Flu Vaccinations

Questions for Urgent Oral Answer — Health – in the Northern Ireland Assembly at 4:15 pm on 16 November 2020.

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Photo of Alex Maskey Alex Maskey Sinn Féin 4:15, 16 November 2020

Colin McGrath has given notice of a question for urgent oral answer to the Minister of Health. If Members wish to ask a supplementary question, they should rise continually in their place. The Member who asked the original question will be called automatically for a supplementary.

Photo of Colin McGrath Colin McGrath Social Democratic and Labour Party

Mr McGrath asked the Minister of Health how his Department will address the shortage of 200,000 flu vaccinations, which has been described as deeply concerning and frustrating by senior GPs.

Photo of Robin Swann Robin Swann UUP

I am glad to have this opportunity to come to the House today to clarify some of the issues regarding this year's flu vaccination programme.

First, let me assure Members and, more importantly, those listening at home, that there is no shortage of ordered vaccines. This year in total, 1,050,300 doses have been procured for the flu vaccination programme. As of last Friday morning, 826,890 doses have been delivered to Northern Ireland. A total of 601,243 doses have been delivered to GPs and trusts. I can confirm that, as of this morning following two further deliveries totalling 192,700 doses, the total vaccines delivered now stands at 1,019,590 doses. Around 30,000 doses of the childhood vaccine are still to be delivered and that is the only order that remains outstanding.

As was outlined by the Public Health Agency last month, uptake has been exceptional with higher numbers of people getting the vaccine than ever before. A temporary pause was placed on some aspects of the seasonal flu vaccination programme but those additional vaccines are now available.

Let me assure Members that there significant quantities of the vaccine available for those over 65. There are approximately 323,000 people over the age of 65 in Northern Ireland. Initially, we aimed for a target uptake of 85%, which equates to 275,000 vaccines. Therefore, we purchased 286,000 vaccines. Last month, I approved the purchase of a further 10,000 vaccines bringing that total to 296,000. The additional 10,000 vaccines arrived in Northern Ireland on Thursday 5 November. Therefore, the reports in the media today that Northern Ireland is almost 200,000 doses short of the flu vaccine for the over-65 age cohort, or that we are unable to complete the vaccination programme, are simply not true. I want to reassure everyone listening that there is no shortage. Further plans are now in place to procure even further quantities of vaccine at a later date, if necessary.

Finally, I would like to thank all of our GPs, practice nurses and Community Pharmacy for their expertise and persistence over recent weeks. This is an incredibly busy and pressurised time for them all, and yet, without them, our flu vaccination programme would simply not succeed.

Photo of Colin McGrath Colin McGrath Social Democratic and Labour Party

I thank the Minister for coming to the Chamber today. When the news broke this morning, it was deeply worrying and concerning for people who are facing the perils of COVID and who fear getting the seasonal flu, which may put them into a position where they are more vulnerable to other illnesses. This was scaring and frightening people, so it is welcome that the Minister has been able to come here today, put the record straight and send a clear message to people that they will be able to receive the vaccine that they require.

May I ask two questions? First, can the Minister given an assurance that all people over the age of 65 and those with underlying conditions will be able to access that vaccine in a timely manner before, as is projected, the flu season starts in December? Secondly, does he have a sense of the breakdown in communication that led medics in the sector to make that announcement today?

Photo of Robin Swann Robin Swann UUP 4:30, 16 November 2020

I thank the Member for his questions. Prior to coming to the House, I had a meeting with representatives of the Public Health Agency (PHA) and the Health and Social Care Board so that we could discuss how that communication failure came about. A meeting of all parties last week seems to have led to what I think has been described as inaccurate reporting by the BBC. Its report incorrectly stated that Northern Ireland did not receive its full vaccine quota. One million doses were ordered; the BBC claimed that between 500,000 and 600,000 were delivered. My first answer has assured the House of the number procured, ordered and delivered to Northern Ireland.

The Member mentioned uptake, and I am due to receive a report by the end of this week on the normal uptake of the different flu vaccines. We use different strains for children, the under-65s and the over-65s. The concern seems to be in the over-65 population, and my original answer details how our order equates to an uptake of 85% in that cohort, which is far in advance of what was used this time last year, when we had an uptake of 74·8%. We have ordered additional vaccines. On top of those, we are getting additional vaccines to ensure that those cohorts can be vaccinated. We are working with GPs to ensure that we can get those vaccination programmes and mass vaccination events back up and running in order to ensure that vaccinations are given in a timely fashion.

