THE vaccination roll-out against Covid-19 have been disrupted by a setback following the cancellation of clinics in a South-East Clare Mass Vaccination Centre.
The UL Hospitals’ Group confirmed earlier this week that all clinics and appointments using the AstraZeneca Covid-19 vaccine, including those at the Mid-West Vaccination Centre in the Radisson Blu Hotel, Meelick, have been deferred in line with the national guidance.
This decision was taken after the national HSE temporarily deferred the administration of the AstraZeneca vaccine in Ireland, after a request from the Chief Medical Officer, with effect from Sunday March 14th.
The HSE stated on Thursday it was reviewing this deferral after a ruling from the European Medicines Agency stated the AstraZeneca vaccine is “safe and effective”.
HSE chief executive Paul Reid has pledged the agency will respond quickly to whatever decision is recommended by the National Immunisation Advisory Committee.
The National Immunisation Advisory Committee stated on Friday evening the administration of the AstraZeneca vaccine should be recommenced for use in all those aged 18 and over.
Healthcare professionals and vaccine recipients should be informed that very rare, complicated clotting events have been reported in a small number of people who have recently received the AstraZeneca vaccine.
Medics should be alert to the signs and symptoms of blood clots and/or low platelet count and report any suspected adverse reactions to the Health Products Regulatory Authority (HPRA).
Recipients of the AstraZeneca vaccine should be advised to seek immediate medical attention if they develop symptoms such as shortness of breath, chest pain, leg swelling and/or persistent abdominal pain within weeks of vaccination.
Additionally, anyone with neurological symptoms including severe or persistent headaches particularly three days after vaccination or blurred vision after vaccination, or who develop skin bruising beyond the site of vaccination, should seek prompt medical attention.
Dr Máire Finn of Ennis Medical general practitioners were not affected by this deferral as AstraZeneca was not licensed to be administered to those 70 and older.
Dr Finn acknowledged this unexpected deferral of the AstraZeneca vaccine would result in delays for front line health workers, patients under the age of 70 with underlying conditions and was very hard on pharmacy workers, who would be subjected to another wait.
Following further meetings scheduled by the European Medicines Agency last this week, Dr Finn believes the decision to postpone administering the AstraZeneca vaccine as a precautionary measure will be reversed.
The Ennis-based doctor said hopefully those affected by this cancellation will only have to wait another week for their vaccination appointment.
“Personally, I have always been pro vaccination and immunisation. This has become a huge issue now because people are affected by Covid-19, but there are more vaccination programmes.
“I think it is important that people have confidence in vaccination programmes, that immunisation programmes are proven to be safe and regulated and stringently observed.
“While it would appear this deferral has been an over reaction, I believe it is entirely appropriate to have a caution reaction rather than an under reaction.
“This stands for all immunisation programmes. We can’t rush through a vaccination programme because there is such a need for it now. We need to do what is safe for the entire vaccination programme worldwide.
“It is important to prove to people we take these things seriously and that vaccination programmes can be trusted. I understand this deferral is confusing for people but by being over cautious we are ensuring our population will not be put at any risk.”
While general practitioners have not administered the AstraZeneca vaccine, Dr Finn confirmed any patient who has a genuine concern about any side effect from a vaccine can contact a family doctor.
Commenting on the AstraZeneca deferral earlier this week, the Mid-West HSE has confirmed the CMO was acting on the recommendation of the National Immunisation Advisory Committee (NIAC), following information received from the Norwegian Medicines Agency about four new reports of serious blood-clotting events in adults after vaccination with the AstraZeneca vaccine.
It has not been concluded that there is any link between the AstraZeneca vaccine and these cases. However, acting on the precautionary principle, and pending receipt of further information, NIAC recommended the temporary deferral of the AstraZeneca vaccine in Ireland.
The HSE appreciate the concern this temporary deferral causes, especially for those directly affected by the decision, and await further advice from the Chief Medical Officer and NIAC.
Nationally, the HSE estimates that around 30,000 dose of AstraZeneca were to have been administered this week.
The vaccination of people aged 70 and over will not be affected by this national temporary deferral of administration of the AstraZeneca vaccine. That group is being vaccinated by GPs with mRNA vaccines, which are not part of the temporary deferral.
The groups likely to be affected are frontline healthcare workers, and the planned start of vaccinations for Group 4 – people who have conditions that put them at very high risk if they get Covid-19.
In the Mid-West, the vast majority of healthcare workers have received their first vaccine dose. Some healthcare workers who received the Pfizer BioNtech vaccine have received both doses.
The recommended dose interval between the first and second dose of the AstraZeneca vaccine is 12 weeks. There are no appointments scheduled for second doses at the present time. Further information will be provided about second doses as soon as it is available.
Nationally, as of March 12th, 124,510 doses of the AstraZenca vaccine had been administered, and there were 49,109 doses in the HSE’s cold chain store.
The HSE stated events reported about AstraZeneca are very rare, and it does not know if they are caused by the vaccine. This vaccine is a very important tool in the fight against the virus.
Side effects of the AstraZeneca vaccine can occur within the first couple of days of vaccination, when more than one in 10 people may experience feeling tired; tenderness, bruising, pain, redness or itching in the arm where they had the vaccine injection; headache, muscle pain, joint pain,
nausea, diarrhoea or vomiting, fever (temperature of 38 degrees Celsius or above)
More than one in 100 people may have redness or swelling where they had the injection. It’s common to develop a fever (temperature of 38 degrees Celsius or above) after any vaccination.
This usually happens within two days (48 hours) of getting the vaccine, and usually goes away within two days.
If a patient feels uncomfortable, they are advised to take paracetamol or ibuprofen following the instructions on the box or leaflet.
People who have received the AstraZeneca vaccine and feel increasingly unwell for more than three days after vaccination, and/or who notice larger or smaller blue spots in the skin (purpuric, non-blanching rash, skin haemorrhages) should consult a doctor or out-of-hours medical service.
The rare events that have been reported have usually occurred within 14 days of the vaccine.
The HSE reiterated there is no proven link between these events and the vaccine at this time.