The next item is a statement on COVID-19 vaccinations. I call on the Minister for Health and Social Services to make the statement—Vaughan Gething.

Thank you, Llywydd. Today we have published the second of our reports summarising progress against our national COVID-19 vaccination strategy. These reports are published every Tuesday, in addition to the surveillance data being published by Public Health Wales that is published both daily and weekly, and the operational data that is being published by Welsh Government statisticians. According to the figures published at midday today, the NHS Wales-led programme has vaccinated more than 439,000 people across Wales. That is almost 14 per cent of the population. The latest information I have also shows that over 60 per cent of our first priority groups have now received their first dose of the vaccine. The pace is continuing to increase, and we are making strong progress. The effectiveness of our infrastructure and the growth in capacity are clear for all to see.

We have already hit two markers in our vaccine strategy. We have offered all front-line Welsh ambulance service staff their first dose of the vaccine. We also exceeded our end-of-January marker to have more than 250 GP practices deploying the vaccine. Last week’s report confirmed that this marker had been achieved ahead of schedule, with over 300 practices running clinics. The number has increased again to over 400 practice locations, demonstrating the high level of engagement across all parts of our health service to work together to deliver the COVID-19 vaccination programme as quickly and as safely as possible. Protecting the vulnerable has always been at the heart of our response to the pandemic and it remains at the forefront of our fight back against this terrible disease.

The final marker that we've been working towards is vaccinating the first priority group set by the UK’s independent expert Joint Committee on Vaccination and Immunisation—people living in a care home for older adults and their staff carers. We set out to reach all those care homes that it was possible to reach by the end of January and to make sure that plans were in place for those care homes that have had COVID-19 outbreaks and incidents to be done as soon as possible. I am pleased to confirm again that we have achieved this marker, as confirmed yesterday by my colleague Eluned Morgan. Health boards have confirmed they have visited all older person care homes that it has been safe to send vaccination teams into. For those homes where it has not been safe, visits are planned during February, as soon as the public health advice allows.

As with our delivery model generally, a blended approach is in place for older person care homes. For some care homes, health boards are sending in vaccination teams to vaccinate both residents and staff. For other care homes, GP practices are organising vaccination for residents, often through a district nurse or small team, with staff being invited to attend mass centres. This mixed model ensures the right approach for the right home, given its context and location. With the three markers on the journey to milestone 1 having been achieved, our focus now is on completing vaccine offers for all those in the first four priority groups. In the last week, we have vaccinated more people as a percentage of our population than any of the other UK nations. We are moving through the priority cohorts and are on track to deliver against our first milestone by the middle of February.

We expect to sustain this level of progress and, in fact, expect to see an additional step up in the rate of vaccination this week. We've built a sustainable programme and are building pace and capacity within it all the time. This week, an additional military aid to civil authorities request has been agreed. This will see a further 90 military personnel brought in to support capacity in the vaccination programme across Wales. I am extremely grateful to our NHS colleagues across Wales whose continued hard work and dedication is making this incredible progress possible, and, of course, their partners in local government, the military and beyond, including the voluntary sector. I am very proud of what we are doing as a country with the vaccination roll-out. We still have a marathon ahead of us, but we can face the next stage with a real sense of confidence in our NHS-led programme here in Wales. Thank you, Llywydd.

Good afternoon, Minister. Thank you for your statement. Credit where credit's due, the situation has moved on enormously since last week, and I'd like to say well done to the whole effort, from Government down to those on the front line, for cracking on with the vaccines, especially as we were behind. It is really good to see that some of these priority groups have been picked up and are moving forward.

I do want to emphasise the importance of communication, because I have a lot in my constituency, and I know, in fact, in Hywel Dda, it's the same—we have a lot of those who are in their 80s plus who haven't yet been vaccinated, but have got appointments during the course of this coming week and next week. That is different from saying to everyone, 'You will be vaccinated by last weekend', which was the target, and I think that's caused some confusion. So, going forward, down all the other priority groups, I would urge that some more thought is given to the communication message. But it's really great to see that we are making strides to try to vaccinate the whole nation.

