Dr. Colm Henry:

First, we have a very strong uptake, if not the highest then almost the highest in Europe, of primary vaccination. That is the initial two course regime. We had a very good uptake of booster one. Upwards of 78% of those who got the primary course got the first booster. Again, this is among the highest levels in Europe. That gives us good protection against serious illness but it does not give us good protection against infection. We know immunity begins to wane against infection after a few months and particularly among those who are older or whose immune system is not up to scratch for whatever reason. They just cannot muster the same antibody response both to a vaccine or to natural infection. We want people to continue to get vaccines, particularly those in these vulnerable groups. The direction of travel here and abroad is to focus on vulnerable groups such as people as they get older, those with immune suppression and those with chronic disease. The question then is what the impact will be if we do not see a good uptake in vaccines. While there is still some protection against serious illness, which is good, we will see waning immunity against infection which is not so good. As we know from previous surges of infection, if enough people get infected, eventually that converts into a bigger proportion of those, even with a subvariant that is not as bad such as Omicron, coming into hospitals, some people getting intensive care and some people unfortunately passing away.

In answer to the Chair's question, yes, we have a combined flu and Covid-19 vaccine for booster three which has been there since October. As he points out, that includes this new bivalent vaccine which addresses earlier variants of the Omicron variant, which is good, and gives marginal additional protection. The uptake has been sluggish, particularly among people with immunosuppression. At our discussions in the Covid advisory group, which is the successor of the National Public Health Emergency Team, NPHET, we are advised by representatives of the Economic and Social Research Institute, ESRI, in the group that perhaps the greatest single driver for uptake in the past has been fear, not so much vaccine weariness. Those factors which compelled and motivated people to get vaccinated before, whether it was fear from themselves or for other family members, is just not as strong as it was before. As was pointed out earlier, we certainly do not want to be complacent in the HSE, particularly among healthcare workers, because we are aware of how vulnerable healthcare settings can become if there is a surge of influenza or of Covid-19.