Item 4 on the agenda is a statement by the Minister for Health and Social Services—update on the COVID-19 vaccinations. I call on the Minister for Health and Social Services, Vaughan Gething.

Apologies, Deputy Presiding Officer. I'm just getting my statement up. Here we are. I hadn't remembered all of it just yet.

Thank you, Deputy Presiding Officer. Today we have published the third of our reports summarising progress against our national COVID-19 vaccination strategy. These reports are published every Tuesday, in addition to the surveillance data that is published by Public Health Wales 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 vaccination programme has now vaccinated more than 628,000 people across Wales with their first dose. That's essentially one in five of the population, and over 80 per cent of those included within the first four priority groups. Over the last week, our teams vaccinated someone in Wales every four seconds. We expected a further step up of activity over the last week. I'm pleased to say that happened and is borne out in the published data.

Friday, 5 February marked the sixtieth day of the vaccination programme, and was also the day when the number of people to have received their first dose of the vaccine in Wales reached the 0.5 million mark. NHS Wales also broke the daily number of vaccinations recorded on two consecutive days on Friday and Saturday. More than 30,000 vaccines were administered on both days, with almost 34,000 reported on Saturday alone. That means for Friday and Saturday, we vaccinated 1 per cent of the Welsh population on each day.

The vaccination programme continues to go from strength to strength. By the end of last week, we had vaccinated a larger proportion of the total population than any other part of the UK. That is still the case today with the figures just released. Last week, not only were we vaccinating more people each day as a percentage of our population than any other UK nation, but at that point we ranked third in the world, behind only the United Arab Emirates and Israel. That is a fantastic achievement and testament to the efforts of everyone involved—our NHS, local government, the military and all of the volunteers.

We delivered more doses of vaccine to health boards than on any other week, and vaccines were being administered in 493 locations across Wales. We are progressing well through the priority cohorts, and are on track to deliver against that first major milestone in line with our national plan. We expect to have offered the vaccine to all those in cohorts 1 to 4 by the end of this week.

Until now, we had been asking people to wait until contacted by the NHS. However, as the pace of our vaccination programme increases, our health boards are starting to ask people over the age of 70 to get in touch if they haven’t been invited for their vaccination, but that is only people over the age of 70. We'll communicate the arrangements for this over the next week through our health boards. Sorry, we'll communicate this through our health boards over the coming days. This is a key part of us ensuring that no-one will be left behind.

This week, we have also seen more good news about the vaccinations. The Medicines and Healthcare products Regulatory Agency, the independent regulator, released research demonstrating that the current vaccines are extremely safe, with only mild and expected side effects. Also, a study on the Oxford-AstraZeneca vaccine suggests that it could lead to a substantial fall in the spread, the transmission of the virus, and that protection remained at 76 per cent during the first three months after the first dose, and rose to 82 per cent after the second dose.

I am immensely proud of our NHS colleagues across Wales, and grateful for their and their partners' unrelenting hard work in sustaining the pace of our vaccination programme. This really is a marathon, but we have made a fantastic start. I hope that Members across the Chamber share that sense of pride in our national achievements. Thank you, Deputy Presiding Officer. 

Thank you, Minister, for your statement this afternoon, and I too want to join in putting thanks on the record to all of the teams of vaccinators, and everyone concerned with the roll-outs across the whole of Wales. The numbers have gathered pace week in, week out now, and it's pleasing to see progress being made on the targets that were set by the Welsh Government early on in the campaign. And the point that you make about 60 days since the start of the vaccination programme clearly shows how right and proper it was that the UK Government went alone and purchased vaccines early, to allow us to get onto the field of play and start vaccinating people across the whole of the United Kingdom, but in particular here in Wales. 

I'd like to ask a series of questions, if I may, Minister. Are you able to update us on the work that's going on with the black, Asian and minority ethnic community? I raised this issue about hesitancy about taking the vaccine up in certain communities across Wales, based on the Scientific Advisory Group for Emergencies evidence that indicated a 70 per cent to 75 per cent reticence from certain communities about engaging with the vaccination programme. It's really important that any misunderstandings or false stories that are put out there are stamped on very early, and I'd be grateful if you could enlighten us with more information following me raising this with you when I was the health spokesman for the Conservative group a month ago.