Unfortunately, the number of registered deaths, although they have decreased from 467 to 447, which is obviously very welcome—it's still the third highest of any point in the pandemic, which shows how very distressing and awful it is, and the fact that this disease is a killer. Are you able to update us on any more that you might be able to do to reach those hard-to-vaccinate groups, the people who are either refusing the vaccine or the groups, the cohorts of people, who we know are harder to persuade to take it up? And for those people who have been phoned up and offered a vaccine and are saying, 'No, I don't want it', what plans are in place to be able to perhaps follow up on them individually, by perhaps their local GP, to try to have a conversation? Because until more of us are vaccinated, we're still going to see these awful deaths occurring in hospitals and in our communities. So, any update that you can give us on that would be really welcome. 

Of course, the other concern that people are now beginning to flood inboxes with is whether or not the vaccines are efficient against all these new strains, especially the new UK strain that Andrew R.T. Davies mentioned on the business statement, and, of course, the South African strain. Perhaps you'd like to make some kind of public comment on that, because I think it would be really useful to try to reassure people and put minds to rest. 

You mentioned the very welcome work on reaching the care homes, but can you please tell us how many care homes have yet to be vaccinated, or how many residents and staff within certain care homes? I appreciate that some care homes were deemed red because they had some element of coronavirus; I know that different health boards have got different policies in place about whether or not they will go in and try to vaccinate in part of a care home, even if some of it has got the COVID virus in it. But I also would like to build on Delyth Jewell's question that she put to you during the business statement, or asked the Trefnydd to look at: are care homes being recategorised at all? Is there any plan that some care homes have perhaps been changed into different categories? Anything you can tell us on that, again, would be very useful.

Finally, I just want to raise the issue of pharmacists. We know that we have the mass vaccination centres, we know that GPs are doing it, we know that there's an awful lot of work going on within the hospital environment and within social care, but of course our pharmacists are still standing in the wings ready to help what is basically a national effort. Can you outline any plans to involve them? I have heard from the health boards throughout Wales that they are talking to pharmacists, but actually they've been talking to them for the last two, three or four weeks. Nothing yet is happening. There seems to be nothing really concrete on the ground.

As we go down those category groups and we start looking at vaccinating the sixties and the fifties, those groups are going to get bigger and bigger and bigger. We're going to need everybody. You've already talked today about deploying 90 members of the military—very welcome, but we have some 710 pharmacy operations waiting in the wings. So, any update you can give us on that—because I do think that they are a squandered resource and that we can really use them. They want to be used, they've said it very loudly, very clearly, they've put forward the proposals and, of course, if you are somebody who is perhaps less keen on travelling, going to your local pharmacy, a bit like going to your local GP, is a much easier option than travelling to a mass vaccination centre. So, any update on when they may be used and on what category of people the pharmacists may be involved in. Thank you very much.

Thank you for the comments and questions. In particular thank you for recognising the progress that is being made and the pace of what we're able to deliver in Wales with a joint team approach.

On the questions, with the death toll that we're still seeing, it's a reality that, as we're going in the right direction, we're still going to see relatively high numbers of people coming to harm, and we'll see that in the death figures. As we went through the first peak, when we were moving in the right direction, we still had to go through a number of weeks of quite large death tolls to report, I'm afraid. And given the numbers of people we still have in our hospitals, I'm afraid we are going to see more people losing their lives in the coming weeks ahead, even though the picture is improving. So, there'll be more families each week who will be mourning the loss of loved ones, and that is why it's important that we're positive about not just what we're doing in the vaccination programme, but the reassurance for people that they won't be forgotten or left behind. So, if there are people who are over 80 who have yet to have their jabs, they will get appointments and they will get covered; they will get protected in Wales just as in the rest of the United Kingdom.

On progress on those people who are refusing, part of our challenge obviously is that the vaccination is voluntary, and so there are people who for different reasons are more or less anxious about what to do, and it builds on your point about communication, about the range of concerns that there are, so we are looking at, as we've gone through this, understanding more of the concerns that people have to be able to combat them, and these are issues that are not just here in Wales; they're common issues right across the UK and indeed across Europe.

