The next item is a statement by the Minister for Health and Social Services, an update on COVID-19 vaccinations. The Minister, Vaughan Gething.

I'm proud to announce that we have had another week of real progress and highlights for our vaccination programme here in Wales. One million people have now had their first dose of this potentially life-saving vaccine. This is fantastic news—another significant milestone for this truly remarkable programme. Once again, we've reached this marker ahead of the indicator date set out in our recently published strategy update. This is thanks to the sheer hard work and determination of the many hundreds of people working both behind the scenes and in vaccine delivery clinics right across the country.

I am sincerely and genuinely grateful to each and every person who has taken up their offer of the vaccine. They have played their part, done their bit, in this national effort to keep Wales safe, and they should be proud of the contribution they have made in this national effort. Every single dose really does count. Every vaccine administered is a step closer to a brighter future for us all. The vaccines are safe and effective, and I urge everyone to take up their offer when it is their turn. I look forward to having my own first vaccine in the coming days.

We're making significant progress towards achieving milestone two, as set out in our vaccine strategy update. More than 85 per cent of people between the ages of 65 and 69 have already received their first dose of the vaccine, and people in the 50 to 64 years old age groups are already being called for their appointments. With four in 10 of the adult population now vaccinated with at least one dose, we are making excellent progress.

I want to end by thanking everyone who has played their part, not just in the success to date, but more so, to recognise that this has come with support from all sides within this place and outside it, and I look forward to more support for our vaccination programme in the days and weeks ahead. We still have a significant task ahead of us, but I'm confident that we'll achieve it on time and in a really successful way, as we have done to date. Thank you, Llywydd.

Thank you, Minister, for your statement, and once again, it is good news that we are vaccinating as many people as we are at present in Wales. I do have a couple of questions to ask you, though, in general about the vaccine programme. 

The first is that 15 per cent of care home staff have yet to be vaccinated, compared to less than 5 per cent of residents, and it's a much lower take-up than the healthcare staff—87.5 per cent of them have been vaccinated. Are you satisfied that all is being done to convince the more sceptical members of staff to get vaccinated, and what can we do to encourage them, because, as we know, our care home residents are among the most vulnerable in our communities?

My second question is about hospital outbreaks of coronavirus. What review is going on into the causes of hospital outbreaks? They're still occurring in pockets, and they're very detrimental to the starting up of services. Excuse me. I have read your framework for COVID-19 testing for hospital patients in Wales, but, of course, it doesn't really cover prevention within hospitals, and I wondered if you felt that we should do more to try and move that agenda along. I know, for example, in Hywel Dda University Health Board, we have quite a significant hospital outbreak at present in Withybush, and it is stopping the resumption of services.

While we're on the subject of health boards, would you consider what advice might be able to be given to health boards on cancelling and rearranging vaccine appointments? Many people have contacted me to say that they've received texts, they're desperate to go for their vaccine, they can't get there for one reason or another, but they haven't been able to get hold of anyone to rearrange it. And there's a feeling of guilt—I have to confess, I'm one of those—where I couldn't get back to anybody to rearrange my vaccine appointment, so I missed the first one, couldn't tell anyone, and they're now trying to make the second one. But I'm just one voice; I have been contacted by loads of people. They either get text messages where there's no phone number to go back to or no e-mail that they can drop it. And, of course, we can't all just suddenly appear to a particular date or a particular time. Can we do something about it? Because I think it's holding up some people being able to access vaccines, especially some of the more hard-to-reach groups that we've talked about many times before.

Andrew Evans, the chief pharmaceutical officer, has said that we have the capacity in Wales to deliver more than 30,000 vaccines a day. Now, we've not hit 30,000 vaccines a day since 4 March. I do understand some of it's to do with the supply, but reading your COVID update, dated 9 March, you're expecting that to increase with supply of vaccine, starting from this week and going forward, that there should be no problems. Do you think we'll be able to achieve that 30,000?