Could you also highlight what progress is being made in particular with the second dose of vaccines, vaccination, and informing people of the call-back for the second dose of vaccines, because come March that will be a big part of the programme and it's important that the two run side by side without any disruption? I hope you'll agree with that, Minister.

Could you also identify the advice that is being given from Welsh Government in relation to the 70 to 74-year-old cohort? I certainly have evidence that that cohort are being directed to the mass vaccination centres rather than, obviously, having the vaccine in the GP surgeries, and when the GP surgeries are challenged on this point, they say it's due to advice that's come down from Welsh Government to direct people to the mass vaccination centres. So, I'd be grateful to understand how that advice has been distributed, because certainly for individuals who have been shielding in that cohort—. I have constituents who've raised problems in relation to the referral that they've had to undertake.

In particular, you'll be aware of the campaign regarding children with learning disabilities and in particular about trying to get prioritisation for the vaccine for those who are responsible for caring for children with learning disabilities. I appreciate the First Minister did touch on this, and the evidence that the Minister and the Government work to is the recommendations from the JCVI, but have you made any referrals back to the committee to seek clarification on the evidence that they've given you and the advice that they've given you in relation to the groupings, in particular when we talk about learning disabilities and in particular how they're more prone by six times to be susceptible to the virus? I think that's an important consideration when considering the advice they're giving.

Can you also confirm that there will be no interruption in supplies whatsoever because the supply base has now resumed because of the Pfizer maintenance that went down a couple of weeks ago? Your understanding would greatly enlighten people's views as to any possible supply problems that might be in the system, because I have a letter here from a GP surgery that indicated that they'd been told that there might be a pause in the supply of vaccines the week commencing 15 February. I'm not asking you to comment specifically on that particular matter, but I'd be grateful to understand the more general issue around the supply of vaccine into Wales. Thank you, health Minister.

Thank you for the series of questions. I'll start with your first point and your last point together on vaccine supply. It is a UK Government responsibility, and the contracts that they've procured on behalf of the whole of the UK have allowed us to go out and deliver, and it's a credit to the way that our teams in Wales have then used that supply over the last weeks. I think from within your comments there was even some credit for the Government, as well as people outside the Government, for delivering that here in Wales at such a tremendous pace.

On vaccine supply, I've spoken not just with Nadhim Zahawi on a regular basis, the UK vaccines Minister, but I've also had conversations with both Pfizer and AstraZeneca and my officials. Pfizer had a planned pause in their production to restart on a more efficient basis. They are confident that that means they will be producing a vaccine at a higher rate, both to meet their commitments with the contract they have with the UK Government for all four nations, and indeed their commitments through Europe. That's good news and they also think that they will be able to negotiate the changed arrangements for goods to transfer between the European Union and the UK, and that of course is hugely important for all of us too.

On your point about BME take-up and hesitancy, it is a matter that I have been concerned about from the outset. We're well aware that there is a range of fake news and media associated with a wide group of people across the country. Some of that is particularly targeted around faith communities and around some particular communities, black and Asian-origin communities in particular. So, we're doing work, not just—. Other Governments are also doing something similar as well, in terms of UK-wide messaging, but also, later on today, I'll be joining a round-table with a range of community leaders to help address some of these very points. You'll have heard the comments that I've made and the First Minister has made at yesterday's press conference, indicating how we want to go about making this as open as possible in terms of what the Government does, but also the way that our health boards are doing direct outreach work with some of these communities. And I'm very grateful for individual healthcare staff who are reaching back into their communities to highlight the fact that the vaccine is safe and effective, and there is no bar to them taking it from either a religious or ethnic origin point of view, and that's really, really important for all of us, regardless of our own politics in the Chamber, to get on top of the fake news that will leave people more vulnerable to harm.

On second dose plans, that is very much part of what we're doing; you'll see more and more people getting their second doses in the information published every day. You'll also see the rate of second doses going up slightly. We did nearly 700 second doses yesterday and we're soon going to be in the territory of doing thousands of second doses through each week and then tens of thousands as we get to those people who need to have their Pfizer second dose as well. We need to make sure that the stock is available to make sure that we're giving people the right second dose over the weeks ahead.

