Publication
Provisional Vaccine Allocation Groups
From Department of Health
Published on
Last updated on
- 1. Adults aged ≥65 years who are residents of long-term care facilities
- 2. Frontline healthcare workers
- 3. People aged 70 and older
- 4. Aged 16-69 and at very high risk of severe COVID-19 disease
- 5. Aged 65-69 whose underlying condition puts them at a high risk of severe disease and death
- 6. People aged 65-69, other healthcare workers, and key vaccination programme workers
- 7. Aged 16-64 and at high risk of severe COVID-19 disease
- 8. Residents of long-term care facilities aged 18-64
- 9. Aged 18-64 years living working in crowded accommodation where self-isolation and social distancing is difficult to maintain
- 10. Key workers in essential jobs who cannot avoid a high risk of exposure to COVID-19
- 11. People essential to education and who face disease exposure
- 12. Aged 55-64 years
- 13. People in occupations important to the functioning of society
- 14. Aged 18-54 years who did not have access to the vaccine in prior phases
- 15. Children, adolescents up to 18 years and pregnant women (to be refined)
The COVID-19 Vaccine Allocation Strategy sets out a provisional priority list of groups for vaccination once a safe and effective vaccine(s) has received authorisation from the European Medicines Agency (EMA).
The Strategy was developed by the National Immunisation Advisory Committee (NIAC) and Department of Health, endorsed by the National Public Health Emergency Team (NPHET), and approved by Government on 8 December 2020.
The Strategy is a further component to the State’s response to the COVID-19 pandemic, and will evolve and adapt with more detailed information on the vaccines and their effectiveness.
This is the provisional order in which people in Ireland will be vaccinated against COVID-19.
| 1 | People aged 65 years and older who are residents of long-term care facilities (likely to include all staff and residents on site) |
| 2 | Frontline healthcare workers |
| 3 | People aged 70 and older |
| 4 | People aged 16-69 with a medical condition that puts them at very high risk of severe disease and death |
| 5 | People aged 65-69 whose underlying condition puts them at a high risk of severe disease and death |
| 6 | Other people aged 65-69, other healthcare workers not in direct patient contact, and key workers essential to the vaccine programme |
| 7 | People aged 16-64 who have an underlying condition that puts them at high risk of severe disease and death |
| 8 | Residents of long-term care facilities aged 18-64 |
| 9 | People aged 18-64 living or working in crowded settings |
| 10 | Key workers in essential jobs who cannot avoid a high risk of exposure |
| 11 | People working in education sector |
| 12 | People aged 55-64 |
| 13 | Other workers in occupations important to the functioning of society |
| 14 | Other people aged 18-54 |
| 15 | People aged under 18 and pregnant women |
Consider offering vaccination to all residents and staff on site.
Rationale
At greatest risk of severe illness and death.
In Ireland, in the first wave of COVID-19, 56% of deaths occurred in this setting.
Ethical Principles
In line with the principle of minimising harm, vaccination of this group would protect those at greatest risk of a poor outcome from infection. It adheres to the principle of moral equality and the principle of fairness in recognising the disproportionate burden this group has carried.
Frontline healthcare workers (HCWs)* in direct patient contact roles (including vaccinators) or who risk exposure to bodily fluids or aerosols and those providing services essential to the vaccination programme.
Rationale
At very high or high risk of exposure and/or transmission. In the first wave over 30% cases were in healthcare workers.
Ethical Principles
The principle of minimising harm is realised, as benefit will accrue to healthcare workers and the patients they care for, producing a multiplier effect. Society also has a reciprocity-based duty to protect those who bear additional risks to safeguard the welfare of others.
In the following order: 85 and older, 80-84, 75-79, 70-74.
Rationale
At higher risk of hospitalisation and death.
Ethical Principles
The principle of minimising harm, moral equality and fairness are relevant as this group are at greater risk of carrying disproportionate burdens from the pandemic.
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, on dialysis, or eGFR <15 ml/min.
Chronic neurological disease or condition with evolving ventilatory failure (requiring non-invasive ventilation), for example: motor neurone disease, spinal muscular atrophy.
