Today, the Riigikogu deliberated the matter of significant national importance “Organisation of COVID-19 vaccination”, initiated by the Social Affairs Committee.
Minister of Health and Labour Tanel Kiik, representative of the Estonian Health Insurance Fund Maivi Parv, Deputy Director General of the Estonian Health Board Mari-Anne Härma and member of the Board of the Estonian Family Physicians’ Association Dr Elle-Mall Sadrak made reports.
In his report, Tanel Kiik said that the total number of vaccinated people in Estonia had been growing steadily for seven consecutive weeks. As at today, around 150,000 vaccine doses have been administered and more than 100,000 people have received at least one vaccination and more than 40,000 people have been vaccinated with the second dose.
In his words, it is positive that for some time now the weekly numbers of vaccinated people have been several times higher than the numbers of infected people. “This means that increasingly more and more people are receiving protection through vaccination as compared to having the disease, which in terms of health is definitely a significantly better way to develop antibodies and a significantly safer way for the health of a person,” the minister said.
Kiik said that a marketing authorisation for Janssen Pharmaceutica was expected on 11 March and several other manufacturers had applied for marketing authorisation. The minister added that Pfizer/BioNTech, Moderna and AstraZeneca would ensure roughly 2.5 million vaccine doses to Estonia, that is, in any case sufficient availability to vaccinate the entire adult population. The minister said that the current vaccine deficit would be replaced by a sufficient amount of vaccines during this summer at the latest, in order to ensure a vaccination opportunity for all residents. In the minister’s words, in March, significantly more vaccines would be arriving to Estonia than the total that had arrived over the whole winter.
Minister Kiik noted that, according to his position, any vaccine was welcome in the Estonian market as long as it received marketing authorisation from the European Union. In his words, under the conditions of deficit, it has been paramount to use vaccines as purposefully as possible, that is, to start from the health care sector and to start from the staff and residents of social welfare institutions. “I am very pleased that as many as around 70% people in the health care sector have used this opportunity,” Kiik said. He added that, in welfare services, around 85% of clients had been vaccinated, more than 80% of the people on the education sector list who had expressed interest had been vaccinated, and more than 90% of those on the list of rescue workers and police officers who had reported their interest had been vaccinated.
In her report, Mari-Anne Härma introduced the role of the Health Board in vaccination. She explained that, in the organisation of vaccination, the Health Board had been put in charge of the technical side: the ordering of vaccines, the placing of orders, the remaining stock, and the organisation of logistics.
In her words, the principle in placing orders is that all orders must be placed three working days in advance and the quantity must correspond to the limit prescribed for service providers by the Estonian Health Insurance Fund. Härma said that there had been cases where a certain quantity of vaccine had been ordered, but patients had already been invited to vaccination before confirmation of the order. In such cases, the gap is tried to be covered by borrowing vaccine from hospitals who have placed larger orders.
Härma also touched upon the effectiveness of the vaccines. She emphasised that, according to the data received by the Health Board, all the vaccines were very effective. “We have as few as seven people who have become infected after the end of their vaccination programme. There are 311 people in total who have become infected after receiving the first dose, or who have contracted the infection after vaccination. 38 people have become infected after the second dose but not after the end of their vaccination programme,” Härma said. In her words, in terms of percentages this is a very small amount and gives assurance that all the vaccines are very effective, in particular in preventing severe illness as well as infection.
Maivi Parv said in her report that approximately 500 health care providers were currently vaccinating – that included hospitals, family physicians, but also providers of specialised medical care and nursing services not included in the hospital network development plan. The Defence Forces and the prison medical services are also vaccinating.
She pointed out that, for example, the vaccination of the police and rescue workers had been organised with the help of Qvalitas Medical Centre. “In order to organise the vaccination of general education school staff, we collected data on all people who wished the vaccine with the help of the Ministry of Education and Research. We forwarded the lists that reached the Estonian Health Insurance Fund to the vaccination centres closest to the educational institutions. The vaccination mainly took place either at the hospital included in the hospital network development plan located near the seat of the educational institution or at a family health centre designated by the Estonian Health Insurance Fund,” Parv said.
Parv said that currently the vaccination of the staff of child care institutions was underway. This week, the vaccination of other frontline social care workers will be started, where for example local government social workers, child protection workers, home care workers and family caregivers will be referred for vaccination.
Parv also mentioned that, in order to make the vaccination process smoother and less labour-consuming for the vaccinator, it was planned to automate the registration for vaccination, and this was being done through the national digital appointment system.
Elle-Mall Sadrak said that 81 per cent of family physicians had been vaccinated against COVID-19. Sadrak admitted that there was very little vaccine. She explained that on Fridays the Estonian Health Insurance Fund made offers to family physicians regarding the quantities of vaccines that they could order for their risk-group patients in two weeks’ time. In her words, so far this offer has been 30–36 doses for a practice list every 3–5 weeks.
Sadrak added that patients began to be invited to vaccination only after it was clear what quantities of vaccine would actually arrive and on which days. She confirmed that family physicians would be able to vaccinate every day and in reasonable numbers within working hours so that it would not interfere with their daily work.
Sadrak said that it was necessary to have better communication with the population regarding the need for vaccination and better communication with the population regarding the organisation of vaccination. “It is vital that family physicians obtain new information in a timely manner and from a reliable source,” she said.
Sadrak also made a number of proposals to improve the situation, for example, in her words, vaccine supplies could be increased and agreements could be made with other countries to buy vaccine from them if possible. She also suggested removing the upper age limit for AstraZeneca vaccine and extending the interval between the two doses.
In the conclusion of her report, Sadrak stressed that the greatest concern of family physicians was the need to make the ordering environment and confirmations reliable and to have no more surprises regarding quantities, so that family physicians would receive what they ordered.
During the debate, Siret Kotka (Centre Party), Priit Sibul (Isamaa), Martin Helme (Estonian Conservative People’s Party), Hele Everaus (Reform Party) and Jevgeni Ossinovski (Social Democratic Party) took the floor on behalf of their factions.
The Riigikogu passed an Act
The Riigikogu passed the Act on Amendments to the Alcohol, Tobacco, Fuel and Electricity Excise Duty Act (297 SE), initiated by the Finance Committee. The Act gives undertakings who are applying for a permit for exemption from excise duty on energy and those holding it flexibility to choose the length of the period for the assessment of qualification for a reduced excise duty. While the current Act provides the possibility to assess electrointensity and gas consumption intensity on the basis of the data of the last financial year ended, under the amendment, undertakings will be able to choose freely one to four consecutive financial years to be the length of the assessment period.
The greater flexibility will provide undertakings experiencing temporary economic difficulties due to the pandemic or for other reasons an enhanced opportunity to meet the threshold criteria for a reduced excise duty and thereby to avoid a potential obligation to pay the excise duty difference in a more difficult period.
85 members of the Riigikogu were in favour of passing the Act.
The first reading of the Bill on Amendments to the Social Welfare Act (281 SE), initiated by the Social Democratic Party Faction and Member of the Riigikogu Raimond Kaljulaid, was postponed to the next day due to the end of the sitting.
Verbatim record of the sitting (in Estonian)
Photos of the sitting (Author: Erik Peinar, Chancellery of the Riigikogu)
The video recording of the sitting will be available on the Riigikogu YouTube channel.
(Please note that the recording will be uploaded with a delay.)
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