First vaccine delivery could be smaller than anticipated

Illustrative photo of Covid-19 vaccine. Photo: Sander Ilvest

The government unveiled Estonia’s vaccination plan on Tuesday. Even though exact quantities and dates were not provided, the first doses of vaccine should reach Estonia in early January, while inoculation of risk groups might not commence before spring.

The COVID-19 vaccine by Pfizer and BioNTech could be the first to reach Estonia. The European Medicines Agency has set a meeting to discuss its sales permit on December 21.

“We could see the first approvals in terms of sales permits around the turn of the year that would mean January deliveries,” Minister of Social Affairs Tanel Kiik (Center) said.

Deputy Secretary General Maris Jesse added that the ministry is not sure when. “We do not know the date yet. We know that the contract prescribes the first delivery three days after a sales permit is granted,” Jesse explained.

Postimees’ information suggests it is doubtful whether Pfizer will manage to keep its promise. Jesse said she knows nothing of such doubts. “Processes have not gotten as far as discussing delivery dates with other manufacturers,” the deputy secretary general added.

Little clarity

The ministry held a round of talks with an undisclosed manufacturer on Friday. The company offered to deliver 10,000 doses initially, while the ministry wanted more. The sides settled on 40,000 doses.

Jesse emphasized that the first delivery should be as big as possible to allow Estonia to start inoculating front-line staff. “We can provide dates as soon as we have final confirmation,” she said.

Minister Tanel Kiik said that Estonia should have 200,000 doses of vaccine for 100,000 people, as immunity requires two shots, in January.

The vaccine will be made available to front-line workers first, followed by family doctors, people in risk groups and finally everyone who wants it. Kiik did not wish to speculate which hospitals would be prioritized should initial deliveries not match forecasts.

Should the initial delivery be insufficient to vaccinate all medical personnel, the vaccine will be made available to those who have direct contact with COVID-19 patients first. Medical workers who are themselves part of risk groups are also higher up on the list. Estonia had 24,740 healthcare workers in late 2019.

CEO of the North Estonia Medical Center (PERH) Agris Peedu said that the hospital has a staff inoculation plan and personnel standing by. The hospital also has the necessary equipment to preserve quantities of the vaccine in both the short and long term.

“Vaccination will be available to all our employees, while the law states that inoculation is voluntary,” Peedu added.

The hospital is making preparations to launch COVID-19 vaccination of staff and later other members of the population.

Director of the infection control service of the Tartu University Hospital Matti Maimets said the hospital stands ready to inoculate staff and patients. The process will be handled by members of staff in charge of flu vaccinations.

The Pärnu Hospital will put together its inoculation plan based on Health Board guidelines and has procured the necessary equipment.

We have brigades with inoculation training standing by. Questions pertaining to equipment (cotton, syringes and preservation) aren’t really relevant – most hospitals have this capacity,” Aino Rõõm, infection control doctor at the East Tallinn Central Hospital (ITK), told Postimees. She added that vaccination schedules will be drawn up based on individual vaccine parameters.

Member of the board of the Kuressaare Hospital Edward Laane said the hospital is making preparations, while sales permits are needed first. “Not a single vaccine for the SARS-CoV-2 virus has been approved in the European Union today,” Laane emphasized.

Because the West Tallinn Central Hospital (LTKH) handles vaccinations every day, it has enough trained staff to handle COVID-19 immunization.

Family doctors are the next group to be vaccinated. Estonia had 929 family doctors last year. From there, the plan will move on to COVID-19 risk groups.

Family doctors to decide

Once front-line workers have been vaccinated and Estonia has taken delivery of additional and larger quantities of vaccines, family doctors can start putting in requests. “We have a general list of risk groups, while we also know that the older a person is – especially if they also have diabetes – the more vulnerable they are,” family doctor Marje Oona said. She added that every family doctor will decide which of her patients will be vaccinated. No one else will be in charge of these decisions

The Health Board will organize transport of vaccines. “The contract prescribes that the manufacturer ensures transport to the Health Board’s central warehouse and is responsible for the safe transport of vaccines. The goods are inspected upon delivery,” Minister of Social Affairs Tanel Kiik said.

The ministry’s data suggests Estonia has 260,000 people belonging to risk groups. Marje Oona said that every family medicine center will discuss their vaccination process as the number of family doctors and patients belonging to risk groups differs greatly from one center to another. Vaccines will also be delivered gradually.

Staff and residents of nursing homes who number around 25,000 in all will also be prioritized in the vaccination process. Oona said that most healthcare institutions have trained staff who can carry out vaccination. Elsewhere, nursing home residents will be vaccinated by family doctors.

The latter will be delivered the vaccine complete with syringes and cotton pads. “The Health Board currently has 41,000 dissolving needles for the vaccine and 50,000 syringes for vaccine shots,” Jesse read out.

The Pfizer vaccine can be transported and preserved at -70 degrees, which is why the Health Board has procured proper refrigeration devices that have already arrived in Estonia. “These need to be installed properly in Health Board premises. Preparation work will be completed before Christmas. We are on and ahead of schedule,” Tanel Kiik said.