Alan Kelly (Tipperary, Labour) | Oireachtas source

I will now turn to the vaccine itself.

The manner in which the vaccine itself has been attacked by a number of different organisations and groups is very regrettable. It is irresponsible and the targeting of certain schools is not justifiable or fair because, in response, we have seen a difference in the take-up of the vaccine in disadvantaged schools. The HPV vaccine is completely safe and is endorsed by the Irish College of General Practitioners, ICGP, the Irish Pharmacy Union, the Irish Cancer Society and by major medical and scientific bodies worldwide, including the World Health Organization, the Centers for Disease Control and Prevention in the USA, the EU-funded European Centre for Disease Prevention and Control and the International Federation of Gynaecology and Obstetrics. Professor Grainne Flannelly, consultant obstetrician-gynaecologist at the National Maternity Hospital, has noted:

As a Consultant Gynaecologist I see all too frequently the impact of HPV infections and the reality of cervical cancer. The evidence for the vaccine is compelling. We have a very real possibility now of eliminating cervical cancer in future generations of Irish women. But to achieve that we need to maintain our momentum in addressing our uptake rates and continue to restore them to where they were [a number of] years ago.

We also need to extend it to boys. The universal HPV vaccine will have a dramatic impact on HPV and related cancers in men. HPV causes multiple diseases in males such as genital warts and certain cancers like anal cancer and skin cancers. The vaccination of boys in addition to girls will reduce the HPV-related disease burden in males and would allow a reduction in HPV-related cancer cases in females, compared with vaccinating females only. HPV transmission is higher from women to men than from men to women, suggesting a need for prevention interventions such as vaccination for men. Antibody response to natural HPV infection is lower in men compared with women and there appear to be differences between men and women in the efficacy of this response to protect against future infections.

Screening methods for cancers caused by HPV in men are currently not routinely available. The inclusion of boys in a national HPV immunisation programme is likely to reduce the impact of temporary changes in vaccine uptake. Though there might be an increasing HPV vaccine uptake nationally, there are regional variations, which mean that men are particularly vulnerable in areas where female vaccination rates against HPV are low. Mapping vaccinations show these regional differences and if one considers the evidence alongside the misinformation that is being spread across the country, one can see a correlation that is quite disturbing.

I have looked at the success of immunisation programmes in other states. Australia introduced its national HPV vaccination programme in 2007 and recent research suggests it will eliminate HPV-related cervical cancers in the future. Over 9 million doses of the vaccine have been given to girls and young women in Australia. There has been a 92% reduction in the HPV types that are responsible for almost 75% of cervical cancers. There has been an almost 50% reduction in the frequency of high-grade cervical abnormalities in girls in the state of Victoria aged between 18 and 21.

In Scotland, researchers have found a 90% fall in levels of the human papilloma virus in women since the vaccine was made available. In Sweden, a nationwide register-based study included the entire Swedish population of girls and young women aged between 13 and 29 and showed that the vaccination was effective against high-grade cervical lesions in real-life settings. It has a dramatic impact in the prevention of cancer.

We should all support this and be very positive about it, as it can prevent cancer in future generations of girls and boys. We need to improve the rate at which vaccinations are given to girls and we need to extend it to boys in the coming months. Almost every sexually active man and woman in Ireland will get HPV in their lifetime. For many people, HPV clears up on its own but for others it can cause certain cancers and disease like cervical cancer. Ireland has one of the highest rates of cervical cancer in western Europe, and that is the key message we need to take home from this. An estimated 420 cancers were caused by HPV in Ireland each year in the period between 2010 and 2015 and an average of 178 men and women die from HPV-related cancers in Ireland every year.

Currently, 18 countries globally, including large countries, provide successful universal vaccination programmes. They are supported and promoted by national organisations and world regulatory bodies. In Ireland, the National Immunisation Advisory Committee, NIAC, recommends that HPV vaccines be given to males as soon as possible. The vaccination of boys is particularly important in the context of herd immunisation, given that the disease can be transferred from male to male, and it will protect gay men into the future. The National Sexual Health Strategy 2015-2020 calls for an extension of the HPV vaccine and the National Cancer Strategy 2016-2025 states that the vaccine should also be available for men between the ages of 16 and 26. It expresses the belief that international evidence supports its roll-out and that it should be done as soon as possible.

We brought forward this motion to raise the level of awareness of the need for the vaccine to be taken up by more girls in order that we can get back to where we were a number of years ago, at over 80%, and thus to ensure young women and young men are protected into the future. We need to push on with putting the vaccine in place for boys as soon as possible as this can reduce the volume of different cancers that are becoming prevalent in the absence of bringing this in thus far. I implore the Minister to ensure that the Health Information and Quality Authority, HIQA, brings in its assessment on the vaccine as soon as possible because the timeframe is critical. If it does not bring it in until September 2019, as is currently projected, some 30,000 boys will not get the protection, which will ensure men and women will end up with cancers that could easily have been prevented.

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