Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank Deputy Higgins for raising this important matter. Vitamin D is essential for bone and muscle health and to support the normal functioning of the immune system. Vitamin D can be found in a variety of foods, including in fortified cereal and dairy products, and humans can also absorb it from the sun. I take this opportunity to highlight the importance of a balanced diet that not only supports overall health but can also help to increase vitamin D intake. This is particularly important for vulnerable populations. I ask that nursing homes and all service providers continue to ensure suitable food offerings and outdoor activities are provided, as appropriate, to further maximise vitamin D intake.

Department of Health guidelines on vitamin D, which were updated in November 2020, advise adults aged 65 and older to take a daily vitamin D supplement of 15 micrograms to support bone and muscle health. In the context of Covid-19, it is currently advised that those who are self-isolating or are unable to go outside, including adults and children over the age of one, should consider taking a daily supplement containing 15 micrograms of vitamin D to ensure a healthy vitamin D status.

The role of vitamin D supplementation in the prevention or treatment of Covid-19 has not been definitively established. NPHET considered an evidence synthesis paper on the role of vitamin D in the prevention and treatment of the virus on 28 January 2021. The paper examined available research evidence up to January 2021, including recent rapid reviews, randomised controlled trial evidence, observational studies and laboratory studies. A recently updated rapid review conducted by the National Institute for Health and Care Excellence in the UK concluded that there is currently a lack of evidence linking vitamin D and the incidence and severity of Covid-19. The report advised increasing awareness of existing recommendations relating to vitamin D supplementation. Results from a randomised control trial reported reduced admission to ICU and reduced mortality in patients with Covid-19 receiving standard care plus vitamin D compared with standard care alone. However, this trial was noted to have significant methodological limitations, including low participant numbers and a serious risk of bias. Collectively, other evidence provides conflicting reports of an association between vitamin D supplementation and a reduced risk of poorer outcomes from Covid-19 infection.

NPHET agreed that, at present, there is insufficient high-quality evidence with respect to vitamin D in the prevention and treatment of Covid-19. NPHET also agreed that efforts should be made to increase awareness of existing guidance. Adults spending increased time indoors, those who are housebound or in long-term residential care and people with dark skin pigmentation are recommended to take a daily vitamin D supplement. NPHET's recommendations for the use of vitamin D are being incorporated into wider messaging and, additionally, are being communicated across the health service, including in nursing homes and social care settings as necessary. The Department of Health has recently written to the HSE and Nursing Homes Ireland to encourage implementation of guidance on vitamin D supplementation in nursing homes. In the coming weeks, a presentation will also be delivered to GPs through the Irish College of General Practitioners on the importance of vitamin D and it is expected that this will reach upwards of 3,000 GPs.

NPHET will continue to monitor ongoing developments and research in this area, particularly randomised control trials, and will review guidance accordingly. The Government will continue to look to NPHET to provide recommendations with regard to vitamin D supplementation and Covid-19. The Government remains united in its resolve to tackle the spread of the virus.

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