1. In light of the statement on a COVID-19 vaccine by Pfizer, what discussions has the Welsh Government had with the UK Government regarding a roll-out strategy across Wales? TQ503

Can we have the Minister's microphone unmuted, please? Yes.

It's normally the other way round. As the Member will know from the two questions I answered last week to his colleague Nick Ramsay and the Member for Islwyn, Rhianon Passmore, the Welsh Government has been working closely for many months with the UK Government, other devolved nations, and on an all-Wales basis with key stakeholders such as Public Health Wales, health boards, trusts and local authorities on our plans to distribute a vaccine in Wales.

Thank you, Minister, for that answer. Could I seek assurance from you on two fronts, and some availability of the planning to date? Yesterday, in First Minister's questions, the First Minister highlighted that the chief medical officer has been in discussions since June, and then in direct discussions with the health boards from July, about the availability and distribution of the vaccine here in Wales. Could I ask that those discussions are made available and the outcomes of those discussions are made available for Assembly Members to see, so that we can understand how prepared Wales is to make sure the logistics are in place when the vaccine becomes available? Are you confident enough to be in a position, like the UK health Secretary did yesterday in the House of Commons, to commit that, from 1 December, the Welsh NHS will be in a position, irrespective of when the vaccine will come, to be able to distribute and administer the vaccine here in Wales? 

In terms of the point about when will we be ready in Wales, we have had planning scenarios so that if a vaccine—and it is still an 'if'—is available before the end of this year, then we will be able to undertake that programme here in Wales. And if that was 1 December, then we could do so. That does depend on a number of factors, though. It depends on who we'd be delivering the vaccine to, and that depends on the allocation of that and the understanding of the advice that we and every other UK nation will have had from the Joint Committee on Vaccination and Immunisation, the expert committee that advises us on the effectiveness and prioritisation within the population for any new vaccination. It also, of course, depends on the vaccine being available in any event. Whilst the trials are promising, this is not ready and available to us. It also depends on the particular characteristics of this vaccine, which needs not just two deliveries, but requires storage at very, very low levels. So, yes, I can give the assurance that I gave last week as well, that, if we are in a position to have a vaccine delivered to us, then we can deliver it and distribute it across Wales this December. 

In terms of the conversations and the range of conversations that are taking place with the chief medical officer and others, what I think would be more helpful would be if I provide a note to Members more generally, rather than a data dump, that sets out the nature of the arrangements we have. And I'd be happy to provide a written statement in the coming days to set out the nature of our planning and where we are with each of our organisations. And the Member will of course understand that those conversations do, as I said earlier, depend on the particular characteristics of each vaccine, and this one in particular, with its requirement for very low temperatures for storage. 

Rhun ap Iorwerth's microphone, can that be—? Yes, here we go. 

Thank you very much, and thank you for that response. We had an opportunity at health committee this morning to question members of the technical advisory cell on the next steps, but I wonder if you could tell us a little more, Minister, as to when the opportunities provided by the vaccine will be included in modelling for the likely pattern of the pandemic over coming months. This is only a development, of course. We're very pleased to hear of it, but we're a very long way from being in a situation where a vaccine will be available to be administered to people. But to date, of course, we don't know what the expected impact of the introduction of a vaccine will be on the spread of the virus in months to come. So, I wonder if there's any modelling on that, and more assurances, perhaps, if you could provide them, on the guarantee that Wales will receive at least its population share as the vaccine is distributed, whenever that may be?

Yes, I'll happily deal with the last point first, as it were, on Wales receiving its fair share. That is absolutely going to happen. So, the advance procurement of this by the UK Government, there's already agreement as to how that will be distributed and there's a clear written agreement between the nations on that, and Wales, as other UK nations, will get a Barnett population share. So, we'll get 4.78 per cent of the total stock. And it will then be our responsibility and our choice as to how that is distributed to people here in Wales. 

On your first point, I think it's helpful to, again, take a step back and remind ourselves that the vaccine isn't available today, and there are many other vaccine candidates as well. So, it is possible that there could be a potential hold-up in this gaining approval by regulators, and that's really important. So, we can't yet model that in, because we don't know that it's available. And so that will be both the safety and effectiveness of their safety data—that'll have to be published—then our medicines regulator will be able to make choices and make decisions about when or if it can become available.

We'll then need to try to model in what that looks like. We'll need to have a modelled understanding of how we go about not just the delivery, but the potential impact on the population. But, again, that depends on the exact characteristics of the vaccine, which we don't yet understand. It could be possible that this vaccine is highly effective in our most at-risk groups. It's also possible that the vaccine could be less effective in the groups at most risk of the greatest harm. So, we need to know all of those things before we provide some sort of modelled evidence. What I can say though is that, as we are providing weekly briefings to the Health, Social Care and Sport Committee and also providing regular information opportunities, we'll make sure that, as we're developing that and as we have some more certainty to provide, we'll share that with Members and with the public. We're not looking to keep secret the potential impacts of a vaccine, but we all need to take account of the fact that it is still some months away before it would have an impact.

What we should not do, given all of the hard work and sacrifice we've just gone through with the firebreak, is to potentially throw that away by acting as if the vaccine is here today. Our behaviour today and for the coming weeks will determine how many of us are here to celebrate with each other at the end of this year and going into the new year. A vaccine may have an impact going into the new year, but at this point in time, it's really important to continue to behave and to continue to change our behaviour to keep each other safe, and again, as we've said many times before, to think now about what we should do to keep each other safe.

Minister, it is promising news about the Pfizer vaccine, and I hope that it does meet its potential. However, it will be some time before we can secure the nearly 6 million doses needed. Turning to the practicalities of roll-out, should this and other vaccines meet safety and efficacy standards, there have been reports in the media and GP newsletters that other GP services will be rolled back to accommodate the vaccination programme. Minister, will you assure the Welsh public that this will not happen, and that services will not be put on hold in Welsh primary care settings? Diolch.

We have yet to conclude our discussions with primary care about the delivery of any vaccine, and again it's important to remember 'any vaccine', because there are other candidates, not just the Pfizer candidate, that again, at this point in time, is not approved. And that will affect how we would deliver those vaccines, because my recollection is that this vaccine would need to be stored at below -75 degrees centigrade and there are very few facilities able to do that. You don't find facilities like that in every general practice or in every community health centre. So, we've got to think about a different model and an ability to be able to distribute the vaccine depending on its characteristics, and that will then help to determine who delivers that and where they deliver that.

So, there's a range of things to work through and we'll then have to take a balanced view. If there is a vaccine that is effective and will avoid the significant amounts of harm that we have already seen coronavirus cause, and which it could add to significantly through this winter, we need to make a balanced judgment about offering that vaccine and offering it to the public with those at-risk groups coming first, and to then understand the impact of that on other health and care services. So, that's why it's so important not to get lost in wanting to have a hard-and-fast, detailed plan now for a vaccine that we don't yet have available, and each vaccine will bring different challenges as well, of course, as different opportunities to help protect the public.

Thank you, Minister.