Dáil debates

Thursday, 3 December 2015

Ceisteanna - Questions - Priority Questions

Vaccination Programme

9:35 am

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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2. To ask the Minister for Health while acknowledging the findings of the European Medical Agency in regard to the Gardasil vaccine, if he will acknowledge that there are many young women who are extremely ill and suffering from symptoms such as complex regional pain syndrome and postural orthostatic tachycardia syndrome but who are not eligible for any State support; if he is aware that some symptoms are so severe that some of these young women have had to drop out of school and their parents are faced with no other option but to quit work and become carers for their children; if he will ensure that these parents and young women alike are supported and made eligible for benefits such as disability allowance, carer's allowance, medical cards and so on; if he will ensure that the appropriate support services are set up for these girls and their families; and if he will make a statement on the matter. [43044/15]

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I seek advice regarding the Minister's intention to address the dreadful circumstances that a not insignificant cohort of young women, and their families, face, consequent, they believe, on the Gardasil vaccination at school.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I thank the Deputy for raising the matter. I am aware of claims of an association between HPV vaccination and a number of conditions experienced by a group of young women. Anyone who is suffering ill health is eligible to seek medical attention and access appropriate health and social care services, irrespective of the cause of their symptoms. People are assessed for eligibility for medical cards, disability or carers allowance individually. The assessment takes into account their family income and individual needs rather than a specific diagnosis.

In particular, people who are suffering from the conditions raised by Deputy Ó Caoláin, complex regional pain syndrome and postural orthostatic tachycardia syndrome, do not have to prove a particular cause of their symptoms to be eligible to receive treatment or access other appropriate services. Young women and their families should seek medical advice from their family doctor in the normal manner and be guided by this advice in accessing appropriate services including specialist opinion where necessary.

The HPV vaccine, which was introduced in 2010, protects girls from developing cervical cancer when they are adults. It is available free of charge from the HSE for all girls in the first year of secondary school. Gardasil is the vaccine used by the HSE in the school immunisation programme and more than 100,000 girls have received this vaccine since its introduction. While no medicine, including vaccines, is entirely without risk, the safety profile of Gardasil has been continuously monitored since it was first authorised, both nationally and at EU level. Each year in Ireland approximately 300 women are diagnosed with cervical cancer. The HPV vaccine protects against two high-risk types of HPV that cause 73% of all cervical cancers.

It appears that some girls first suffered symptoms around the same time that they received the HPV vaccine, and, understandably, some parents have connected the vaccine to their daughters' conditions. However, the European Medicines Agency has recently completed a review of the vaccine. The review, in which the Health Products Regulatory Authority participated, specifically focused on two conditions, to which I have already referred, and found no evidence of a link between the vaccine and the conditions. I want to emphasise clearly the expert findings that the HPV vaccine is a safe vaccine, and encourage all parents to have their daughters vaccinated. This will reduce the numbers of deaths from cervical cancer, head and neck cancers and other cancers in years to come.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The Minister's reply will offer no comfort to the 130 families associated with the campaign group, REGRET. The Health Products Regulatory Authority has received 919 reports of adverse reactions and events associated with the use of Gardasil in Ireland. This could affect many more than the 130 families we know about, given that the condition can present by degrees. The 130 girls are displaying debilitating, long-term and chronic symptoms that include severe fatigue, short-term memory and concentration deterioration, food intolerances, visual disturbances, noise sensitivity, severe headaches, burning muscles and joint pain.

Will the Minister ensure that these young women and their families have access to such benefits as disability allowance, carer's allowance, medical cards and what other appropriate supports are deemed necessary? Will the Minister and his Department look favourably on their particular circumstances and needs?

9:45 am

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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Carer's allowance, carer's benefit, disability allowance and disability benefit are matters for the Department of Social Protection, but no one gets carer's allowance or disability benefit based on a diagnosis or a particular set of symptoms. Even if someone has a serious illness, for example, a severe cancer, he or she does not automatically get disability allowance. Everyone is assessed individually based on income and needs regardless of the cause of the illness or what he or she believes the cause to be.

Similarly, medical card applications are assessed initially based on the income of the individual or family. The cost of people's medical treatments and their other potential needs are then taken into account, in particular for discretionary medical cards. I am sure that the Deputy knows this from his own work. It is not that anyone has an automatic entitlement to any of these benefits based on what symptoms they have or what they believe the cause of the symptoms to be. People are assessed individually initially and also on their needs. This is the way it is for every citizen, which is as it should be.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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What I would like to see of course is a situation where everyone would be entitled. Unfortunately, that is not the case. The Minister has made the exception in respect of some specific areas of need, in particular children with cancer symptoms, only in the very relatively recent past. We are not only looking at the 130 young women of whom we know - there are possibly many more - but also their families, some of which have had their lives suspended. Work and other opportunities in the fulfilment of life's hopes have been set aside in order to provide the supports and care for their daughters. It is imperative that some measure of recognition and some realistic reach-out be organised. It is not good enough just to reject their strong beliefs regarding the underlying causes of their daughters' conditions.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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I am sorry, Deputy, but we are over time.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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We have to take on board the facts they outline. I am appealing to the Minister. The representatives of Reactions and Effects of Gardasil Resulting in Extreme Trauma, REGRET, will be before the health committee later today. What would the Minister say to them if he were, as I am, a member of the health committee?

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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I ask Deputies to stick to the time limit. All that they are doing is preventing other Deputies from asking questions.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I agree with Deputy Ó Caoláin that it would be ideal if everyone had a medical card, but that is not the case. We have a means-tested system and people are assessed according to their means, not their diagnoses. In the case of discretionary medical cards, the assessment can take into account the burden of the illness and the cost of medical needs, but that is an individual assessment. After an expert group reported on this matter not too long ago, most people accepted that this was the best way forward.

Regarding the adverse reactions to which the Deputy referred, the Health Products Regulatory Authority, HPRA, had received 936 reports of adverse reactions and events by 27 November. It should be borne in mind that this was out of 100,000 people who had received the vaccine. The majority of the reports received by the HPRA have been consistent with the expected pattern of short-term adverse side effects for the use of any vaccine as described in the product information. The most frequently reported side effects are local redness and swelling at the point of injection and fever. These are usually mild and temporary reactions to any kind of vaccine. Fainting has occurred after vaccination with Gardasil, especially in adolescents, and less commonly reported side effects from Gardasil include pain in the injected arm site, bruising, itchiness, red hives and, on occasion, wheezing. Like most vaccines, severe allergic reactions are rare.

The fact that a suspected adverse reaction has been reported does not necessarily mean that the medicine or vaccine has caused the observed effect, as it may also be caused by the disease being treated, a new disease that the patient has developed around the same time or by another medicine that the patient is taking. Further data are usually needed to complete the picture.