Finally, I just wanted to ask you about future plans. Mass vaccination centres—a number of them are in buildings and facilities that are used for other things, like leisure centres, and eventually they will kick back into play, and, therefore, we will not be able to use them as mass vaccination centres. Staff and volunteers are helping us at present, but at some point, they will have to go back to their other lives or to their day job. What plans are being put in place or looked at now to ensure that we still have the facilities and the human resource to be able to carry on vaccinating at pace, especially if we do anticipate a third wave? Of course, we're beginning to think that we may need to have a regular annual vaccination in order to protect us from coronavirus and the different mutations that pop up, therefore, we need to be able to build this into our system, and I wonder if you could update the Senedd on that. Thank you very much indeed. Apologies for the coughing fit.

I wish I could have brought you more water, Angela. [Laughter.]

Thank you.

Thank you for the questions. There's no need to apologise for needing to take a break with a cough. On care home staff and the vaccination rate, you're right to point out there was a lower rate of take-up amongst staff compared to residents. That's partly a feature of the vaccine hesitancy we see from a range of age groups. Of course, care home staff are made up of people of a range of different ages, including the younger age group, where we recognise that for people under 40, there's a larger hesitancy about the need or the reason to take up the vaccine. Some of the vaccine myths that are being spread by anti-vaxxers, the works of fiction, affect people who have or may want to have children again in the future. So, there is a concern that it may affect male or female fertility; there is absolutely no basis to that, but it is a persistent myth that is reappearing in every part of the UK and further afield as well. It's one of those areas where, actually, I think that one of the best things we can do, again, is to work right across the UK, regardless of our differing political stripes in each of the Governments, and even in this place too, to be really clear there is absolutely no truth to that, and it's about how we have a trusted and a unified message to persuade people to take up the vaccine, to reconsider the evidence about it. As I say, the safety and effectiveness of the vaccine doesn't come because I say that it's safe and effective, but I have a responsibility to be clear about it. It comes on the most trusted conversations people have and people they believe: our health service staff, scientists and often family and friends, people that you're close to, and that, unfortunately is both where people get trusted information, but it's also how misinformation can spread as well. So, there's a constant job of persuasion to do. Despite that, we are seeing very high levels of vaccination take-up within care homes, but certainly more for us to do, and you'll see that again when we move into the vaccination stage after groups 1 to 9 have been completed.

On hospital outbreaks, and the work we do on the nosocomial transmission, that's transmission between health and care staff and others, it's part of the reason why we think that there's been a stubborn continuance in north-west Wales. There's been an outbreak in Ysbyty Gwynedd, and we think that's led to higher figures there than would otherwise have been the case. We're about to publish an update on the advice and guidance on testing in hospitals. A significant part of that is about our work on nosocomial transmission, and we set out there how we're using both lateral flow devices, as well as polymerase chain reaction tests. Of course, that work is led by the deputy chief medical officer and the chief nursing officer here in Wales, so it's led by people who've got real professional leadership and respect, and it's also supported by the consistent advice that Public Health Wales have provided on how to minimise the prospects for nosocomial transmission, because those outbreaks can cause real harm. It's a positive feature of the reducing rates of coronavirus that those outbreaks will be less frequent than they would otherwise have been, and that's thanks to the hard work of everyone right across the country in helping to drive transmission rates down.

On your concern about health boards cancelling or rearranging appointments, I recognise that this happens from time to time, and it's about those people who may or may not be able to reset their appointments. I had to rearrange my own mother's appointment to take place as well, and it took some time to get through on the booking line, but I eventually did, and there was no trouble at all in rearranging the appointment. It is about the real encouragement of people to make the effort to rebook and to be really clear that the NHS won't leave people behind. So, if people do have difficulty attending their appointments, and they haven't been able to get through, they can still rebook and they should do so and take up the offer that is available, including if people have just changed their minds and now want to opt in to taking the vaccine.

