Health unions have queried why frontline healthcare workers are being given what they describe as the "least efficacious" vaccine when they are the workers most exposed to Covid-19.
According to the Industrial Relations News journal published today, the unions have told the HSE that members are complaining that they are being offered the Astra Zeneca vaccine, which only has 60% efficacy, compared to 95% for the Pfizer BioNTech vaccine, and 94.5% for the Moderna vaccine.
The complaint was made in a letter sent yesterday on behalf of the HSE staff panel of health sector unions and associations to HSE management.
The chair of the staff panel Tony Fitzpatrick notes that more than 26,000 healthcare workers have been infected with Covid-19, equivalent to 12.5% of all infections in the state - but says this could be an underrepresentation of the true level of infection.
"Also, it is worth noting that the 26,000 figure is the rate of those detected with Covid-19 and the HSE will be aware of the high levels of asymptomatic infection and spread. Furthermore, the antibody testing process conducted at several acute hospitals have indicated that the number of those infected by Covid-19 exceeds the numbers that have been detected via the PCR testing process," he states.
In this context, unions query the decision made by the HSE and that National Immunisation Advisory Committee (NIAC) to make the Astra Zeneca vaccine available to frontline health workers.
"We note that the HSE have issued guidance documents with regards to the efficacy to the three vaccines currently available in Ireland. It is worth noting that Pfizer BioNTech has efficacy 95%, Moderna 94.5% and AstraZeneca has 60% based on the HSE documents which are attached," the letter to HSE HR says.
Mr Fitzpatrick notes that NIAC and the HSE decided to utilise Pfizer BioNTech for over 65s "and in the intervening time the WHO guidance with regards to same has changed".
He raises a number of questions on behalf of members, including why the HSE is making the "less effective" Astra Zeneca vaccine available to staff, rather than the other two more effective vaccines.
He asks whether the HSE and NIAC are reviewing their decision to consider the amended WHO advice regarding the use of Pfizer BioNTech for over-65s.
He also queries whether the HSE is satisfied that it is compliant with the Biological Agents Directive implemented since 24 November, 2020 with regard to ensuring the availability of a vaccine to health care workers.
He demands to know what arrangements the HSE has put in place to accommodate requests from healthcare workers for an alternative vaccine rather than the Astra Zeneca version.
Mr Fitzpatrick's letter on behalf of the staff panel also queries whether the HSE has considered the implications of utilising a vaccine for healthcare workers which only has 60% efficacy as regards the maintenance and provision of health services in the short to medium term.
Unions also voiced concerns that the workers will not be protected by a vaccine until May or June of 2021, as the gap between the first and second doses of the Astra Zeneca vaccine is longer than the 21-28 day timeframe for the Pfizer BioNTech version - elongating the period where healthcare workers remain at risk of infection.
The letter concludes by urging management to revert urgently, as it is seeing an increased volume of calls each day regarding these matters.
HSE defends use of Astra Zeneca vaccine
The HSE has defended its use of the Astra Zeneca vaccine for health care workers, following concerns expressed by health unions.
It said the Astra Zeneca vaccine was extremely important in the response to Covid-19 and will provide protection to staff, while allowing the HSE to continue to provide vital healthcare services to the population.
It noted that the Astra Zeneca vaccine has been approved for use from the age of 18 by the European Medicines Agency, the World Health Organization and the National Immunisation Advisory Committee.
The HSE pointed out that the EMA had reported a 60% reduction in cases of symptomatic Covid-19 disease from the vaccine, which was above its threshold for authorisation.
It went on to say that further details in studies of the Astra Zeneca showed 70% effectiveness, with no cases of hospitalisation or severe Covid-19 at least 21 days after the first dose of the vaccine.
"Data just released shows 76% vaccine efficacy and no decrease in immunity for the first 90 days after the first dose. Vaccine efficacy was 82% after the second dose with a 12 week interval between doses and this longer interval resulted in the highest vaccine efficacy, which is why this interval has been chosen to ensure the highest and longest immune response," the HSE stated.
It also noted that the Astra Zeneca vaccine was the first to report that it will not only only protect against symptomatic Covid-19 disease but also reduce transmission by reducing the number of infected individuals in the population.
Vaccination sick leave should be categorised as special leave
Health unions have demanded that sick leave taken due to adverse reactions to the Covid-19 vaccination should be categorised as special leave, and should not be deducted from their standard annual sick leave entitlements.
They have written to HSE management stating that an specified number of staff have become unwell and been absent from work "directly relating to receipt of the vaccine" - including some who have been hospitalised as a result.
In the letter on behalf of the health unions' staff panel reported by the Industrial Relations News journal, chair Tony Fitzpatrick says that members have been told that that period of absence will be deducted from their sick leave entitlements.
He cites one member describing this as a "kick in the teeth" considering the the level of "agility and flexibility" demonstrated by healthcare workers in response to the pandemic.
Mr Fitzpatrick concedes that the number of affected staff is relatively small.
However, he says unions were raising the matter as they were aware that managers were applying the sick leave scheme to members who were feeling unwell and absent from work "directly related to receipt of the vaccine".
"We also note the comments of the HSE CEO Paul Reid, that it would be "inexcusable" for health care workers not to take the vaccine and that he would utilise the Health and Safety Act, for the "removal" of staff from frontline positions," Mr Fitzpatrick continues.
He urges management to issue a memorandum to line managers so that if healthcare workers are absent after receiving the vaccine "... it should not be classified as sick leave and consume their sick leave entitlement".
The HSE acknowledged that the union's claim was submitted yesterday, adding that it is currently under consideration.
