The majority of Ireland’s over-85s will be able to get the Covid-19 vaccine from their own GP while 6,000 will be administered the jab in another surgery or hub, it emerged last night.
A small minority of the 72,000 people in this age group will have to travel to another doctor’s practice or a special centre. They will get the jab from their own doctor.
But an uncertain and limited supply of the Pfizer-BioNTech and Moderna vaccines will mean these over-85s, as well as others over 70, will see an uneven roll-out and access to the vaccine may be dependent on where they live or how soon supplies are delivered to their GP.
The over-70s will be vaccinated through three different systems.
Most will receive the vaccine in their own doctor’s surgery, others will travel to another doctor’s practice where a number of GPs will “buddy up.”
In other cases they will get the jab in vaccination centres .
The first will be in Dublin City University (DCU) in Dublin and centres will all be opened in Galway and Cork, according to an email from the Irish Medical Organisation (IMO) to GPs late last night.
The email said all practices with more than 200 over-70s on their list will receive deliveries through cold chain and operate their vaccination clinics within their own practice premises with the GP practice team.
“In certain areas where there are a large number of smaller list practices there will be a GP run vaccination clinic at an agreed location such as Dublin, Cork and Galway”
The first clinic will be DCU, Dublin, where there are 121 practices in the surrounding area with fewer than 200 over-70s in total.
This will operated by GPs, practice nurses and staff who will do sessions and be led by a lead GP to organise rotas and scheduling.
“All booking, registration and payment for your own patients will be via your own practice management system – the only change is the venue at which the patient will receive the vaccine.
“The clinics will operate in the agreed age phases until all these patients are vaccinated and at the 28 day intervals. These clinics will operate at weekends.”
It said that “for a small number of practices outside of Dublin, Cork and Galway we are assisting those GPs who have less than 200 patients on the over-70 age category in buddying up with a larger practice in the area.
“In this way the small patient numbers from one practice will attend at the larger practice for vaccination but this will be delivered by the patient’s own GP team in that setting.
“We will be contacting those practices and assisting with the buddying-up system.”
Doctors will identify their patients, register them and invite them to the location where they will receive the vaccine.
There are around 490,000 patients over 70 in the community “almost all of whom are patients of GPs around the country. Within this group the first patients to be vaccinated are those 72,000 over-85s, then moving on to patients between 80 and 84, 75 to 79 and 70 to 74.”
Dr Denis McCauley of the IMO, who met with the HSE yesterday, said: “The majority can get the vaccine at their own GP’s surgery.”
GP practices with a lower number of patients in these age groups will link up with other surgeries and, in exceptional circumstances, they will all set up in a designated centre. “The alternative plan is just a tiny amount of patients,” he said.
Dr McCauley said the deliveries would be staggered, with some GP practices in an area getting them before others.
However, the plan still is to begin the roll-out in the week beginning February 15.
“If people are given a date to get the vaccine, they will not care if another practice gets its first.”
Doctors will be given about five or six days’ notice of when their supplies will be delivered.
It follows the decision to make these two vaccines the preferred jabs over the Oxford AstraZeneca vaccine because of a lack of evidence to the European Medicines Agency on how effective it is on older people.
Chief medical officer Dr Tony Holohan said last night: “Data on efficacy among older adults with AstraZeneca vaccine is lacking at this time.”
GPs are expected to get a clearer idea of how the roll-out will operate today after a briefing from Irish Medical Organisation representatives.
However, several doctors across the country say they are in the dark about the arrangements and they have concerns about some elderly patients living in rural areas.
Health Minister Stephen Donnelly said yesterday the vaccination of the over-85s would start in the week beginning February 15.
Dr Gary Stack a GP in Killarney, Co Kerry, said he had 45 patients over 85 who are eligible for vaccination but was waiting for clarity on how the vaccination would operate.
“Around one in 10 of these patients are living in quite rural areas and two or three are housebound.”
He said he would still like to see a role for the Oxford AstraZeneca vaccine to allow him to give it to housebound patients.
He said doctors were still unclear how much vaccine they would get.
There are other issues arising where a patient is entering a nursing home and has not been vaccinated although all the other residents have already received their first dose.
His call was echoed by Dr Michael Harty. The former Independent TD, who is a GP in rural Clare, said the Pfizer and Moderna vaccines created logistical complications due to storage and temperature
“There is not a critical mass of patients in each practice in west Clare,” he said.
He said they would team up in a central location which could be located in Ennis.
Dr Ken Egan, a GP in Co Mayo, said he had 243 patients over the age of 85.
It was important to ensure there was safe transport provided for those who must be supported to travel to a surgery or vaccination centre, he said.
The HSE is also recruiting vaccinators and nurses, physiotherapists, doctors, paramedics and advance paramedics can apply.
The first batches of the Oxford AstraZeneca vaccine are due at the weekend with 21,600 doses. Another 190,000 are expected in February and these will now be offered to frontline healthcare workers.
These were earmarked for the over-70s but will now be given to frontline workers instead.
As of yesterday, 220,000 doses of vaccine have been administered since December.
Meanwhile, 35 more Covid- related deaths were reported yesterday with 1,047 cases.
The median age of those who died is 84 years and the age range is 63-96 years.
Among the new cases 292 are in Dublin, 119 in Cork, 76 in Wexford, 60 in Limerick, 47 in Kildare with the rest of the 453 cases among the remaining counties
The number of patients with Covid-19 fell to 1,221 with 181 in intensive care.
Dr Holohan said: “No single intervention is perfect at preventing the spread of Covid-19. It takes many different individual actions to slow down the spread of the disease.
“Every action you take is another layer of protection between you and the virus – the more layers you have the more protection you have.
“Public health measures are based on this principle.
“Keep physical distance from others, wash hands regularly, avoid crowds, wear face coverings and vaccines: all provide you with layers of defence against Covid-19.”