I think you're right to point out the future challenges we'll have about multivaccination centres returning to their former purpose at some point in the future. It's a good problem to have, about our success in driving down the transmission and the need to have current facilities available in a different way. The positive aspect, though, is we have 546 different venues where the vaccine is already being delivered. So, as we get through more and more stages and successfully vaccinate the current groups of the population, the challenge will reduce. But your point about the longer term future is a fair one, too. We'll learn lots from this phase of vaccination about what we are likely to need to do in terms of redelivering a COVID vaccine in the future. What we don't know yet is when that would be and the sort of programme we'd have, because the current flu vaccination programme, for example, is largely delivered in general practice and community pharmacies. We still don't yet know if that normalisation is going to be possible in, if you like, the next stage of the vaccine, after we've protected the adult population in Wales. But we do think that we've already got the flexibility for future delivery to cover all adults within the country. 

Finally, on Andrew Evans's point about our need to deliver and our ability to deliver more than 30,000 doses a day, yes we do think we're going to be able to do that. We haven't done so in the recent past. That is simply a factor of supply. But, we do think that, through the rest of this week, you're going to start to see those figures return to about 30,000 doses in a day, and you'll see that carry on for a brief period of time, then a lull and then a steady rate of vaccine delivery as supply normalises out. And, on that basis, we're still in the fortunate position of having the best vaccination rate of any UK nation, with a greater portion of people in Wales having had both doses of the vaccine. That's good news for us, but it also shows that we're at the head of a very successful group of nations right across the UK at present, and I look forward to having more success to report in the coming days and weeks. 

May I once again congratulate everyone who has ensured that we've reached these incredible milestones—over 1 million people having their first dose; almost 1.2 million will have had either their first or second doses. It bodes very well for reaching targets in the coming months.

I'll make a few points, as I do every week. You don't need to respond to these, Minister, because we know that we disagree. I think we're in such a good place that we could be running a parallel programme with this in order to ensure that those workers who are most likely to be exposed to the virus could be vaccinated earlier, but we disagree on that, I know. I'll also ask once again, as I've done so many times, please can we have the full data on how much of each vaccine is provided to each nation? The past few days have been a good example of why that would be useful. Many have been contacting me over the past few days drawing attention to the fact that there is relatively more of the second dose being provided in Wales—people seeing that we are falling behind in their eyes in terms of the first dose. Now, it would be useful to have clarity from you on the record as to what is happening. Why has this strategy shifted towards the second dose and does that have anything to do with the fact that there are deficiencies in the supplies of one of the two vaccines coming to Wales? So, explain to us what's happening there, because people are looking very carefully at the data and they can see patterns emerging, and they can see that there has been change over the past few days. 

Two brief questions: unpaid carers—I'm certainly pleased that they've now been included in priority group six for vaccination. I know that the online form is available so that they can fill it in. I think it's available from most of the health boards, I think all bar one. Could I just ask what publicity work is being undertaken to ensure that unpaid carers are aware of that form and where to access it?

And the second question is on asthma. Now, research shows that people with asthma are at a slightly higher risk of being admitted to hospital if they catch this virus. They're also far more likely to suffer long COVID. But I've had one example of a constituent failing to find out whether she qualified for the vaccine. Ultimately, she got the vaccine. I was in touch with the health board on her behalf. But I understand some information has been provided to surgeries as to who with asthma should qualify. So, could you make that information publicly available? 

Thank you for the points and the questions. I welcome your congratulations to the NHS-led team for the significant achievement already achieved to date, and the confidence in the future delivery of this NHS-led vaccination programme in Wales. And, again, you're right, we do disagree on the JCVI advice, how we should follow it, and whether we should prioritise one group and deprioritise others. So, that's a point of fact that we disagree on that.

