Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I thank Deputy Alan Kelly for putting down this very important motion. I genuinely believe it is one of the most important Private Members' motions we have had in this House in long years. As Deputy Burton eloquently said, it is not a party political pop or a motion to score points. It is providing the House with an opportunity to unite and send out a very important, powerful message that all of the people's representatives stand behind our doctors and our immunisation programme, and stand behind debunking the myths. I really hope all Deputies on all sides of this House will unanimously support the Labour Party's motion. The most important line in the motion is the one calling on Dáil Éireann to support unanimously the campaign to encourage parents to avail of the HPV vaccine for their children in their first year of secondary school. I certainly hope there is no Member of this House who would have any difficulty with supporting that call. It is also a very important motion in the sense that it gives me an opportunity to update the House on where we are currently and where we would like to be in the future in respect of boys as well.

I thank Deputy Burton for sharing her own family story in respect of her late cousin, Marie. That makes it very real. This is a very real and painful situation that has been experienced by so many families, and we have a way of preventing it. It is so important that we all do everything we possibly can in this regard.

I think we all know that immunisation is regarded as one of the safest and, indeed, most cost effective of all health care interventions. It is also one of the most effective ways a parent can protect the health of their child. The childhood immunisation programmes in Ireland have had a huge impact in improving the health of Irish people. Diseases that used to be common in this country and around the world such as polio, measles, diphtheria, whooping cough and many other serious infectious diseases are now preventable thanks to vaccination. I am proud to note that the uptake rates for many vaccines included in the childhood immunisation programmes are close to the WHO recommended uptake target of 95%. However, we must continue to work so that uptake rates for all childhood vaccines do not just meet but exceed the WHO target.

It is important that we remember why this issue is so important. Worldwide, cervical cancer is the fourth most common cancer in women and HPV immunisation is an important part of our childhood immunisation programmes, which protects women from developing cancer later in their lives. Cervical cancer impacts the lives of a large number of women in Ireland every year. It is the second most common cause of death due to cancer in women aged from 25 to 39 years. Mortality from cervical cancer in Ireland is above the European average. In 2018, more than 90 Irish women will die from cervical cancer. A further 280 women will need intensive treatment such as surgery, radiotherapy or chemotherapy to help them overcome invasive cervical cancer. Unfortunately, four in ten of these women will die within five years. A further 6,500 women will need hospital treatment to remove precancerous changes to the cervix. The average age of diagnosis is 46 years and the average age of death is 56 years.

Treatment is very dependent on a number of individual factors. Where exactly the cancer is detected, whether it has spread, how abnormal the cancer cells are - these are just some of the factors that a treatment team will have to consider. Doctors can draw on a number of different forms of treatment to treat and manage cervical cancer. If the cancer is diagnosed early, these treatments usually have a good outcome. However, if the cancer presents later or is more aggressive, outcomes can be less favourable.

We are all aware of the old saying that prevention is better than cure, and this is especially true when it comes to cervical cancer. That is why in September 2010, the HPV vaccination programme was introduced for all girls in first year of second level schools. In 2011, a catch-up programme commenced for all girls in second level school and was completed in 2014. Uptake rates for this vaccine peaked at 87% in 2014-15 but have fallen since then.

There are two licensed HPV vaccines available in Ireland, Gardasil and Cervarix. Gardasil is the vaccine used by the HSE in the schools immunisation programme. It provides protection against two high-risk HPV types that cause 70% of cervical cancers and pre-cancers, and two HPV types that cause 90% of genital warts. It has been licensed worldwide since 2006 and is used in over 25 European countries, the US, Canada, Australia and New Zealand. To date, over 227 million doses have been distributed worldwide. In Ireland, over 730,000 doses of the vaccine have been distributed and more than 238,000 girls have received the full vaccine course.

The introduction of HPV immunisation has had a significant impact in many parts of the world. Countries with high vaccine uptake rates have obviously seen the highest impact. In Scotland, where 90% of girls have been vaccinated since 2008, there has been a 90% fall in HPV infections in vaccinated girls. Precancerous growths of the cervix have been reduced by more than 50% in countries such as Australia, which is referenced in the motion, Sweden and Scotland. Finland recently published the evidence that HPV immunisation protects against invasive HPV associated cancer.