So, we are doing some specific work, for example, on black and Asian-origin communities. I think it was a very positive step forward to see Members of Parliament from the Conservatives and the Labour Party who really don't like each other; you wouldn't normally see James Cleverly and Diane Abbott share a platform, but they were both in a joint video, encouraging people to have the vaccine. Now, I think that's really important. In amongst all of the difference of opinion we will have about what has happened or what will happen, it's really important to encourage people to take up the vaccine because it's safe and it's effective.

And I think that then goes into your point about vaccine efficacy and new strains. So, with both, if you like, the Kent-plus variant, and the South African variant, there is concern that there'll be a less effective response for vaccines. That does not mean that vaccines won't be effective at all; they will still offer a good level of protection, and in fact it reinforces the need to continue going with real pace in our vaccination programme. And as you heard the public health director for Public Health England in the press conference that he did with Matt Hancock yesterday, you'll hear exactly the same advice from all public-health agencies right across the UK about the fact that there is concern that the vaccines will be less effective but not ineffective; still safe, still effective, and still important that everyone does take up the opportunity when offered, and you can expect to see primary care clinicians in particular looking to follow-up those people who have yet to have their vaccine, but the real challenge is in getting through groups 1 to 9 as quickly as possible, where we know that 99 per cent of the deaths take place. However, there is still a high number of hospitalisations for people outside categories 1 to 9, so even after that, it's not quite as simple as taking a Ryanair approach, to then saying, 'Everything can start and go back to normal.' We're in this still for some time to come.

On your point about care homes; these have not been reclassified. There is no sleight of hand taking place here. There is no neglect of care home residents taking place. The target was about older person care homes, because that's where the highest risk is, and it's the ones where we're seeing the, at times, horrific results of coronavirus getting into those care homes. People with other susceptibilities to coronavirus will be covered by other priority groups, so if you expect to see people with, for example, a learning disability, then those that are older, over the age of 50, will be covered by their age cohort and those with other healthcare conditions, those people, for example, who can get the NHS flu jab, can expect to be covered in priority group 6 as well, and so we're moving progressively through not just groups 1 to 4, but at some point we'll be inviting in earnest groups of people from 5, 6, and others to come forward as well. So, the pace isn't going to slow up in terms of what we're able to do and we're certainly not forgetting people, either.

In terms of the care homes that we have, I was just looking at some figures earlier, and I'll provide a note back to this, so I'm not misremembering and misrecalling what's happened, but of the care homes that have not been completed, there are a range that have been partially completed, because we did issue guidance across Wales so there was a consistent approach. If there were a handful of cases as opposed to a wider outbreak, on a risk-assessed basis, teams were able to go in and test those people who had tested negative. So, they went in and they'd been able to vaccinate a number of people, so we have a range of care homes that are partially complete for staff and residents, and we have others where they weren't able to go in at all, and I think the numbers for those are in the low 30s, where that's because there's been an active outbreak. But given you've asked the question now, I'll send a note out to Members afterwards to confirm that position.FootnoteLink

And then, finally, on your point about pharmacists, we expect to make more use of pharmacists, both in our mass vaccination centres and those that are able to undertake vaccinations on their premises as we go through. And the limiting step—and you'd have pretty much the same answer from any health Minister within the UK—is vaccine supply, because I think in every nation in the UK, and certainly here in Wales, we could deliver more vaccines if we had more supply, especially if it was the AstraZeneca supplier, because it's easier to use. We haven't completely maxed out the ability of primary care to deliver against that, and as we have more vaccine coming on board, and we certainly hope we will have in the future, we should then be able to make even greater use of the well of goodwill as well as the physical ability to deliver more vaccines than exist in primary care.

Information further to Plenary

Thank you very much, Llywydd, and thank you for the statement. I'm also very pleased to see the ground that's been gained in terms of the vaccination process in Wales. There are enthusiastic teams of vaccinators in all parts of the country, and I hear very positive reports of the experience that people have in accessing the vaccine, and that's to be welcomed.

I will ask the first question emerging from that. Given that things are developing well at the moment, and I agree entirely with the Minister's comments that supply is the problem, not the number of vaccinators, but given that Novavax and Janssen are to come on stream soon, is it the Government's intention to move forward the target for vaccinating the whole population? I think we could now try and be more ambitious, if truth be told, and that's a very positive note.