Now, on 70 to 74-year-olds, I haven't given a direction that requires 70 to 74-year-olds to go to a mass vaccination centre. It would probably be more helpful if I could see the correspondence or the suggestion you refer to to try to address it. It's always a possibility that there are anecdotes and a suggestion that the Welsh Government has intervened when we haven't, and I'll be very clear that there is no policy choice that I have made requiring 70 to 74-year-olds to go to a mass vaccination centre. We're operating a deliberately blended approach, with 438 different locations where people can be vaccinated.

On your point about people with learning disabilities, it depends whether they're in scope to have a vaccine in the first place, because actually the Medicines and Healthcare products Regulatory Agency authorisation doesn't cover every child, as you'll know, and it's also then about people who are carers and those who are carers within group 6, and those who are older adults with learning disabilities as well. And that very much is part of the challenges that we're considering, both in terms of our interaction with the JCVI and our Welsh representatives on that forum, but also in terms of our broader public health advice as well. In the course of rolling out to group 6 in particular, we will be doing some communications around that and trying to make that as clear as possible, and that'll inform not just what we do as a Government and the interactions health boards have with you, in your local capacities as Members, but obviously I will continue to make that available to health committee members in the regular briefings that we are continuing with. I believe that answers the questions that have been posed at this point.

I would like to thank everybody involved in the vaccination process in Wales, which is clearly on the right track and that's something that we should celebrate. I was over in the vaccination centre in Ysbyty Enfys in Bangor yesterday, at the invitation of the health board, and it's useful to be able to see for ourselves in order to give comfort to some people who may be still concerned about the process. But it's very striking, not just how smooth and effective the system is, but how committed the staff are who are part of the process, and I know that we're all very grateful to them.

I was pleased to hear today that there will be a change to the appointment system, where people will be encouraged, at the moment the over-70s will be encouraged to phone if they haven't had an appointment. There is still a problem with the system and I hope that the Minister would recognise that. One solution that I've discussed locally is the need for more volunteers to do that work of phoning to ask people to come in. There is work within the health board in north Wales to create that army of volunteers. But what support can the Government provide at a national level to ensure that we have those people in place to do that appointment work, because that's going to become more and more intense, as we reach out to more and more groups of people to be vaccinated?

I would ask once again for the full data. I think it is important that we have that full data on the allocation of vaccines to the various nations of the UK and then within Wales too, and the different kinds of vaccines available as well. It's one thing to say that there is information of commercial sensitivity, but it's another thing to hear from Government that they don't know how much has been allocated to each nation. I would suggest that you need to know.

Again, I would ask for investment now, or at least start to invest and plan for investment, in the infrastructure required to deal with the new kinds of mRNA vaccinations. I don't want to hear about a GP, as I have heard, who refuses a tray of Pfizer because he can't deal with the 1,000 doses, and it's that lack of infrastructure making it difficult for that GP to accept that tray that he would have liked to have accepted. So, let's see the plan for the creation of a health and vaccination system in Wales that can cope with this new technology in terms of vaccination.

Finally, now that we see very positive evidence that the vaccinations do provide some protection against the transfer of the virus, isn't it now really time to look again at the list of priorities provided by the JCVI, and bring people such as those working in our schools, in the emergency services and public transport into the system sooner rather than later, as a means of cutting that transmission link from one person to another? We are in a very good place, but there's always room for improvement.

There is always room for improvement, and I look forward to the coming weeks and months. There is certainly no complacency from our fantastic vaccination teams across the country in terms of what we're doing and what we think that we're going to be able to do, and need to do, in the weeks and months ahead.

On the appointments system, we are already looking at other potential uses of staff and volunteers, and, indeed, an online booking system, as we are rolling out to wider groups of the public, to make it easier for people to get a booking. We will also need to make sure that the second booking is done effectively and efficiently, while still running large numbers of first doses as well.

On vaccine supply, I expect that, this week, we will, in each of the nations, be able to publish some information on vaccine supply already received, which I hope will put the Member's mind at ease about the share that we are getting, but also about the use that we are making of that supply as well. It's taken certainly longer than I would have wanted to, but we, I think, have finally got to a position where all four Governments—and, indeed, the manufacturers—can have something that we can all provide to give the clarity that some people are looking for.