Photo of Jonathan Buckley Jonathan Buckley DUP

First, I put on record my sincere thanks to the doctors and nurses who have been implementing a very successful flu vaccination programme to date. We have all seen in our community the level of organisation required.

I came to the Chamber with considerable concern about what is going on in the Department and the PHA. This morning's statement from the PHA said that the demand for vaccine has resulted in a "temporary pause" in the supply of vaccine for eligible people under the age of 65 and that additional controls were in place to ensure fair distribution to all GP practices across Northern Ireland. Dr Gerry Waldron, the PHA's head of health protection, said that he regretted that some flu clinics had had to be cancelled. That is in stark contrast to what the Minister is saying in the House today. In that spirit, Minister, does this build confidence in people who are looking towards how a potential COVID-19 vaccination programme would be implemented across Northern Ireland?

Photo of Robin Swann Robin Swann UUP

I do not think that it is in contrast, if you listen to what the PHA actually said. There was a pause in the supply of the vaccine. The Member may not be aware that the delivery of flu vaccines comes in two batches; the initial batch is the one that we ordered at the start of the year; the additional batch is the one that we ordered in the summer. Some clinics were paused to allow for the delivery of the second batch. In the initial set-up of the mass flu vaccination programmes, we saw an exceptional uptake. I referred to that when answering a question from the Member's colleague Paula Bradley in the House last week. Some GPs reported that 499 people attended in response to their sending out 500 letters. In the past, the maximum uptake was in the region of 75%.

The Member's assertion was, I think, an attempt to talk down the programme, but the early uptake was exceptional, as was the delivery and coordination between the PHA, GPs, Community Pharmacy and nurses. Now that we have those structures in place to enable us to run vast vaccination outreach programmes, should they be in community halls, church halls or car parks, including underground car parks, where we have been doing in-car vaccination programmes as well, it sets us up with a sound basis for what the COVID vaccination programme will look like once that vaccine becomes available.

Photo of Colm Gildernew Colm Gildernew Sinn Féin

I thank the Minister for coming to the Chamber to answer questions. Minister, you have referred to modelling and planning. What specific modelling and preparation did the Department do for the demand and uptake of the flu vaccine this year? When was that completed and by whom?

Photo of Robin Swann Robin Swann UUP

I thank the Committee Chair for his questions. The planning that we did this year was for an uptake target, specifically among the over-65 cohort, of 85%. As I said in an earlier answer to Mr McGrath, last year, we saw a 74·8% uptake and, the year prior to that, a 70% uptake. The numbers that we ordered to target an 85% uptake even allowed for a 7% wastage rate, which is normal in a large-scale vaccination programme. Those calculations were done by the PHA. We ordered that additional vaccine over the summer to complement our original order, which was made at the start of the year to allow for production and delivery.

Photo of Alan Chambers Alan Chambers UUP

Minister, one of the benefits of being part of the United Kingdom is that the four nations have shared resources throughout the pandemic. Whilst I very much welcome today's clarity from the Minister, which again emphasises the need for accuracy in public reporting at this time, will the Minister contact the Department of Health and Social Care in England if, in the days and weeks ahead, he believes that he will require even greater quantities of vaccine to fully meet the needs of Northern Ireland?

Photo of Robin Swann Robin Swann UUP

I thank the Member. He makes a valid point. As I said earlier, specifically for the over-65 age group, we had set an 85% uptake target, which is 275,000 people. We approved the purchase of another 10,000 vaccines, which arrived on Thursday 5 November. I can report to the Member and the House that, having contacted Matt Hancock, over the last 24 hours, we have been able to obtain an additional 15,000 vaccines. So, in addition to the vaccines that we had ordered to achieve the 85% target that we set ourselves, we now have more vaccines on the way, which will be put into a further programme of vaccination.

Photo of Paula Bradshaw Paula Bradshaw Alliance

I thank the Minister for coming to the Chamber. You talked about the exceptional uptake of the flu vaccine. What lessons are being learnt for the forthcoming roll-out of the coronavirus vaccine programme in both operational issues and communication?