Now, although things are developing well, there are still concerns—concerns about the mix of Pfizer and AstraZeneca that we receive here in Wales. Of course, it would be easier if we had more of the vaccine that's easier to administer, and I'll ask the same question that I ask every week: can we have the data on how much of each vaccination is distributed to all nations and to all parts of Wales, in the spirit of transparency, so that we can identify any systematic problems? I know that the Minister suggested last week that he now agrees that it would be useful to have that data, and that he is going to try and get that data, so can we have an update on that?

May I also make an appeal to the Government not to invite people to doubt the figures by failing to be entirely open in the statements that you make? We recall the Government saying that they were a little short of the target of 70 per cent of over-80s; well, that figure was 52.8 per cent, and that's a bit more than falling short. So, be transparent on the way that the figures are released.

Likewise, we are seeing the older people's commissioner having to point out that she is concerned that a quarter of people in care homes still haven't been vaccinated. The figures as to where we are aren't included in the statement, aren't included in that information that's easiest to access by the public. So, be upfront about these figures so that we can see where we are. There is plenty of good news to focus on. Let us see where the problems are, too, so that everyone can see where those problems are.

One question, if I may, specifically on the front-line ambulance service staff. It is a concern that a substantial number, perhaps, weren't willing to take the vaccination. So, could I have your comments on the concerns that that could put patients at risk? What's the Government's view on that?

And a question that I asked last week, which I didn't receive a response to: the mRNA technology is new technology. The storage requirements mean that we need a new kind of infrastructure. It's very possible that we will become more and more reliant on that new vaccination technology, possibly to deal with new variants and so on. So, what consideration is now being given to investing in infrastructure that will make it easier to handle that kind of vaccine? Because it's possible that we will be far more reliant on it in future years.

Thank you for the list of questions. I'll try to go through these quickly to allow time for other questions, Llywydd. In terms of whether we can move faster on completion, that is really a circular question, because it goes back to supply. If you have more supply of more vaccines, as long as they're approved as being safe and effective, then we can go faster, and I think we've demonstrated that over recent weeks. In terms of data on the vaccines for each UK nation, we continue to have these discussions with colleagues across the UK and all of us need to be responsible for what we're doing. You will no doubt have noticed the difficult public fall-out between the European Union and the UK Government and, indeed, vaccine manufacturers. I hope we're now in calmer waters on that front now, but there is understandable sensitivity about stocks on order and stocks held. I want to get to a position where we can publish the stocks that we have, and to be clear about what we have and how that's being used. We're publishing currently wastage rates, and we have very, very efficient use of vaccines here in Wales, which is another real bright mark for our vaccination programme here in Wales.

When we get to agreement on being able to have those figures openly, then we will certainly do so. I'm keen that we're able to do so, but I do understand the sensitivity, particularly at this point in time, on what we're able to publish, and it would be useful if all Government figures in all four nations could respond in the same way as we are trying to do as grown-ups across all four nations. 

On the openness on the figures, I think we are being remarkably open. We have daily figures, we have weekly figures published by Public Health Wales, we have additional weekly narratives that actually provide some of the information you're looking for in terms of the percentage within each of the cohorts. They're published on a daily basis now through Public Health Wales, so I don't really take the point that we're somehow hiding information; we are publishing a huge amount of information so that people can see openly what is happening. 

And I think the older persons' commissioner's concerns were rather unfair, if I may say. The older persons' commissioner has had a member of her staff taking part in the vaccine programme and on stakeholder groups since the summer. She's well aware of what we're doing within the programme. She's also well aware of her ability through regular meetings with Ministers and officials, and in dealing with the programme board, about how to raise concerns. And actually, we're going as fast as possible, and the only reason we haven't reached an even larger percentage of older people resident in care homes is for the entirely straightforward reason that Eluned Morgan explained yesterday, and I have re-explained again today about active outbreaks. 

When it comes to the potential for staff not to have the vaccine and what that means for the public, that is part of the conversation that peers have with each other, as well as at a leadership level, particularly given the amount of harm that is taking place. I'd like to be in a position where our front-line staff are taking a lead. I'll look again at the percentage of that, but there is a challenge and a choice about keeping that member of staff safe and, indeed, the public. 