On your point about the information you have about a GP who can't accept a full tray of Pfizer at present, it's a combination of different points here, I think. It's the way that we get the trays, the size they are available in, and how they can and can't be broken down. It's also the reality that we aren't in a position to create that infrastructure in the immediate here and now. I appreciate that you are asking a future question, but it is a future question. Right now, with the amount of priorities that we have to deal with to roll out the programme, I think that to be wondering about how we can have storage facilities that can keep vaccines at under -70 degrees centigrade in local GP practices is probably the wrong priority for what we actually have to do now.

We do have to think about the lessons that we are learning as we go through the pandemic, as well as future courses, because it is entirely possible that there will be future pandemics. In many ways, the UK was lucky with SARS because SARS didn't arrive here and stay in larger numbers. SARS was actually even more deadly in terms of its acquisition rate and fatality rate than the current pandemic is. So, we have been incredibly fortunate. But, because other parts of the world were burned much more significantly by SARS, they had to have those arrangements in place. I have no doubt that, at the end of this, in every nation of the UK, we will have different arrangements in place for future pandemics, and that has to be a good thing for all of us.

When it comes to the JCVI priorities, it's a question asked on a consistent basis. Indeed, it was in First Minister's questions. We have a list of JCVI priorities that are about saving the maximum number of lives. We have asked, and we have representatives who are constantly looking at evidence from the JCVI and the questions that we have. We are looking not just at 1 to 9, but at the next phase as well, and about how we continue to save the maximum number of lives possible. That advice, at present, gives us our current priority groups. That's what we are working through at tremendous pace, and we will continue to do so.

Minister, I was at a meeting last night in Community House in the Maindee area of Newport East, which has a number of ethnic minority communities regularly involved in its activities. There was a presentation on the vaccination programme, around the reluctance of some black and ethnic minority communities to take part. One of the major issues was that the presentation that we had from public health focused on UK statistics. The group felt that there is a dearth of information, at least that they have, at a Wales level on that reluctance that would seem to be present in black and ethnic minority communities to have the vaccine. So, their plea, really, was for that information to be available on a Wales level, so that they could best direct their efforts in terms of community outreach messaging and communication to the groups that most need to have the benefit of that effort. I wonder if you could tell me today what information the Welsh Government might be able to produce for groups such as Community House to bolster their efforts to encourage take-up of the vaccine in those groups. 

We're doing a number of things on this. It's not just about the publication of the data we have; it is about that deliberate outreach into communities that every health board is doing. They've appointed people to undertake those outreach roles. It's also about the engagement that we need to continue to have in a variety of ways. The meeting that I am having tonight is only one part of it. The work of our staff in reaching out to communities is part of it as well. On the data, there is some data that we're looking to have clarified and tied up. It won't ever be perfect. That's because we don't have the ethnicity of every single member of Wales available in a general practice record. We do have a range of approximations that we can take with some of the data we have, which would give us an idea and an indication. I think that will confirm that there is a differential level of take-up. It's about being able not just to confirm that, but I think more than that, to understand what lies behind that, and to be able to address it. That really is, I'm afraid, about taking on some of the myths and some parts of distrust between communities and larger public services that we know exist. The more we can do, the better for all of us, because the sooner we have population coverage, the sooner we'll be into a different way of dealing with coronavirus, which, I'm afraid, we may not get to eliminate, but we may get to live with in a way where it's an endemic condition that we can be regularly protected against, and remember the harm that it's caused in these last 12 months.

Minister, well done on a really impressive performance over the last couple of weeks. You and everyone who's working as part of this have dealt with the gap with vaccination rates with England that I previously criticised you for, and I think I should recognise how good it has been over the past two weeks. So, well done. Because, on average, people have been vaccinated later in Wales, because of the earlier slower start, will that lead to anyone being infected or potentially hospitalised or worse because of that slow start? Or do you think any effect from that has now been undone?

Do you yet say that we have caught up with where things had been in England in terms of the percentage of the most vulnerable, groups 1 to 4? We've discussed before that in Wales we have a more elderly age structure. So, are the same percentages yet vaccinated in those most vulnerable groups? Are you getting just a population share of supply from the UK, or is there a recognition in the supply of that higher proportion of elderly people, such that we may now get a bit more than that?

