Dr. Colm Henry:

On haemochromatosis, I engaged with the association as we worked together to produce the model of care some years ago. It was welcome to meet with them again and that will be part of ongoing engagement to ensure that we follow through on implementing an agreed model of care that looks to shift the care of haemochromatosis from specialist services to primary care, where appropriate, and also to bolster up specialist services.

The second issue raised by the Senator is vaccine for this coming season. Once again we see what we call a multi-pathogenic winter. In other words, a mixture of influenza, RSV and Covid, which is becoming increasingly a seasonal pattern although not completely so yet but it coincides with people being indoors and together. As we know, last year we saw a confluence of these three viruses cause enormous pressure on our acute hospital system and on general practice also. Regarding influenza, we are delivering the stocks of the vaccine now. There are two types. The injected vaccine for children aged six to 23 months and adults aged over 18 with chronic medical conditions, pregnant women and health care workers. The second is the intranasal type for children between aged two and 12. Our uptake last year among healthcare workers varied according to location and also the type of healthcare worker being considered. It was of the order of 55% for the influenza vaccine. Our uptake for people over 75 years was very high at 75%, achieving a target we wanted. Our uptake for children was quite poor at about 14%. Hence the move for the intranasal vaccine towards delivery of the vaccine directly to school sites for senior infants and for special schools this year. We want to see a significant uptake in influenza vaccine among children. There were about 1,400 hospitalisations for children last year with influenza but of course children also represent a reservoir for influenza.

Regarding the booster campaign, again we are directed, as with the influenza vaccine, by clinical policy makers of the National Immunisation Advisory Committee, NIAC. This organisation is familiar to everybody after the pandemic. We will be focusing on those aged over 50 and younger people of all ages with chronic underlying conditions or with immunosuppression. Of course those who have had Covid in the past three months or had a vaccine in the past three months have to wait for that three months to pass before they get another booster vaccine. We did see a differential uptake last year, with lower levels of uptake among healthcare workers of the booster. We achieved extraordinary levels at the beginning the pandemic of the primary vaccination programme of upwards of 90% plus for healthcare workers and for different age groups. I do not think we will ever reach those targets again. With each successive booster campaign, we see a levelling off of uptake to about 45% to 50%. There are other reasons also, not least that people may be exempt because they have had Covid in the past three months.