henry told Newstalk’s Pat Kenny show that Niac had sent new advice to the Government.

“We received some information over the weekend indicating the line of thinking of Niac as it was relayed by the CMO to the Minister for Health.

“That certainly shows that Niac certainly considered the administration of these vector vaccines - you know AstraZeneca and Johnson & Johnson – to 40 to 49-year-olds with some conditions attached to that.”

“We need to go through that information ourselves and think, how do we translate that information and those requirements into a mass vaccination programme where we can do this at pace.

“Pace is really important now coming out of a week where we delivered well over 230,000 vaccines and into another week where we expected to do more vaccines than that. We wanted something not just that is clinically sensible but also something we can implement at pace and with safety to all those target populations.

“So, we have received that information, we have to go through it with our vaccination teams in the centre and decide how can we implement this speedily and how can we implement it among those target groups in a way that ensures we are giving the vaccine safely with full information to patients.”

On Monday, The Irish Times reported that clarity on the use of hundreds of thousands of doses of Covid-19 vaccines is not expected for several days as the HSE examines the conditions to be attached to the use of AstraZeneca and Janssen shots.

The HSE is examining the implications of the advice from the National Immunisation Advisory Committee (Niac), which is thought to support the use of the vaccines in principle among those aged 40-49. However, sources said a set of conditions under which the people in this group can be given the shot are also contained in the advice.

These relate to communicating what risks may be involved and to assess the availability of other vaccines before administering either the AstraZeneca or J&J doses. This will present challenges in terms of implementing the advice, informed sources said.

The HSE is working on a plan based on a letter sent by the chief medical officer, Dr Tony Holohan, to the Minister for Health, outlining the Niac advice. However, Dr Holohan is yet to send a letter outlining his views on the advice to the HSE – which may ultimately vary from the Niac advice.

Sources said that implementing the advice will be “tricky” as it is not clear whether the information on risks can be given through existing frameworks and structures in the vaccination programme, or if they will need to be modified.

Other aspects, such as whether the conditions attached complicate plans to roll out the vaccine through community pharmacies, also need to be examined.

Second doses

The Government is hopeful that the advice will clear the way for the use of hundreds of thousands of doses of the singleshot J&J vaccine in particular. Many of the AstraZeneca shots due to be delivered in the months ahead are earmarked for use as second doses. Sources involved in the vaccine rollout have said failure to substantially use much of the 600,000 J&J shots would limit the ability to hit Government-mandated targets for the programme for the end of June.

Speaking to RTÉ’s This Week programme on Sunday, the HSE’s chief clinical officer, Dr Colm Henry, said information on when people in their 40s will be vaccinated will be announced later this week, but that the expectation is people in this cohort will begin vaccination later this month and throughout June.

Regarding whether people in their 40s will be offered the AstraZeneca or J&J vaccines, Dr Henry said: “We have just received that information before the weekend and we’ll be going through the impact for us on the response regarding Johnson & Johnson, AstraZeneca, and the choice of vaccines for those people.

“Clearly what we want to do is progress with a safe, effective vaccination programme at speed and at pace to cover as much of the population as possible, and using the stock of vaccines that are coming into the country in the most effective and safe way.”

He said the HSE “needs time” to analyse the information it had been given on the use of the vaccines. “We’ve just received the information ourselves in the HSE. We’ll be going through that in the coming days and I expect we’ll come to an operational decision ourselves in mid-week.”

A memo for Cabinet on travel, which is expected to cover potential revisions to the State’s mandatory hotel quarantine system, as well as a pathway to lifting travel restrictions for vaccinated people and plans for the implementation of the EU digital green certificate, is being prepared. It will be brought by the Department of the Taoiseach.

The Cabinet will also discuss the report of the tourism recovery taskforce. The taskforce has argued that travel from Britain should resume as soon as July, while about €1 billion in extra revenue and 50,000 jobs could be generated by reopening the State to holidaymakers during the summer.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.

Jack Horgan-Jones

Jack Horgan-Jones

Jack Horgan-Jones is a Political Correspondent with The Irish Times