WE have the priority list for the Covid-19 vaccine at last – now all we need is the vaccine itself.
The layout of the pecking order, and its omissions, have already drawn dismay and concern.
It’s just the start of a long road stretching well into 2021 for the Covid-19 vaccination campaign and there may be just one chance to get it right.
Can the HSE and Government deliver? And how well will it perform with the obstacles ahead?
There needs to be an uptake of around 70pc at the end of next year to secure a high level of protection from developing Covid-19 illness in the country.
Prof Brian Hughes of the Psychological Society of Ireland, which has drawn up a document about vaccination uptake, said: “Most people hold favourable views about vaccination. As such, the attention given to vaccine scepticism can often be disproportionate.
"Nonetheless, it is important to address queries about vaccination in non-threatening ways, in the knowledge that most vaccine hesitancy results from barriers to motivation and not from hostile attitudes.
“The best available research tells us that vaccination programmes are most effective when they are routinised within standard healthcare, when they are easy to access, and when they are straightforward to navigate.”
The guidance says that vaccination systems should seek to engage people directly, rather than wait for public attitudes to evolve.
Public figures and other role models should be consistent in their statements about vaccination. Reservations about vaccines should be acknowledged and addressed in a non-threatening manner.
People have legitimate questions about the vaccine which can be separated from the anti-vaxxer movement. How this is done in an era of social media is the big challenge.
The HSE needs to answer questions with full transparency – no time for ducking and diving or journalists getting no response.
Pictures of President Michael D Higgins getting the jab may not inspire people from minority communities here who have little English but live in very overcrowded conditions.
The difficulties posed by the need to store the Pfizer BioNTech vaccine at under 70 degrees C will have to be overcome if the jabs are not to get too warm to render them ineffective.
Pfizer has developed a reusable suitcase-sized shipping container where 975 doses of the vaccine are kept on dry ice. The vaccine is suitable for ten days from the point of departure in the case and up to 15 days with more dry ice.
Dry ice is a hazardous material and must be transported by ground. The case can be opened just twice a day, for one minute each time. If too much is taken out, the jabs can go to waste.
Getting the vaccine to nursing homes
It is unclear what the European Medicines Agency will say about the prospect of breaking up the large packs to take to nursing homes and other long-term care facilities with maybe just 50 residents.
The UK regulator says it is possible in the coming weeks but the European watchdog could take a different view.
Shortage of vaccines
Ireland has advance purchase agreements with five companies developing potential vaccines. However, it is unclear how soon they will all get regulatory approval, allowing for consignments be sent here.
The expectation is that the Pfizer vaccine will get the go-ahead at the end of the month and the Moderna vaccine will be approved in January. However, each must be given in two doses, so they will be used up quickly. There could be a lengthy period where there is no supply next year.
Justifying more lockdowns
If Ireland faces another lockdown in January, after Christmas and New Year celebrations, there will inevitably be resistance from businesses, who will challenge the need for such measures if there is a vaccine starting to roll out.
It is also expected that pressure will be exerted to overhaul the priority list. This could be done with the aim of ensuring hospitality staff, and other workers who have unavoidable contact with the public, receive the vaccine earlier.
Explaining the limitations of the vaccine
For now, there is no evidence that the Covid-19 vaccine will stop transmission of the virus. It will provide protection from developing serious illness among those who do contract it. So it means that a person who gets the vaccine could still pass on the virus to another person who has not had the jab
If a person gets the jab and then picks up the virus, they will still need to self-isolate to protect other people. One of the toughest tasks ahead is getting people to maintain a high level of compliance with physical distancing, hand washing and mask wearing.