One of the reasons we need this motion is that unfortunately, in recent years, the spread of inaccurate mistruths and misinformation concerning the safety and effectiveness of the HPV vaccine in the media, particularly on social media, has had a significant impact on uptake rates. If parents are worried tonight about getting factual information about a vaccine, I urge them to get it from a doctor. I beg them not to get it from a public representative who might like to be a doctor but is not, or from anonymous accounts on social media.

We have a doctor in the House - Deputy Harty - who, I am sure, will tell us that this is a very safe vaccine. It is supported by the medical community. I take my medical advice from doctors and other medical professionals. There is one Irish website that is WHO-accredited for information about this vaccine, and that is www.hpv.ie. Parents requiring factual information should have a conversation with a doctor or check out that website.

Misinformation is not harmless. It is not something that is a bit irritating or annoying. It is dangerous; it causes death. It will cause the unnecessary deaths from cancer of Irish girls. The responsibility for that must rest with those in this House who advocate against a vaccination programme. If a person advocates against a vaccination programme, he or she is doing so in the knowledge that all of the WHO evidence suggests that the vaccine is safe and that it saves the lives of girls. That is backed up by our medical community. The fall in take-up rates to 50% in 2016 will result in 1,000 girls requiring invasive therapy, a further 100 developing cervical cancer, which will require life-altering treatment, and the deaths of at least 40 from cervical cancer who did not receive the HPV vaccine. These are numbers, but they represent real girls in parts of this country who are going to require invasive treatment or who will die as a result of not getting this vaccine.

It is very important that we passionately unite to fight back and combat the misinformation. One of the most important things we can do is provide accurate and credible information. I am encouraged by the fact that the HSE launched a very effective campaign to raise public awareness in conjunction with the medical community and an alliance of health care professionals. I thank Deputy Kelly for his kind words about the HSE in that regard. As a result, we have seen the take-up rate increase this year to 62%. We have a long way to go to get back to the 87% coverage we previously had, but I welcome the reversal of the trend.

Two weeks ago, I had the great pleasure of joining with the HSE to launch phase 2 of the new campaign. I want to pay particular tribute to an amazing girl called Laura Brennan, who has just turned 25 and who is from County Clare. Laura has incurable cervical cancer and she contacted the HSE to say that she wanted to front this campaign and spread the word to girls and women of her age, and to mothers, that this vaccine is important and can save lives. I want to thank Laura and her family for their generosity and for the power of her story, which can be seen via the HSE's social media portals and also through its advertising campaign.

I am aware that this House is also discussing the matter of extending the immunisation programme to include boys, who are currently not offered the vaccine. It should be remembered that our understanding of HPV as a cause of cancer originally concerned cervical cancer, and that much of the early work focused on the introduction of HPV immunisation programme for this purpose. There was a large amount of evidence at that time to show that HPV immunisation was effective in preventing the development of cervical cancer. However, there was less evidence available at that time that there was a health benefit to boys. Consequently, it was decided that the vaccine would be offered solely to girls. In recent years, there has been increasing evidence to show an association between HPV and other cancers, found both in men and women. Indeed, the evidence of a link between HPV and these cancers has become stronger. I am aware that 17 countries have already adopted a universal, gender-neutral vaccination policy.

There is a process in place to enable me, as Minister for Health, to make decisions concerning changes to our immunisation programmes. The national immunisation advisory committee, NIAC, makes recommendations on immunisation policy. This is an independent committee of the Royal College of Physicians of Ireland and is comprised of experts in a number of specialties. NIAC's recommendations are based on the epidemiology of the relevant vaccine-preventable disease in Ireland. The HIQA conducts health technology assessments, HTAs, to establish the clinical effectiveness of any proposed changes. I have asked that HIQA carries out a HTA. I share the Deputy's view that it should be concluded as quickly as possible and, subject to a favourable HTA, I will prioritise this motion in terms of seeking to extend this vaccine universally.

I thank Deputy Kelly and the Labour Party for its leadership on this and I look forward to all colleagues uniting to send a strong, unanimous message in support of this life-saving vaccine.

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