Photo of Robin Swann Robin Swann UUP

I thank the Member. Her last point is bang on the money. It is about communication. As I said, I had a conversation this afternoon with the PHA and representatives of the board about how we get right the communication on how the distributions of the vaccines work, especially the COVID vaccines. There are now two COVID vaccines on the market, one of which the UK has pre-ordered. There are logistical challenges regarding how that is managed because it has to be stored at -70°c for a period before it can be stored in normal fridges for the last five days before its use, so there is a large piece of logistical work.

However, it is also about communication to identify the cohorts that will be eligible in the early stages. We must make sure that GPs, Community Pharmacy and all the other aspects have clearly identified those people and that we put in place a process and locations for doing it safely. I talked earlier about some of the fantastic work that GPs and community pharmacies have done in delivering mass vaccination programmes. I do not think that any of us in the House, even this time last year, would have envisaged flu vaccination programmes being completed in underground car parks, but those have proved to be highly effective and deliverable. In most cases, people were able to do it in the comfort of their car. It is about making sure that we get the communication phase right when the COVID vaccine becomes available.

Photo of Pam Cameron Pam Cameron DUP

I thank the Health Minister for his attendance. I also welcome the news that the flu vaccine will be made available to those who are most vulnerable. On 12 October, there were 46 care homes with a COVID-19 outbreak. By 12 November, that number had risen to 143. In all that time, hospitality and close-contact services were closed. It makes no sense that, many months into this pandemic, there is no rapid testing or mass testing of staff in key wards or in care homes to complement the vaccines. That should be a daily occurrence for those key healthcare workers. Regardless of what other regions are doing — I have heard that some care settings in England are carrying out daily testing for staff and visitors — I respectfully ask the Minister why he is not testing healthcare staff on a daily basis.

Photo of Robin Swann Robin Swann UUP

With respect to the Member, I am aware that this is something that has been raised in a number of press releases from her party, although not connected directly to the flu vaccination programme. What I will say to the Member is that the number of care homes that are currently indicated as having outbreaks is due to our positive and reactive testing programme that we have introduced — something that I know the Member supported. The Commissioner for Older People supported it as well.

The Member spoke of a number of pilot programmes that are currently ongoing in Liverpool and, I think, in a number of care homes in the south-east of England which have been in the media today. One of the things I will say is that we are fully plugged in to those pilots, because that is what they are. They are actually testing the viability of the testing machines, their protocols and their utilisation to make sure that they use them in the best way to support the residents, the patients and the staff.

With regard to testing hospital workers, which I think was part of the Member's question as well, in line with our current testing protocols, testing is prioritised for all our healthcare workers, and that includes hospital staff who are symptomatic or whose household contacts are symptomatic, to help enable those essential workers to return to work as soon as possible. The position with regard to testing of all hospital staff is kept under active review.

With regard to the new testing technologies that I was talking about, there are emerging plans — sorry, it is the technologies which are emerging. The plans are progressing with a range of local partners and experts for testing those pilots across different settings, including healthcare settings. That will include repeat testing for asymptomatic healthcare staff. The new test for asymptomatic people aims to identify those at risk of spreading the virus, reduce the risk of onward infection and to find positive cases earlier to actually reduce transmission of the virus. Those pilots are something we are watching, and watching with interest, to make sure that the equipment is effective and efficient enough to bring benefit to what we want to do.

Photo of Órlaithí Flynn Órlaithí Flynn Sinn Féin

I know that one of the Members touched on guaranteeing that the over-65s would have access and whether there is enough stock of the flu vaccine, but I wonder whether the Minister can guarantee that everyone over the age of 65 will be able to receive the vaccine before the end of November.

Photo of Robin Swann Robin Swann UUP

I thank the Member for her point. As I said earlier, our original estimates were for an 85% uptake target, which equated to 275,000 vaccines. We actually purchased 286,000. We have received an additional 10,000 and, as I said to Mr Chambers, an extra 15,000 has been agreed by the Department of Health and Social Care for part of the Northern Ireland allocation, so we will have in excess of 311,000. Our current population of over-65s sits at 323,000, so there is enough there — not for everyone, but for the vast majority — and far in excess of the percentage uptakes that we have seen in previous years.