And then on mRNA, we will, of course, need to look at the end of this at proposals on what we'll need to do, not just with our current storage facilities where we've been able to take on board significant amounts of the Pfizer vaccine—let's not forget we have accepted significant amounts of those—but then the infrastructure for the testing of each of those, and then the release of each of those, rather, for the vaccination programme. So, we'll of course look at lessons learned both during the time as well as lessons for the future. I just don't think I'm in a position now to confirm an amount of investment that we will definitely make in the future, but it's certainly all part of lessons learning and there'll be a need for essential honesty as well as openness about that now and in the months to come. 

Minister, I'd like to take the opportunity to pass on the many positive comments that I've received from residents in the Cynon Valley, who have contacted me to express their relief and their jubilation at having received the vaccine, and their thanks to all those that made this possible. The Welsh Government's vaccination delivery plan explains that all vaccinations in Wales are recorded directly into the Welsh immunisation system, a bespoke software package developed by NHS Wales Informatics Service, and integrated into the GP record, which makes it easy to rapidly call people forward for the vaccine, in line with the Joint Committee on Vaccination and Immunisation guidelines. What assessment, Minister, have you made to date about how well this digital recording and reporting system is operating? And what lessons can we learn from this innovation about how we can make use of digital technology at speed to enhance patient experience within the NHS in Wales? 

Yes, thank you. I think that's one of the things that has been largely overlooked—the fact that NWIS, who at times have been criticised, have actually delivered a bespoke piece of software to really help us understand what we're doing, and to make sure, not just in terms of recording information, but that that information is then going to be used to make sure we're generating new appointments for those people when they need their second dose, but to make sure they get the right vaccine for their second dose as well. And again, it does show that a can-do approach from committed public servants really is making a huge difference throughout this crisis. And the fact that it's integrated into the GP record will be useful for the future as well.

So, I think the Welsh immunisation service is not just going to be useful for now, but on a longer-term basis in the future. And I think you'll see more of that innovation more broadly than the vaccination programme as well. So, in the software we're using, for example, Attend Anywhere, that was driven by necessity, because people had to have appointments on a remote basis. We rolled that out very rapidly. It would have taken years otherwise to have rolled out software like that across our NHS. And that will not just be a crisis-led response to the pandemic—that's going to be part of the way that our service works in the future. If you think about us as a group of not entirely typical workers, but, you know, politicians and others find it difficult to be at one place at one time, and to have a different set of appointments where you're required to physically attend a hospital premises, for example, for appointments you could do over the phone or on screen. So, more and more we're going to need to be responsive to the person, to the patient, but also in how that works for the member of staff as well. So, a lot done in terms of the digital innovation, and much more to do for the future that should benefit all of us. 

Can I thank the Minister for his statement, and also begin by saluting the terrific performance of all those involved in the vaccination programme? Truly heroic, epic, and every similar adjective applies. Can I also say that lockdowns actually work? I think it's important to emphasise that point. It may come as a shock to one or two of my regular correspondents online, but lockdowns do work, the figures show. And also can I pay tribute to the excellent genomic expertise we have here in Wales? The sequencing tech that we have is absolutely brilliant. And as regards that, and that expertise, which is how you pick up new variants, obviously we have the new South African variant, and we have this new variant, Kent plus, as the Minister implied, that allegedly could more easily evade the full effects of vaccination, and evade the full effects of our own immunity. 

The question that—. I hear what the Minister has said about that, and, obviously, I'm more than reassured. In terms of how we test for those new variants in Wales, though, how widespread is our ability to pick up on these new variants in the testing regime we have at present in Wales? And my final question, as regards testing in general, is: what is the progress in allowing individuals, i.e. ordinary members of the public, to request their own test when they have vague or non-classical symptoms of COVID? How can we deal with those non-typical, though important, situations? Diolch yn fawr. 