Thank you for the new report that's come out today. Looking through that, you speak of the achievements of the markers and the milestones. You refer to three markers through January for ambulance staff, care homes and deployment to GPs, and celebrate having achieved that. What's happened to the marker of 70 per cent of the over-80s by 24 January? Was that never a marker, or has that been airbrushed from the history of this? You highlight the very good numbers on Friday, 30,000, and 34,000 on Saturday. Are you able to update us on the numbers for Sunday and Monday, and how do those compare?

And finally, it's good to know that the over-70s should be getting in touch. I think that will help Members where we've had people who've perhaps said they hadn't it yet. We can get back and say that if they're over 70, they need to get in touch. Just yesterday I was listening to the BBC Radio 4 PM programme. It was explaining that people in England should call if they were over 70 and haven't had it, but people in Wales shouldn't. Yet, today, we're told they should. Is there still more work to do in joining up communications and trying to have a better UK approach to those communications when things are different or changing, so that we try and co-ordinate those in a clearer way for people?

Thank you for the recognition of the significant pace and scale of improvement over the last few weeks in the programme. There is always more to do, but I think everyone can take a share of pride in what we're doing across the country.

On your point about the future infection rates, full protection isn't provided until some weeks after the first jab has been provided, and then the second dose should provide a greater level of protection, but also longevity as well. The reality is that we won't know more about that until we're actually in a phase of having surveillance and understanding what then happens with the population. That's when we'll know more about transmission, as well as longer term protection, whether we will need to have future vaccination programmes, and, potentially, the frequency of those as well. There is still a range of unknowns, but what we do know is that the vaccines we have are effective, they're safe, and everyone should take up the opportunity to have their vaccine when they are offered it by our NHS.

On whether we've caught up with England regarding 1 to 4 and your question about whether population share or whether the need base within the priority groups governs supply, there was a pragmatic choice made between all four health Ministers in the UK that population shares were the neatest and the quickest way to make sure that vaccines came out. Then, the Prime Minister introduced a different target that actually then rehighlighted that there are different percentages of the population within those priority groups. I have had several conversations with Nadhim Zahawi about the reality that that changes the picture, and we then need assurances that we will have an adequate supply coming into Wales to meet priority groups 1 to 4. We do think we'll have adequate supply, but we haven't seen a bump-up over and above our Barnett share in terms of population. That means that we think we're going to have enough to cover groups 1 to 4, but the programme in Wales has to be even more efficient than programmes within the rest of the UK to meet that target, both in terms of correctly identifying and inviting people in groups 1 to 4 to come forward, as well as then delivering it, as well as getting on top and making sure we have a very minimal level of wastage as well. We're able to do that, and that's why I think we have some confidence that we will get to that milestone of groups 1 to 4.

On the question about over-80s, I think we've answered this question on many occasions. We didn't reach the over-80s milestone at the time, when we expected to, but we have now got to 86.1 per cent of over-80s, and the figures published today were at 79 per cent for 75 to 79-year-olds. On older people's care homes, we have completed 679 out of 691. There is literally a handful of older people's care homes left, and that is because they've had active infections within them. So, we're doing remarkably well. On the figures published today—you asked about our comparisons with England and others, and how does Sunday and Monday compare; we've published those figures. On a population share, Wales has now vaccinated 19.9 per cent, in England it's 19.1, in Scotland it's 17 per cent. The figures in Northern Ireland aren't available yet. On the population above the age of 16, Wales has vaccinated 24.3 per cent, England 23.7 per cent and Scotland 20.4 per cent. So, in each of those measures, we're maintaining a high rate of achievement in our relative position with other UK nations. But, actually, we still have to keep on going as quickly as possible until the fight is won with the virus.

On UK-wide comms, it would always be helpful if we could have a longer term conversation and one about information in advance rather than having to respond to statements made in other parts of the UK, but that is, as ever, a work in progress.

Minister, can I commend Dr Sarah Medlicott of Bron-y-Garn surgery and other GPs who contacted me over a week ago expressing their desire to begin vaccinations of a relatively small group of front-line police medics, who are at higher risk of exposure to the virus in a very specialised line of work? As you know, Minister, we hit a frustrating problem immediately in that the JCVI did not, at that point last week, include police medics in their top priorities. Minister, can I thank you and your officials and your advisers for the work you've done to advocate for the inclusion of police medics in the priority 2 group, which, of course, includes front-line health and social care workers? Could I ask you, Minister, for an update on this so that Dr Medlicott and fellow GPs can get on now with vaccinating police medics across the Bridgend and Cwm Taf Morgannwg health board area, but also, so that all health boards in Wales ensure that police medics are now recognised as front-line healthcare workers and can be rapidly vaccinated as part of priority group 2? And finally, Minister, can I just say well done to team Wales and NHS Wales, including medical staff and volunteers, for the success with the vaccine roll-out? It's been one heck of an effort, and I've seen it first-hand. I commend them all.