On second-dose delivery, we've made a choice on managing our stock of the Pfizer vaccine so that we can run the second doses effectively. It's about how efficient our programme is in making sure people receive their second dose in time, and that we don't end up with a problem later in this month where we potentially won't have enough second-dose stock available. And that would be a really big problem, I think. There are many people concerned about having to mix vaccines. Well, we're not doing that in Wales: a very clear approach to this. We're being efficient, and we have a different risk appetite, I think, to other countries about how they're going to run these doses deliberately, because you're right that there is some difference in the figures. The overall total of first doses delivered—the UK average is 33.5 per cent of first doses for the whole population; it's just short of that here in Wales. On the second dose, it's 1.7 per cent, but it's 5.8 per cent on second doses in Wales. And on the total doses delivered, the UK average is 35.2 per cent; in Wales, it's 37.5 per cent. So, we're delivering more vaccines per head than any other UK nation. And that information is available in the public domain, and I'm looking to make sure we publish not just the tables on the figures, but also some of those figures on UK comparison points as well. So, you don't have to wait for my statement; they'll be a regular part of how we publish information. And each country is already publishing their figures on how they use their vaccine stocks. So, rather than me trying to give a commentary on a run on how other countries are doing, I can talk about what we're doing and how we're effectively managing the stocks we have in a way that I think is highly successful.

On unpaid carers, it's possible that I'll be talking with the chair of one of the health boards who doesn't have the online form available later this week to understand why they haven't got that online form available. It is available online, and awareness of it is being spread not just through primary care, but, actually, crucially, through carers' organisations, who—. We went through a programme of co-designing the form—the Government, the NHS and those carers' organisations—and so we settled on something that we all think will work. And that takes you through a series of questions to make sure that you get your entitlement. That information is then entered into the Welsh immunisation system, and that should then generate the appointment. So, we want to see as much use of that online form as possible to give people a consistent experience across the country. 

On asthma, you're right, there has been a letter that's gone from one of the senior clinical leads in the Government, and there's a letter that's gone out to primary care, and, given that it will have gone out to a whole range of primary care providers, I think that's essentially public. I'll just make sure that arrangements are made to publish that advice, so everyone can see how that advice has been provided for primary care to then manage their lists of people in a way that, again, should be as consistent as possible across the country. I don't think there's any difficulty in doing it, and I'm sure we can issue a simple written statement in the coming days to do so. 

The people of Islwyn who I represent congratulate you and the Welsh Labour Government on hitting the historic milestone of the millionth vaccination. In my constituency of Islwyn, the mass vaccination in Newbridge leisure centre is effectively, and with skill, vaccinating large numbers of people. Minister, with four out of 10 of the Welsh adult population having had at least one dose, what is your message to the communities of Islwyn in regard to the progress being made to vaccinate every adult by 31 July?

I think people can have a high level of confidence about where we're going to get to, both in the middle of April, and, indeed, by the end of July, depending on supply. And it's supply that is the only issue that potentially holds us back. I think, to be fair, you'd have the same if you spoke to any of the NHS-led programmes in the UK. We could have delivered more by now if more supply was available. That's not a criticism; it's a statement of where we are, and I think that goes back to Angela Burns's questions as well. So, if you're waiting for your vaccine, and you're in groups 1 to 9, you can be confident that you will have had it, or should have been offered it, by the middle of April. I think that means we're in good shape to be offering the rest of the adult population in Wales their vaccine, if supplies hold up, from the middle of April onwards. And, again, the longer-term forecast on the stability of vaccine supply should mean we can do that by the end of July. It gets more uncertain the further into the future we are, but, in the conversations I've had not just with the UK Minister on vaccine supply, but other health Ministers in the UK, and, indeed, the two vaccine suppliers at present, both Pfizer and AstraZeneca,I think we will get a level of supply that allows us to do that. And that, again, will give us different choices about how the public can go about their business and return to more normality, all the while we're managing the risk of what is still an unfinished pandemic. But I'm grateful to hear that the constituency you represent are proud of what we're doing in this NHS-led programme.

Thank you, Minister.