Photo of Justin McNulty Justin McNulty Social Democratic and Labour Party

I thank the Minister for coming to the Chamber today. First, I put on record my thanks to the healthcare staff in GP surgeries, schools and healthcare settings who have administered the vaccine so diligently and proactively so far. I spoke with one GP last week, and she told me how incredibly, exceptionally hard everyone is working. Have all residents in nursing homes been vaccinated, Minister? What has the Chief Medical Officer (CMO) advised will be the impact on the battle against COVID of not having the flu vaccine administered?

Photo of Robin Swann Robin Swann UUP

I thank the Member for his questions. One of the points that the CMO has been making in the last number of weeks and months is about how vital it is that nobody should contract flu and COVID at the same time.

Our flu vaccination programme is well ahead of schedule of where we would be in any normal year, but, as everyone in the House, including the Member, knows, this is not a normal year. I welcome the Member's acknowledgement of the GPs, community nurses and community pharmacies that have taken forward the vaccination programme.

Everyone over 65 is eligible for the flu vaccine, no matter where they are resident.

Photo of Alex Maskey Alex Maskey Sinn Féin 4:45, 16 November 2020

Before I call the next Member to speak, I ask Members to come to their questions quickly. A number of Members still want to ask questions, so please keep your introductions very brief and to the minimum.

Photo of Robbie Butler Robbie Butler UUP

I very much welcome the clarity that the Minister has given us. It stands in stark contrast to what has been reported up to now. Will the Minister give us a commitment that there will be close monitoring of the development of the additional vaccine by the PHA and the Health and Social Care Board?

Photo of Robin Swann Robin Swann UUP

I thank the Members for his question. Following the meeting today, I asked for weekly updates on where we are with the flu vaccination programme, not just on the distribution of the vaccine but on what the percentage uptake has been across all groups. While we are specifically talking about the over-65s today, a number of other groups are also eligible for the flu vaccine, including all pregnant women, all individuals under 65 with current chronic medical conditions, primary-school children and front-line healthcare and social care workers who are employed by a trust. A number of additional groups are eligible for the flu vaccine, and I have asked the PHA and the board to make sure that I receive regular updates on how the remaining part of our flu vaccination programme is progressing.

Photo of Gerry Carroll Gerry Carroll People Before Profit Alliance

Does the Minister seriously believe that the potential COVID vaccination that is being touted by the media as being available here in December will be available, or was that just a line inserted into an Executive press release last week to save face during the mother of all Stormont shambles?

Photo of Robin Swann Robin Swann UUP

I thank the Member for his question. I am here to answer questions about the flu vaccine, but I am happy to talk about the coronavirus vaccine as well. What we saw in the media was an advance statement by a company that it has a vaccine that is 90% effective. That is one of the vaccines that the UK Government have pre-bought, so we will be part of that uptake, as I reported to the House last week. Off the top of my head, our allocation will provide enough vaccine for, I think, 275,000 individuals in Northern Ireland.

There are reports today of another vaccine coming on to the market, which its makers claim to be 95% effective. That is not one of the vaccines that were part of the UK pre-procurement exercise, but I am led to believe that the UK Government are in negotiation with that company to make sure that, if it becomes available safely on the market, they will have access to it. By default, we will get our share as part of the United Kingdom.

It is widely believed that some vaccine will be available by the end of this year, but it should not be perceived as a panacea for everything or for COVID. Any of the experts who have spoken about the efficacy and utilisation of vaccines have indicated that it will be well into next year before we see the real effect of the vaccines in combating COVID in the community.

Photo of Alex Maskey Alex Maskey Sinn Féin

I ask the next Member who is called to ask a question to relate it to the question for urgent oral answer.

Photo of Claire Sugden Claire Sugden Independent

Minister, are there any know contraindications of those who have received the seasonal flu vaccine receiving the COVID-19 vaccine? Will patients who have tested positive for COVID-19 make use of the anticipated COVID vaccine? I ask those questions because the answers will help with the management of an expected programme in the winter months.

Photo of Robin Swann Robin Swann UUP

One of the points of concern expressed by the GPs that I share is that we need to get the flu vaccination programme out of the way before we can commence the COVID one. There is advice and guidance that there should be at least three weeks between the vaccines being delivered to ensure that both have the maximum effect.

In regard to whether there are any known studies, I am sure that that is ongoing. As we are well aware, neither of the two COVID vaccines that are now reported to be available have gone through the full clinical and safety trials for utilisation in the community, and, until that process is completed, I do not think that they will be used widely in the United Kingdom. That work still has to be done. To back up what the Member said, it is important that any COVID vaccine is safe to use and that we promote it as widely as possible. Those who are eligible to get it should get it. There is no barrier, for want of a better word, and nobody who has contracted COVID in the past or tested positive for COVID will be ineligible for the vaccine.

