Dr. Colm Henry:

I will start with the final point first. We have built up experience in informed consent for vaccination programmes among older people with the pneumococcal vaccine and the influenza vaccine programmes. Deputy Naughten is correct that they should never involve a threat, direct, indirect or otherwise, and should involve providing information in a way that a person can best understand the benefits and risks. The principle of informed consent has evolved over the years. It is not a binary concept. It is complex. In this case, it is the duty of the healthcare provider, namely, ourselves, to explain things as best we can, according to each individual situation. That includes people who may have cognitive impairment. They should not be excluded from consent just because they are on a journey of cognitive impairment towards dementia. Our colleagues in nursing and GPs who vaccinate older people have a lot of experience in explaining the benefits of vaccines. They trust that older people, like younger people, are able to ask for the information that is important to them. It is obvious to everybody that they have suffered greatly, not just in terms of the impact of the virus, but from the impact of the social restrictions. I hope we would be leading from the front and providing impartial, correct information to people. My guess is that based on the optics from the influenza vaccine this season, which has been taken up at very high levels among this age group, we would see a big appetite among older people for a vaccine that would reduce what is a very high risk for some of them.