The next item is a statement by the Minister for Health and Social Services, an update on COVID-19 vaccinations, and I call on the Minister for health to make that statement.

Thank you, Llywydd. The hard work of all those involved in our COVID-19 vaccination programme has continued yet again this week. We are maintaining the best vaccination rate within the UK and a greater proportion of people in Wales have had both doses of the vaccine compared to any other part of the UK.

There is just one month to go now until the mid-April target date for achieving milestone two in our strategy. We are progressing with confidence and pace towards this next key milestone of offering a first vaccination to all those in the current nine priority groups. With increased vaccine supply at present, we expect to see higher numbers of first doses administered whilst also maintaining the pace of our second dose programme at the same time. We have flexed our delivery capacity upwards in response to the increase in supplies. It remains the case that if supplies are provided, then we will deliver.

More than 90 per cent of people between the ages of 65 and 69 have already received their first dose of the vaccine, and people between the ages of 50 and 64 are beginning to be called for their appointments. We are making strong progress.

Our second dose programme has been running for around a month now, and already over 0.25 million people here in Wales have had their full course of the vaccine, which is of course encouraging news. This includes more than one third of care home residents and over half of their care staff. The second dose is essential for longer term protection, so it's really important that second dose offers are taken up.

Thank you to everyone who has taken up their offer of the second dose so far. And I encourage everyone to take up the offer of a vaccine and to encourage your friends and family to do the same. I received my first dose on Sunday, and I look forward to getting my second dose in due course.

And I want to reassure Members that people's safety will always come first. We continually and closely review vaccine safety reports and the independent regulator, the Medicines and Healthcare products Regulatory Agency, continues to review the evidence on safety. I recognise reports about some European countries pausing AstraZeneca delivery because of concerns around blood clots. Across the UK, over 12 million doses of the AstraZeneca vaccine have now been delivered and the MHRA state:

'Reports of blood clots received so far are not greater than the number that would have occurred naturally in the vaccinated population.'

'People should still go and get their COVID-19 vaccine when asked to do so.'

The World Health Organization, the European Medicines Agency, Thrombosis UK and all four UK chief medical officers all support the MHRA position on the safety of our vaccines, and the alternative risk of not receiving the protection that the vaccines provide. The alternative risk from COVID includes, amongst others, an increased risk of blood clots, lasting organ damage and, of course, mortality.

We are confident in our vaccines and certain that we must keep up the momentum. Over the weekend we recorded delivery of more than 40,000 vaccines in a single day—that is comfortably more than 1 per cent of the population vaccinated in one day. We still have more to achieve to keep Wales safe. However, I am grateful for the support from all political sides and the public for our successful vaccination delivery programme. I will of course continue to keep Members and the public updated.

Thank you, Minister, for your statement. I'm very pleased to hear you say so unequivocally that people must go out and get their vaccine, whether it is a Pfizer vaccine or an AstraZeneca, and I join with you in saying that the risk of blood clots from any potential vaccine is far, far less than anything else. Given that, what public message—? And I've heard your message, and I've said it, and the First Minister's said it, and I'm sure every single Member here will cleave to this, but how do we get that message out to the areas of Wales where people are very concerned, perhaps already slightly anti-vaccine for various reasons, and this will help to compound it? I really urge you to look at a very strong public health campaign, and ask what your thoughts might be on that.

In terms of care home residents, there's no doubt that the statistics outlining the uptake of the first doses of the vaccine are impressive, but I do have some concerns surrounding the data that is shown in them, namely the group size of care home residents. Now, between 1 and 2 March this group size fell from 17,630 to 15,398, a drop of 2,232. The statistics published today show the number of care home residents at 13,780, so a drop between 17,630 and 13,780 over the space of 16 days is a decrease in the care home population in Wales of 3,850 in less than half a month. Minister, as I've consistently said, data is king and, across the UK, Governments are being driven by data, not dates. Therefore, we need to have huge confidence that the data we have is reliable. When your data shows that over 95 per cent of care home residents have been vaccinated, it is essential that we can trust, and you know, that that data is correct. Now, while I accept that some care home residents have sadly passed away, are you able to explain why there is a 21.9 per cent drop in the number of care home residents over the course of half a month?

I just want to turn briefly to the difficulties in altering the dates of tests. I'm still getting so many e-mails about the difficulties people are having in rearranging tests that were arranged through mass vaccination centres. I am concerned that we run the risk of seeing doses wasted if we do not get to grips with this problem, especially as we move into vaccinating the working-age population who may have more constraints on their time, and thus may be unable to drop everything and attend a date given to them because of work or childcare issues. Are you able to tell us what might be able to be done to help address this?