If I deal with the last question first, because I think, actually, if people go to a testing centre with a range of symptoms that aren't classical, but they can explain how they feel, then most people are not going to be turned away. That isn't going to be the experience. And, actually, our bigger problem is that there are people who have symptoms but don't get a test. If you look at the technical advisory group reports that we have continued to publish every week, you'll see there's a regular feature in there, and one of the regular features that I certainly look at every week, even if others don't, is you look at the number of people who acknowledge they've had symptoms and then how many of them go on to have a test, and only about half of the people who have the classic symptoms, as was put in the question, actually go on to get themselves tested. So, there is a real issue there, and there's a divide in age ranges, and a divide between genders as well. Men, frankly, are much less likely to get tested, and, actually, we know that older men are one of the higher risk categories as well. So, it's really frustrating. We need to get the message out: if you've got the symptoms, get yourself a test. And there is plenty of testing capacity at this point in time, because—one of your earlier points was that the lockdowns have worked in driving down transmission rates. Transmission rates are falling, case rates are falling—we want to see that continue—and that means that fewer people are going to get tests. 

And in terms of the genomic expertise that we do have, we punch well above our weight here in Wales, and we should be really proud of what our genomic experts are delivering in terms of the overall effort, not just to Wales, the UK, but the wider world as well. The labs we have currently are in a position where we're able to pick up a range of new variants. We've had agreement about making sure that we have a representative sample of Welsh tests to go to lighthouse labs so they can pick up the new UK variant, the Kent variant. And we also have a range of testing in place to pick up where we might have the South African variant. That's why—. We have low numbers of the South African variant here—literally handfuls—as opposed to the much larger numbers that, unfortunately, have tested positive in England. And it'll be really important for us—we want that testing programme in England looking for the South African variant to succeed, because that will actually help to keep all of us safe as well. And some of the areas where they're testing are on the Welsh border, so it's really important that we keep close to each other across the UK to understand the knowledge that we're each acquiring, and then to share it openly. And that has been a really important feature in this pandemic. It will have to carry on for many months ahead into the future.

Thank you for your update, Minister, and a huge thanks to the army of people responsible for ensuring that over 13 per cent of the Welsh population have received a first dose of the vaccine, not forgetting the help we receive from our armed forces during this pandemic. Minister, in the next few weeks, we begin the roll-out of our second doses. What steps are you taking to ensure that the roll-out of first doses can continue apace without any drop in capacity? Over the past week, we have seen European Union bureaucrats threaten our vaccine supplies. So, what discussions have you held with the UK Government about how we can ensure the security of our supply? And whilst the EU can never actually be able to prevent the exports of our vaccine supplies, they can in fact delay them, and the debacle has highlighted the inherent risks of relying on imports. So, in light of this, could you tell me what discussions you've had about producing vaccines in Wales?

And finally, Minister, we have already seen the emergence of new variants, which appear to have some vaccine resistance. This could mean that we have to constantly keep adapting the vaccines to keep pace with the virus. When life returns to some semblance of normality, we won't be able to rely upon the current mass vaccination centres, so what steps have you taken to ensure that we have long-term vaccination capacity in all communities? And I'd like to thank the constituent who rang me, who was jubilant to say that, on his seventy-fifth birthday, he received his vaccination. He says a big 'thank you'. Diolch.

Thank you. On the second dose, without affecting the wider roll-out, we're already planning for the delivery of second doses, which—. In, literally, the coming few weeks we'll start to see more people getting their second dose, and those numbers will increase, because, as you'll know, in the first three to four weeks, we had lower numbers of people being vaccinated compared to what we're doing within this week. Our ability then to keep on going at the  first dose rate we're currently doing will be affected by the overall amount of supply. So, we're going to need to think about making sure we have the right vaccine available for the second dose—so people who have had Pfizer should get Pfizer for the second dose, fewer concerns and issues about AstraZeneca, and we'll then need to know what then is left for us to deliver in terms of new first doses. So, again, it's a matter of supply, as well as then, going back to Angela Burns's point, about making use of the wider primary care team—so, our pharmacists—and our ability to then deliver an even bigger programme. If we have the supply to do that, we'll need to make use of that wider team in primary care.