Photo of Paul Frew Paul Frew DUP

The Minister will know — I have corresponded with him about it — about the growing number of vulnerable residents in north Antrim who have been unable to avail themselves of the flu vaccine because they have had to drive into a practice instead of walking in. Can the Minister shed some light on that issue? Is it a growing problem? How does he fix it?

Photo of Robin Swann Robin Swann UUP

I thank the Member. He has raised that with me in correspondence. We talked about the protocols and the advances that we have seen in GP surgeries. The drive-ins and the underground car parks are great advances, but our GP colleagues, community pharmacy and our practice nurses have always made available the ability to walk into clinics, should they be in community halls or church halls, so that people can avail themselves of the flu vaccine. What is being done at GP level is that, if people do not make themselves known, other ways of obtaining the vaccine will be made available to them. I think that I have given that answer to the Member in writing as well.

Photo of Pat Sheehan Pat Sheehan Sinn Féin

Gabhaim buíochas leis an Aire as ucht a fhreagra. I thank the Minister for taking the question. I am surprised to hear him say that the story that was broken by a reputable journalist this morning is not true, because there has been other evidence of difficulties with the roll-out of the vaccine. The Minister mentioned the pauses, and his colleague on the Health Committee told us some weeks ago that there was a delay in the roll-out of the school vaccination programme. There are issues. Confidence in the PHA is not at a premium at the moment given its woeful underestimation of the number of positive COVID cases, so can the Minister explain why he is so confident — he answered a question from my colleague Órlaithí Flynn — that everyone who needs a vaccine or wants a vaccine will get it in a timely fashion?

Photo of Robin Swann Robin Swann UUP

I thank the Member. He made a comment about the PHA: I noted his exchange with PHA officials in the Health Committee a number of weeks ago, and I do not think that his comments were edifying. I do not think that an elected Member of the House should speak to any official in that way, no matter how much they disagree or want to challenge the evidence that they bring or what they say. I do not think that how the Member spoke to the PHA officials who were before the Committee did him any good.

In regard to my comments about the reporting, I actually said that the BBC report had incorrectly stated:

"Northern Ireland did not receive its full vaccine quota - while one million doses were ordered, between 500,000 and 600,000 were delivered."

That is inaccurate, and I stand over that comment. It is in Hansard as well.

In regard to the uptake, work is ongoing by GP practices, the Health and Social Care Board, Community Pharmacy and the PHA to make sure that we can roll out the second batch of vaccine, which has now been delivered to Northern Ireland. The programme was paused because of the success of the delivery of those mass vaccination programmes, which were delivered by GPs in the first instance. We actually got in front of the delivery of vaccines that we were expecting and the additional ones that we had ordered over the summer. They are now in Northern Ireland and will be distributed to GP practices, as necessary, to meet the demand. I have gone through the percentages, especially in the over-65s, we had ordered enough for an 85% uptake with a 7% wastage rate, but, on top of that, we have received additional vaccines from the Department of Health and Social Care (DHSC) in the UK.

Photo of Alex Maskey Alex Maskey Sinn Féin

I call Steve Aiken. We have one minute.

Photo of Steve Aiken Steve Aiken UUP

I thank the Minister for his comments so far. I speak as someone who has had the flu vaccine and as a cancer survivor. One of the issues mentioned at my local GP surgery is that quite a few people do not turn up at their allotted time. Will the Minister help me in getting out the message that, if you are allotted a slot for a flu vaccine, you should make every effort to be there for that vital health measure, if you can?

Photo of Robin Swann Robin Swann UUP

I thank the Member. The importance of getting the flu vaccine has been well rehearsed, especially, as I say again, as our colleagues across GP practices, practice nurses and Community Pharmacy go to the effort of organising the flu programmes and flu vaccination programmes that we have seen across the country. I encourage everybody to utilise the slots that they are offered, because they are being delivered in a timely and efficient manner to make sure that we not only get the efficient uptake of flu vaccines here in Northern Ireland but make best use of our professionals' time.

Photo of Alex Maskey Alex Maskey Sinn Féin

That concludes this item of business. Will Members take their ease for a moment, please?