Chronic severe respiratory disease, for example: severe cystic fibrosis, severe COPD, severe pulmonary fibrosis.
Uncontrolled diabetes, for example: HbA1C ≥58mmol/mol.
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
Disorders of intermediary metabolism/at risk of acute decompensation, for example: Maple Syrup Urine Disease.
Down Syndrome.
BMI >40 Kg/m2.
These groups will be completed in parallel.
Rationale
At high risk of hospitalisation and death.
Ethical Principles
By protecting those at greatest risk of poor outcomes from the disease the principle of minimising harm is upheld.
Rationale
Provide essential health services, protect patients.
Ethical Principles
Maintenance of healthcare services, minimises harm by preventing injury, illness and death from causes other than COVID, and the principle of reciprocity is upheld.
Rationale
Provide services essential to the vaccination programme.
Ethical Principles
Upholds principle of minimising harm by protecting the continuing functioning of essential services. The principle of reciprocity is upheld.
Haematological - within 1 year.
Haematological - within 1 - 5 years.
Non-haematological - within 1 year.
All other cancers on non-hormonal treatment.
Chronic heart disease, for example: heart failure, hypertensive cardiac disease.
Chronic kidney disease with eGFR <30ml/min.
Chronic liver disease, for example: cirrhosis or fibrosis.
Chronic neurological disease or condition significantly compromising respiratory function and/or the ability to clear secretions, for example: Parkinson's disease, cerebral palsy.
Other chronic respiratory disease, for example: stable cystic fibrosis, severe asthma (continuous or repeated use of systemic corticosteroids), moderate COPD.
All other diabetes (Type 1 and 2).
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.
Disorders of intermediary metabolism not fulfilling criteria for very high risk.
Intellectual disability*** excluding Down Syndrome.
BMI >35 Kg/m2.
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)”
Rationale
High risk of transmission.
Ethical Principles
The principles of moral equality and fairness are applicable, given the higher risk of exposure to infection and the potential vulnerability of some who may not be able to adequately protect their own interests.
Rationale
Disadvantaged sociodemographic groups more likely to experience a higher burden of infection.
Ethical Principles
The principles of moral equality, minimising harm (especially in the context of multi-generational households) and fairness are relevant. Prioritising this group recognises that structural inequalities make some people more vulnerable than others to COVID-19.
They include workers in the food supply system, public and commercial transport and other vital services.
Rationale
High risk of exposure as unable to work without physical distancing.
Ethical Principles
The principle of minimising harm is upheld by reducing societal and economic disruption and the principle of reciprocity recognises the additional risk these groups bear in order to provide essential services.
These include primary and second level school staff, special needs assistants, childcare workers, maintenance workers, school bus drivers.
Rationale
To maintain the opening of full-time education of all children who have been disproportionately impacted from the pandemic.
Ethical Principles
Maintaining children’s educational and social development and facilitating parents’ employment adheres to the principle of minimising harm. The principle of reciprocity is also relevant given the potential additional risk being borne by such groups.
Rationale
Based on risk of hospitalisation.
Ethical Principles
The principles of moral equality, minimising harm and fairness apply.
For example: third level institutions, entertainment and goods-producing industries who work in settings where protective measures can be followed without much difficulty.
Rationale
Moderate risk of exposure.
Ethical Principles
The principle of minimising harm is upheld as protecting workers needed to maintain critical infrastructure and other important services will enable social and economic activity. The principle of fairness and moral equality also apply.
Rationale
If evidence demonstrates the vaccine(s) prevent transmission, those aged 18-34 should be prioritised due to their increased level of social contact and role in transmission.
Ethical Principles
The principle of minimising harm is relevant should it become clear that a vaccine can impact on transmission of the virus as this would indirectly protect the most vulnerable in society as well as restore social and economic activity.
Rationale
If evidence demonstrates safety and efficacy.
Ethical Principles
The principles of moral equality, minimising harm (if vaccines are shown to be safe and effective in these groups) and fairness.
Ethics vaccine allocation framework
Download*Includes health care workers who work in and out of all healthcare settings.