Finally, I'd just like to touch on the study published by Public Health Wales yesterday, following the mass testing in November and December in the Merthyr Tydfil and Cynon Valley areas, which shows that household contact was the most significant source of transmission. With lockdown rules being in place for close to four months now, and Merthyr once again just showing a bump in the number of cases in Wales, what extra resources and safeguards can you put in place on a local basis to dampen localised outbreaks such as the one that we're seeing in Merthyr? And what community messaging can we put out there about the need to not only address our hygiene measures, but to uptake the vaccine, to ensure that we don't have any further peaks? Thank you.

Thank you for those questions. I think, on your point about the size of the denominator in care home residents—the Scottish terrier has now left the building—then I'll make sure that, in terms of not just the explanation about data cleansing, I will not only provide it to you, Angela, but to Members as well; I'm sure there'll be some wider interest. And I think that that either may be a written statement or, in a sense, the next version of the narrative provided on a Tuesday or a Thursday to provide a proper explanation as to how that number has been arrived at, and the change that has been made in the number progressively.

On your point about rearranging appointments, it's an extraordinary endeavour to organise the whole programme. That does mean there's a lot of interest and there are people who are worried and getting hold of numbers to ring when they don't need to ring. There's a lot of public expectation and demand. When I had to rearrange my mother's appointment, I rang later in the day and I was able to do so, because I found that during the middle of the day and early in the day that it wasn't easy to get through. So, there's a point there about persevering and wanting to rearrange, but, actually, the starting point is wanting people to attend when they're offered the appointment.

And this is something we discussed at the shadow social partnership council, where trade unions were keen to have an understanding of encouragement from the Government for employers to be understanding and to release people from their time, because it isn't always straightforward for people to attend a vaccination if their employer isn't understanding. The employers' representatives on the social partnership council were positive about wanting people to get vaccinated, because they could see there was a benefit for those individuals, but more than that, for their business and for the people that they work alongside as well. The greater the proportion of people that we protect with vaccination, the more that we can do to provide a safer Wales for us all, and the environment for those businesses to improve from their own prospects as well. 

So, we are looking to have not just a public message about that, but messaging within both sides of the employment relationship about wanting to be positive and enable people to have their vaccines without a cost to them, rather than simply saying people need to do it in their own time, which will actually hamper our efforts. And this will be even more important as we go through each age cohort. Once we get to the under-50s, more and more people of working age will need to have an approach that is consistent and enables vaccination rates to carry on at the pace that we have already set.

On household contact, and you were particularly talking about Merthyr, I understand it's around Gellideg in particular, a couple of streets having a very high number of cases and extended family and relationships where social distancing appears to have broken down, and there does appear to have been household contact. This highlights the fact that the extra household mixing—the indoor mixing—is the way in which coronavirus is still most likely to spread, and to spread very quickly, as we've seen with this particular cluster. And it highlights why we asked the public to do the right thing, not for my sake, but actually because you can otherwise see a real cluster that will interrupt the way people are able to live their lives, and some of those people could fall seriously ill; some of those people could lose their lives as well. So, there is a price to pay, unfortunately, if the public don't continue to support this very difficult—. And I know it's not a pleasant way to have to live our lives, even as we're exiting lockdown, but there is a proper point and purpose to it in keeping us all safe. And I hope that the Merthyr outbreak reinforces positive behaviours for others, not just in Merthyr but across the country about the risks that are still there to be run, especially with the Kent variant.

And on your starting point about the vaccine safety and the public messaging on blood clots, I'm expecting to have an opportunity to talk about this again. The chief medical officer has been talking about this today as well in the media. It's very high-profile reporting across all media platforms, radio and television, and I know that BBC, ITV and Sky have all had significant packages on this, particularly as the European Medicines Agency this afternoon have said that they've reiterated their firm belief that the vaccines are safe, and the balance of risk is absolutely on the side of taking the vaccine with the additional protection that that provides. I think, actually, what will be most helpful is if those European countries that have made this decision at present, if they're going to revisit their choices and, again, restart the use of the AstraZeneca vaccine.

It's a case in point that we're further along on vaccinating our populations than most other European countries, of course, so they're still vaccinating in many European countries their over-70s where the risk of harm is even higher. So, there's a real point for us all to see the AstraZeneca vaccination programme put back on track, and that will help people who may otherwise be really concerned here to go ahead and get the protection that the vaccination offers. And I should make clear that the AstraZeneca vaccine is the one that I myself had on the weekend.

The Deputy Presiding Officer took the Chair.

I have two questions and two points, Minister. The two questions relate to questions that are raised with me by constituents, and I'm sure with other Members, on the process. I want to start, of course, by thanking everyone involved in the vaccination process. It's still working well, and we're clearly on the right track.

One of the questions is about what happens at the end of the day. People hear about people getting in through the back door because they might know somebody and so on. A strategy for using up the leftover doses when people don't turn up is very important. You know that I'm eager to see people in particular roles being prioritised. You disagree with me on that, but should an effort be made now to bring those into a robust strategy, even if it's just for using up those spare doses at the end of the day?

