Dr. Tony Holohan:

It is fair to say that I have all the same questions that the Senator has but I do not have any answers at this time. I have a fair sense of what I think is in play. There is increasingly recognition at European level, with the Omicron variant having helped in this advance in thinking, that we have a high level of immunity in populations across Europe, which is certainly true in this country, having done so well with vaccinations and boosters, and also given the high levels of infection. We have seen the performance of the vaccines, which have held up so well in preventing an infection from becoming a severe infection. We have shifted our emphasis from one where we attempt to control transmission and severe impacts of the disease to one where we focus on controlling the severe impact of the disease. That question arises for every element of our response to the pandemic, including our vaccination response.

Almost three weeks ago, I wrote to NIAC to ask it to begin to consider what the long-term plan might be. We have not yet arrived at a point where we can say that this is endemic to the point that we know we will see a seasonal pattern of this infection occurring in the wintertime, receding as winter recedes and so on, in the way that we see with many respiratory viral infections, particularly flu. That has not yet been established. As I pointed to earlier in the meeting, we see a small uptick in the number of infections detected in the 19 to 24-year-old age group. We will keep a close eye on that. I am not expressing any concern about it but simply am making the point that we have observed this. As other countries have eased measures in the last weeks, they have observed an increase in transmission, which the Senator might have seen. We do not know exactly what the pattern will be. We will have to wait and see as our understanding improves.

I refer to the possibility that we end up dealing with a disease that creates a greater challenge for us in winter than at other times of the year and our emphasis would be much more on protecting the people who are most at risk from the severe effects of the disease. That might have a significant impact on the nature and structure of a vaccine programme. As the Senator stated, companies are in the process of developing new formulations that are more specifically targeted at Omicron and so on. As to how many, if any, of those might become part of our response, these are still the questions that we and every other country in Europe are seeking to try to answer. We need to keep working to ensure we are able to shape the response, if one likes, based on the answers to those questions. They are all very good questions.