Government announces changes to the order people will receive vaccines

Those who are more at risk will receive their vaccine first.

The Government has announced changes to its vaccine allocation strategy, which will see people aged between 16 and 69, who are at high risk of developing severe Covid-19, moved up the list. The strategy, originally released late last year, came under criticism in some sectors for failing to recognise the dangers of Covid-19 for some patients with long-term illnesses. The Government said more national and international evidence has enabled a more detailed analysis of underlying conditions that may increase the risk of developing severe disease or death. The strategy has now been updated by Minister for Health Stephen Donnelly after the National Public Health Emergency Team agreed to recommendations put forward by the National Immunisation Advisory Council. “Our Covid-19 Vaccination Programme has always been built on fairness and to ensure that those with the highest risk of severe disease and death were prioritised for vaccines when supplies were limited," Donnelly said. "This is why the focus has been on those living in nursing homes and our older people in the community. “The National Immunisation Advisory Council (NIAC), in conjunction with my Department, have recommended revising the Vaccine Allocation Strategy. The National Public Health Emergency Team (NPHET) endorsed the recommendations and today they have been approved by Government. “The primary aim of Ireland’s Covid-19 Vaccine Allocation Strategy remains the same. We are continuing to vaccinate those who are most likely to suffer severe disease and sadly, death, as a result of contracting Covid-19. "The changes we are making are based on the latest clinical and medical advice that those we are moving up the list would suffer the worst outcomes if they were to get the disease.” The new roll-out strategy means the order in which people will receive the vaccine has changed but full details can be read on the Department of Health website.

New Cohort 4

Those aged 16-69 and at very high risk of severe Covid-19 disease. Cancer All cancer patients actively receiving (and/or within 6 weeks of receiving) systemic therapy with cytotoxic chemotherapy, targeted therapy, monoclonal antibodies or immunotherapies and radical surgery or radiotherapy for lung or head and neck cancer. All patients with advanced/metastatic cancers. Chronic kidney disease Chronic kidney disease, on dialysis, or eGFR <15 ml/min. Chronic neurological disease or condition Chronic neurological disease or condition with evolving ventilatory failure (requiring non-invasive ventilation), for example: motor neurone disease, spinal muscular atrophy. Chronic respiratory disease Chronic severe respiratory disease, for example: severe cystic fibrosis, severe COPD, severe pulmonary fibrosis. Diabetes Uncontrolled diabetes, for example: HbA1C ≥58mmol/mol. Immunocompromised Severe immunocompromise due to disease or treatment, for example, Transplantation: - Listed for solid organ or haematopoietic stem cell transplant (HSCT) - Post solid organ transplant at any time - Post HSCT within 12 months Genetic diseases: - APECED** - Inborn errors in the interferon pathway Treatment: - included but not limited to Cyclophosphamide, Rituximab, Alemtuzumab, Cladribine or Ocrelizumab in the last 6 months. Inherited metabolic diseases* Disorders of intermediary metabolism/at risk of acute decompensation, for example: Maple Syrup Urine Disease. Intellectual disability* Down Syndrome. Obesity BMI >40 Kg/m2. Sickle cell disease*

New Cohort 5

Those aged 65-69 and at high risk of severe Covid-19 disease.

Revised Cohort 7

Those aged 16-64 and at high risk of severe Covid-19 disease. Cancer Haematological - within 1 year. Haematological - within 1 - 5 years. Non-haematological - within 1 year. All other cancers on non-hormonal treatment. Chronic heart (and vascular) disease Chronic heart disease, for example: heart failure, hypertensive cardiac disease. Chronic kidney disease Chronic kidney disease with eGFR <30ml/min. Chronic liver disease Chronic liver disease, for example: cirrhosis or fibrosis. Chronic neurological disease or condition Chronic neurological disease or condition significantly compromising respiratory function and/or the ability to clear secretions, for example: Parkinson's disease, cerebral palsy. Chronic respiratory disease Other chronic respiratory disease, for example: stable cystic fibrosis, severe asthma (continuous or repeated use of systemic corticosteroids), moderate COPD. Diabetes All other diabetes (Type 1 and 2). Immunocompromised Immunocompromise due to disease or treatment, for example: high dose systemic steroids (as defined in Immunisation Guidelines for Ireland Chapter 3), persons living with HIV. Inherited metabolic diseases* Disorders of intermediary metabolism not fulfilling criteria for very high risk. Intellectual disability* Intellectual disability*** excluding Down Syndrome. Obesity BMI >35 Kg/m2. Severe mental illness* Severe mental illness, for example: schizophrenia, bipolar disorder, severe depression. *additional or updated medical conditions ** APECED - autoimmune polyendocrinopathy candidiasis ecto- dermal dystrophy *** WHO definition of intellectual disability as “impairments in adaptive, social, and intellectual functioning (IQ<70), requiring daily support, with onset in the developmental phase (<18 years)”

New Cohort 6

These groups will be completed in parallel. All others aged 65-69 due to high risk of hospitalisation and death. Other Healthcare Workers not in direct patient contact, in order to provide essential health services, protect patients Workers key to the vaccination programme in order to provide services essential to the vaccination programme.