Secondly, you know how people follow the data very carefully, and look at what's happening within their health boards and the rest of Wales at the moment. And they do occasionally see and hear anecdotally a feeling that their area might be falling behind. Now, I'm convinced that we're likely to reach a point ultimately that we all want to get to, but what monitoring do you do as a Government to ensure consistency across Wales, and within health boards, on the pace of the vaccination process, to ensure that there aren't major differences from one area to another?

Now the two points I want to make. My constituency, my county, is one of those areas where there's a stubbornly high number of cases still. I appeal to you to continue to seek innovative and new ways of communicating the danger of the virus, and also to find more ways of supporting people. There are still people who choose not to go for a test, or choose not to self-isolate because they are concerned of the implications of that. They may be on low wages, and they may be concerned about the financial impact on them. So, continue, as I've constantly called for, to look for ways of supporting those people, so that they get the help that they need to self-isolate and to go for a test. 

The other is around AstraZeneca. Just to make the point myself, I believe it's quite right that people take an interest and ask questions about the safety of the vaccination, but we must remind ourselves, if there is a proven risk with blood clots—and there isn't as of yet—we're talking about one in half a million people who are vaccinated, as was explained to us in a briefing this morning. I was looking at a report this morning that says that one in five people with COVID can experience some sort of blood clot, and one in three people in an intensive care department. So, that's the reality in terms of where the risk really lies. 

In terms of your comment about a strategy for end-of-day vaccinations, given the cohort we're currently working through of everyone 50 years and above, and running our second dose programme, at this point of time we really shouldn't have difficulty in using the supplies that we've got. We're largely directing the Pfizer jabs at present for the second dose programme, because that's the stage that we're still working through from the earliest doses before AstraZeneca came on board and was delivered more widely. But in terms of our use of AstraZeneca, it's not the case that we expect to see large amounts of wastage, and that's one of the good things, I think, we've been doing from an early point; we've been publishing our figures on waste, which is showing that the programme in Wales is not just going through at a very fast pace, but it's highly efficient, with very, very low wastage rates. That, again, is to the credit of the programme and the deliberate time we took at the outset to get everything right in the way we set up the programme. As we get towards the end of the cohort, and as we're looking to roll out and go into the next age range, we may face a time where there is a more realistic prospect of needing an end-of-day plan in reality. We've already written out and given guidance to the service on doing that, so we certainly don't want to see vaccines wasted. We've had a range of conversations with emergency services workers and others—but I don't think that's going to be a present problem for us now, given the scale and the numbers of people that we have to do and the cohorts that are still available.

I've got to work too with officials on when we'll be moving into the under-50s age group. You'll recall that we were at the point of practical completion when we had essentially delivered 80 per cent of groups 1 to 4, with others then having had invites to their appointments. We were able then to start inviting as a matter of course people in the next ages, for the next part of the roll-out. So, we need to look again and confirm as soon as possible the approach we'll take for the next stage of the vaccination programme. And we do look at the speed across Wales; it's a conversation we have at the vaccination board each week. So, that is a conversation, and it's an open conversation, in a positively competitive way. Each part of Wales wants to see how quickly it can make progress. In every part of Wales, I think the vaccination programme is in a good place, and it's a good problem to have about how fast can we go, rather than having people who are lagging and outliers. And again, when you compare us to other European countries, we're doing extraordinarily well.

I want to reiterate that people should get a test and seek help. TTP includes the contact tracers, but also the supportive part of it, the 'protect' element of it. There are regular calls to people who are isolating—to make sure they are isolating, but also, and primarily, to make sure that there's a well-being check, there's an opportunity to talk to someone, to make sure they are aware of where they can get help and support practically to manage with isolation. Self-isolating is still really important in protecting people around you. It's one of the most effective things we can do to halt the spread of the virus, and that will be even more important as we go through each stage of unlocking more measures.

And finally, on blood clots, it is a matter of fact that, at present, the risk of blood clots is higher, in fact, from the evidence as we understand it, in the unvaccinated population, compared to people who have had the AstraZeneca vaccine. The figures show it's actually slightly lower. And there is no evidence linking blood clots to the AstraZeneca vaccine itself. I appreciate that other countries want to work that through. But I am definitely confident in the evidence we have across the UK, having delivered more than 12 million doses of AstraZeneca. The numbers of people who reported having a blood clot without there being any evidence that's come from the vaccine is lower than in the rest of the population. So, it's a concern. We hope people will look at the evidence, and act on the evidence, to protect themselves and encourage others to get that protection. Because having COVID means you're much more likely to get a blood clot and much more likely to suffer serious harm.

Thank you very much, Minister.