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Provisional Vaccine Allocation Groups
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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. On Tuesday 30 March, the government approved an update to the COVID-19 Vaccination Allocation Strategy. The move to an allocation strategy focused largely on evidence of clinical risk – that is age and medical conditions – will make Ireland’s vaccination programme more efficient, more transparent and fairer.
While vaccine supply is constrained, this strategy sets out the groups to be prioritised for vaccination to best achieve the vaccination programme’s objectives of preventing serious illness, hospitalisation and death. It is based on clinical, scientific and ethical frameworks and evidence produced by the National Immunisation Advisory Committee and the Department of Health. Read the advice from NIAC.
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 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 16-64 |
| 9 | People aged 16-64 living or working in crowded settings, and in parallel, People aged 64 years and younger |
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.
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% of cases were in healthcare workers.
In the following order: 85 and older, 80-84, 75-79, 70-74.
Rationale
At higher risk of hospitalisation and death.
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.
Diabetes and HbA1C ≥58mmol/mol
Severe immunocompromise due to disease or treatment, for example:
Disorders of intermediary metabolism/at risk of acute decompensation, for example: Maple Syrup Urine Disease.
Down Syndrome.
BMI >40 Kg/m2.
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)”
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 services essential to the vaccination programme.
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.
In the following order:
This is a prototype - your feedback will help us to improve it.