The Health Information and Quality Authority (HIQA) has today published a report, to inform the national policy on the allocation of COVID-19 vaccines to members of group nine (those aged 18-64 years living or working in crowded accommodation, where self-isolation and social distancing are difficult to maintain). The report explored the appropriateness of inclusion of certain populations within the group, based on their risk of infection and or risk of severe disease.

The report found that the risk of severe disease was higher in the Traveller and Roma communities and among people who are homeless, while Travellers were also found to be at increased risk of infection compared with the general population. Limitations in the data relating to these hard-to-reach groups, means that the estimates presented are considered to underestimate the true prevalence.

Within the report, HIQA has outlined 12 potentially at-risk populations for consideration under vaccine allocation group nine. The populations were identified based on the groups considered by social inclusion divisions of the HSE and Department of Health, and a review of international public health guidance. Irish data, where available, were then used to estimate risk of infection and risk of severe disease compared to the general population.

All of the identified groups presented with an elevated risk of infection and or risk of severe disease relative to the general population and when data was limited or unavailable, it was noted that they would have a plausible elevated risk.

Dr Máirín Ryan, HIQA’s Deputy CEO and Director of Health Technology Assessment, said:

“The goal of priority vaccine groups is to ensure that those most likely to be infected or at greatest risk of severe disease are protected first. Although everyone is at risk of COVID-19, some populations have been disproportionately impacted by COVID-19 in terms of severity of illness, mortality, and transmission.”

Dr Ryan continued:

“Rigorous measures taken to prevent transmission in settings such as prisons and homeless services appear to have been effective as rates of COVID-19 infection in these settings have been comparatively low. However, the acceptability of the measures may limit how sustainable they are in the longer term. There are important ethical and equity concerns for these groups living and working in crowded conditions which must be considered in prioritising allocation of COVID-19 vaccines.”

You can find the review from the link at the top of the page.

Ends.

Further information:
Marty Whelan, Head of Communications & Stakeholder Engagement
01 814 7480/085 805 5202, mwhelan@hiqa.ie

Notes to Editor:

• HIQA has today published the following document to inform the groups included in COVID-19 vaccine allocation group nine:
  • Evidence synthesis for groups in vaccine allocation group nine - those aged 18-64 years living or working in crowded conditions
• The following 12 potentially at-risk groups were identified for consideration:
  • Travellers, Roma community, residents and staff of accommodation centres for international protection applicants and programme refugees, prisoners and prison staff, people who are homeless and staff in homeless facilities, addiction service users and staff in these services, people working in food processing plants, residents and staff of women's refuges, undocumented migrants, sex workers, seasonal harvest workers, and religious communities.
• This evidence synthesis faced a number of limitations, including the use of summary case data linked to outbreaks for the majority of groups, the underestimation of cases in hard to reach populations, the lack of standardisation for potential confounding factors such age and sex, and the potential underestimation of risk in a number of the groups identified given limitations in case data and or population size estimates. Furthermore, the estimates of infection risk may be influenced by the degree of testing in the populations included (for example, the use of serial testing).  
• Working with its COVID-19 Expert Advisory Group, HIQA’s COVID-19 Evidence Synthesis Team produces a variety of outputs to support the work of NPHET including rapid health technology assessments, scoping reports, rapid reviews of public health guidance, and evidence summaries, supplemented by an evidence-to-advice framework to guide the development of advice, where appropriate.