Thank you. I'll deal with both points. In terms of Dr Medlicott and the work the local GPs have done around police medics, you're very current, because today I've agreed, and there's a note gone out through our system, that police medics are to be considered as analogous to group 2, because of the direct patient contact work they have, and it's analogous to a range of other activities. So, that does make sense. And a similar understanding of the JCVI advice: it doesn't always allow us to focus on every single nuanced area of practice, and that's why we've had to review some of these as we have gone on—the same points about the intimate care provision that some members of staff in education provide for special educational needs children in particular. So, that should be a consistent picture across Wales, and that's gone out into the system today, and thank you to Dr Medlicott and her colleagues for highlighting the issue, which has allowed us, including the questions you've asked, to make sure that issue is resolved. 

In terms of team Wales, I think it's a tremendous team Wales effort. And as I've said repeatedly, we—. At the start of this, I said that we would end up in a position not dissimilar to other UK nations, and we wouldn't be left behind. After an initial modestly slower start, we've now caught up and surpassed other UK nations. We need to maintain the pace though, not just for the next couple of weeks, but for many, many months ahead. That's why in many ways—. I said it was a marathon in my statement, but in many ways it's an ultra-marathon—one marathon after another after another, and still needing to maintain the same relentless pace to make sure we have different choices to make in the future. And I certainly look forward to being able to do so.

Many then potential vaccinators, including nurses and GPs, contacted me at the beginning of the roll-out, frustrated at the slow start then, but they've observed huge praise for that magnificent way they've risen to the challenge since. 

You referred to second vaccines. I think the latest figures in Wales are one in every 909 people; in England it's one in every 119 people. So, there's still a gap, but I can recognise that the figure in Wales has still improved significantly. How will you ensure that that continued roll-out of the second vaccine programme focuses on what you identify as population needs, and doesn't disadvantage the roll-out of the first vaccine programme where it's most needed? 

And finally, given that people classed as clinically extremely vulnerable are shielding, will you provide or are you able to provide an update on what percentage of the clinically extremely vulnerable group, such as people with cystic fibrosis, have now received their first coronavirus vaccination in Wales?

On your final point, there is work in train that Public Health Wales is doing to provide a useful figure on the clinically extremely vulnerable or the former shielded group of people, and the numbers of people that have been reached. I don't think we're going to be able to break them down into condition-specific areas, but for that wider population, you'll understand that requires some work, because whilst we have about 130,000 people in Wales who are on that clinically extremely vulnerable group, many of those are covered in some of the other areas—some of them will be care homes residents, some of them will be people over the age of 80, 70 or 75. So, we need to make sure that we're not double counting them, otherwise I'm sure that you or other Members will be accusing us of overcounting our success rate. 

On your points—your two earlier questions—about the second dose, I think the comparison with England is misleading: essentially, some parts of England jumped the gun and delivered their second doses much earlier. You'll notice, if you look back over the figures, a significant chunk of second doses were delivered many weeks ago when we'd actually agreed at all four nations to follow the advice of the JCVI, and indeed of all of our chief medical officers, about the inter-dose interval—the gap between the first and second dose. That's why you're only seeing a trickle of second doses taking place now, but you can expect to see a much greater number of second doses taking place in the few weeks ahead. And I am confident that when it comes to the first and the second dose, if we have the supply available to us, then we'll continue to go at real pace with first doses and meeting the second dose requirements too.

This is where I think we're going to see more use of, for example, community pharmacy—it was a point I made yesterday: as we need to have even more capacity, we can create extra capacity within our system. And that's only thanks to the level of planning that has gone into this over many months, but also the extraordinary commitment of our staff. It's a real team Wales effort that seems to be successful to date. We'll need much more of that in the weeks and months ahead, and I remain very proud of the work that everybody's doing on all of our behalves. 

Thank you very much, Minister.