Professor Karina Butler:

I thank the committee for providing the national immunisation advisory committee with the opportunity to explain its work in providing evidence-based advice on immunisation to the Chief Medical Officer, CMO. NIAC was established in 1995 at the request of the Department of Health as a voluntary committee within the Royal College of Physicians of Ireland, RCPI. It has provided advice on immunisation across the ages from infancy to adulthood, on matters such as the human papillomavirus, HPV, vaccination programme and the meningitis and influenza vaccines. NIAC also develops and publishes guidelines for immunisations in Ireland, which are implemented by the HSE and co-ordinated by the national immunisation office. NIAC also advocates for best immunisation practices through the widespread dissemination of information to healthcare providers and other stakeholders, including the public.

The 22-member committee is made up of a wide range of experts, including representatives from the RCPI, its faculties and institutes, the Royal College of Surgeons in Ireland, RCSI, the Irish College of General Practitioners, ICGP, the national immunisation office, the Nursing and Midwifery Board of Ireland, NMBI, the Infectious Disease Society of Ireland, IDSI, the Travel Medicine Society of Ireland, TMSI, the National Virus Reference Laboratory, NVRL, and lay members. Meetings are also attended by representatives from the Department of Health, the HSE and the Health Products Regulatory Authority, HPRA. NIAC members regularly participate in meetings of the World Health Organization, WHO, and European advisory bodies on immunisation.

It may be helpful to outline the process through which NIAC considers new evidence and provides recommendations. The Chief Medical Officer of the Department of Health formally asks the committee to consider a question about immunisation. Since the start of the pandemic, NIAC has considered numerous questions and issued advice to the CMO to inform the Department of Health’s immunisation policy, which is then implemented by the HSE. I have provided a background document detailing the processes that NIAC undertakes, such as reviewing emerging evidence and seeking additional input from a wide range of stakeholders, including medical experts in specialist areas, the Health Information and Quality Authority, HIQA, and the vaccine task force. Thus, all relevant considerations are taken into account, together with the scientific evidence on which recommendations are based. Safety is always a priority.

This workload has been significant in recent months. There has been some concern when new recommendations are made or changed. It is important to remember that we are dealing with a disease that is only just one year old and, amazingly, we have highly effective vaccines to provide protection against Covid-19. New evidence about these vaccines is being published almost daily. As vaccine development and roll-out have been more rapid than ever previously experienced, it is to be expected that there would be many changes to any recommendations, similar to what was seen during the 2009 pandemic. Then, however, we had only two new vaccines to combat that outbreak.

In 2021, with an infection of even greater consequence, greater understanding, adaptability and agility are required to ensure that the safest, most effective course is steered. The goal is to safely protect our population from hospitalisation and death. We need to balance the known very significant risks of Covid-19 against any vaccine safety concerns that may emerge, while weighing in how other measures can reduce the risk of Covid-19, including the use of alternate vaccines.

The guidelines are amended to give the best possible advice on all available evidence at the time, while bearing in mind the safety and well-being of the individual and the population. I reiterate that NIAC is not involved in the implementation of the vaccination policy or in the roll-out of the vaccines. It is an independent advisory committee, which provides advice to the Chief Medical Officer on immunisation.

Final decisions on the prioritisation groups and other aspects of the vaccination programme lie with the Department of Health and the Government.

NIAC acknowledges the significant support of our voluntary members and the collaborations with and by all involved in the vaccination programme in pursuing a common goal of reducing deaths and severe illness from Covid-19. Through maintaining confidence in a high-quality vaccination programme, we can maximise vaccine uptake and reap societal benefits.

I thank members for their attention. My colleague, Dr. Corcoran, who is with me today, and I are happy to take any questions.