On the European Union and the vaccine, I think there's wide recognition, however you feel about the European Union, that the last week or two has not been great from an EU point of view. It was extraordinarily unhelpful in the way that issue was presented. I think common sense has now prevailed. Because we actually all need each other—both about travel, because, actually, coronavirus was largely imported to Wales when Brits went to Europe for holidays and came back in January, February last year; the February half-term was a significant importation event from travel directly from Europe, not from China. So, actually, those patterns of travel aren't going to be significantly different in the future, with future threats. It's also just the case that we are already getting vaccine from Europe, so we actually need good relationships with European partners to make sure that we're able to see vaccines cross international borders, just as the supply of AstraZeneca, some of which is already manufactured here in Wales.

And your question about vaccine production in Wales—of course, AstraZeneca supply and fill is in Wrexham already. So, we already have some of that manufacture, and one of the new candidate vaccines has a vaccination production base in Scotland. So, the UK already has vaccination production within it, but that in itself isn't going, I think, to deliver the sort of certainty that we'd want. So, we still need a very practical and grown-up relationship with European production centres, as well as pharmaceutical companies that have bases in more than one part of Europe. And, when it comes to vaccine resistance, it's one of the things that, I think, has come up before. So, it's certainly a part of what our scientists look at, as well as researchers in individual companies looking to develop the next vaccines.

And capacity—capacity has sprung up because of the way we've been able to move and use our primary care team. Vaccinations are normally undertaken primarily by primary care in any event. The thing about our highly successful immunisation programmes for children and young people around the flu campaign—well, it's primary care that does that, whether in a general practice or, indeed, in a pharmacy, or health visitors and others who will go and visit people at the earliest of ages. So, we're never going to have, if you like, a permanent structure of vaccination centres. If that were the case, then we'd be living with threats on a daily basis forever and a day. But, if we're needed to flex up again, I think what has been shown is that primary care is remarkably flexible and extraordinarily willing to protect people they care for on a regular basis, and I'm very grateful for all they've done. 

Minister, we know that our ethnic minority communities are particularly susceptible to the ill-health effects of the virus, and Welsh Government and its working group have done some very good work in terms of illustrating and understanding and responding to that. There is some concern now that some in our ethnic minority communities might be more reluctant to have the vaccine than the general population. I wonder if Welsh Government has any sense as to whether that is the case in Wales, and, if so, to what extent it is an issue.

And, in terms of getting the right messages and the right communication to our ethnic minority populations, I know work is taking place with people in the community getting those messages across and, indeed, in having members of the ethnic minority community in appropriate positions of responsibility, perhaps health professionals, giving those messages and, of course, making sure that the appropriate languages are used. I just wonder if there is any more that Welsh Government is planning to do in terms of building on that work to date, given the potential problem that exists, and also whether consideration is being given to the use of mosques as vaccination centres, if we could identify buildings that have sufficient space and were suitable in terms of their physical nature. I'd be grateful if you could give us more of a picture of the work going on to address these issues, Minister, because they're obviously highly significant, given the greater ill-health effect that the virus has had on our black and Asian communities.  

Thank you. In terms of this, I refer back to what I said earlier about it was a good thing we had parliamentarians—none of whom were Welsh MPs, but parliamentarians from the Conservative Party and UK Labour, who are absolutely not on the same page on the great majority of issues—all agreeing to do a promotional message that encourages people to take up the vaccine. People recounting their own personal, family and friendship group experiences, hearing James Cleverly and David Lammy talk about people that they both know—from very different parts of politics, but they both have people they know and love and care for who they have lost through COVID. And I think that's a powerful message to then hear those same people encouraging everyone to take up the vaccine.

And we are already doing specific work with community groups here in Wales, and vaccine sceptism is not something that I think we should take a view that that doesn't exist here in Wales. It's about how we try to address it and how effectively we do so. I'll be doing some work specifically with that in talking to community leaders to build on work that's already been done. And we are already talking with the Muslim community here in Wales about whether we can use mosques, but also, though, I'm really encouraged by the message of faith leaders encouraging people to take up the vaccine as well. There is nothing incompatible with their religion in taking up the vaccine and there's also—[Inaudible.]—not just through mosques, but also through churches as well, in terms of a range of our communities. For many of them, faith is more central than, if you like, other parts of life here in Wales. So, we need to think about the different ways in which to have messages that are effective for people, have meaning for them and actually build on trust.

So, I'll be happy to give a further update after half term, because I'll have done more on that direct engagement to give you a feeling back about what we're able to do to encourage people to get themselves protected, because black and Asian-origin communities are at a higher risk than the rest of the country, because of their ethnic origin, from coronavirus.

Minister, this Sunday, Cwm Taf health board completed its vaccination of all the care homes and care home staff, and I think all the staff who contributed to that, in very difficult weather, sometimes, should actually really be congratulated for the effort that's been achieved there.

Can I raise just two points with you? One is the issue of home vaccinations. Obviously, there is a concern that there may be those who cannot get out of their home for whatever reason, et cetera, needing to be vaccinated at home. There appear to be some confused messages over that. I wonder if that could be looked at, just in terms of clarity, because obviously people do feel anxious about that. One further point is, of course, you'll have seen the Office for National Statistics data in respect of the death rate of taxi drivers and bus and coach drivers—for taxi drivers, 101 deaths per 100,000; bus and coach drivers, 83 per 100,000—and I was just wondering if there was any attention being given to either the safety aspects in respect of their work, or the work that they are doing particularly with the transportation of doctors and nurses, to whether it be vaccination centres, surgeries, hospitals and so on. Thank you, Minister.

I thank the Member for that question. On the issue of transport workers in particular, the recent ONS publication confirmed what we knew from the first wave, that transport workers, their occupation does mean they're more at risk compared to the wider population and there's a material difference. So, that's part of what the JCVI have been looking at when they're thinking about prioritisation outside groups 1 to 9. It's also why it's really important for all employers to think about what they're doing in terms of the increased need to risk assess what's happening as well. Some of these people, of course, will be self-employed. Most taxi drivers are self-employed. And we're thinking about whether there is a need, from our point of view, for further guidance on that to protect those workers from harm.

I take on board what you say about housebound members of the public. If you live in an older adult care home, then we are already going out to protect you. There is a range of other people in communities who are housebound for different reasons, and it's part of the reason why the link with primary care is so important. We do have mobile vaccine teams within each health board area, but it will need to be a conversation with general practice about where those housebound residents exist, because the NHS creating a central mobile team won't in itself mean they know who every person is. So, that's why it's really important to have the link-up and the points Vikki Howells made earlier about the link-up to the Welsh immunisation system, to make sure we understand who's doing what and who's going out to visit those people to make sure they're covered, as opposed to double-counted.

And finally, I should say I take on board the significant achievement that yourself, Vikki Howells, and others have mentioned, across parties, to congratulate our staff for what they're doing. It really is significant. On our pace in what we're doing, to give you an idea, in the last seven days the average number per 100,000 is 452 in Scotland for the vaccine, 469 in Northern Ireland, 609 in England, but 680 in Wales. That shows the pace that we're going at over this last week and I'm tremendously grateful for everyone who is playing their part in doing so.

Minister, for a number of weeks now, I've been speaking to Betsi Cadwaladr University Health Board about setting up a central point of contact and a phone line for those who are concerned that they have not received their vaccine yet, and for a small number of 80-year-olds, that is obviously the case. I was particularly pleased this week when that phone line was delivered, and yesterday it was launched. I believe that is part of the answer that nobody misses out who wants the vaccine. As we work our way through the priority groups, Minister, will you have conversations with Betsi Cadwaladr health board, other health boards across Wales and Public Health Wales, to see this phone line extended throughout the pandemic?

Yes, I think this is part of our challenge in managing people's expectations and in making sure, at the same time, that no-one gets left behind, because what we don't want is people generally ringing because they're concerned, and many people will be concerned in groups 1 to 4 at present, but then when we extend that, in groups 1 to 9, because I don't want primary care colleagues, especially general practice and pharmacists, to be overwhelmed. However, we do need to find a way to provide both that confidence and also to make sure that there is a check. So, I certainly will be looking to see what has taken place already within north Wales, to look at the good practice that Betsi Cadwaladr have been able to develop, and to see how we apply that in a more uniform way across Wales to make sure that no-one is left behind as we complete this national mission to ensure that we protect our people.

Thank you, Minister.