Pat Gallagher (Donegal, Fianna Fail)
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The next Topical Issue is in the names of Deputies Brassil, Thomas Byrne and O'Reilly. It is customary to give Deputies one minute each but as Deputy O'Reilly is not here at the moment, I will give the other two Deputies a minute and a half each.

Thomas Byrne (Meath East, Fianna Fail)
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I agree with the comments of my party colleague, Deputy Brassil, who is a pharmacist and a qualified health professional. Indeed, I am very grateful to him for the advice he has given to me on this issue.

The State should be glad that parents are very concerned about a vaccine programme and want it to be made available to more children, given that have been several controversies around vaccines in recent years. Rather than being defensive, if not rude, the Minister for Health should be glad that people are looking for this vaccine.

He should be grateful that people are looking for vaccines against the disease.

As Deputy Brassil noted, the fears of the public were heightened, probably rightly, when a HSE public health doctor appeared on "Morning Ireland" last week and made the case that the recent increase, as described in the official release from the HSE, is a cause for concern. Parents were concerned, in many cases because their children had not received access to the vaccine. In the recommendation from the officials charged with making it, we were told the vaccine should not be provided to children born before 2016, but no reason has been given. Is it refused on grounds of safety, cost or efficacy, that is, whether it works? The evidence is that it does, and last week people were strongly urged by the HSE to take up the vaccine. Complaints were made that the rate of the uptake of the meningococcal vaccine among children has been suboptimal. I strongly encourage those who are able to get the vaccine to get it for their children if they have not done so because it is important. The people deserve an answer from the State about why many of their children cannot get the vaccine.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputies Brassil and Thomas Byrne for raising this important issue and for the opportunity to update the House on it, which has been the subject of recent media coverage. Invasive meningococcal disease is a vaccine-preventable disease which may present as meningitis or blood poisoning, and has a high mortality rate if untreated. It may occur at any age but is most common in infancy and early childhood with an additional smaller peak of disease activity in adolescents and young adults. There are five primary serogroups of the neisseria meningitidis bacteria that cause meningococcal disease. Group B and group C are the most common forms in Ireland.

The immunisation programme is based on the advice of the national immunisation advisory committee, NIAC. The NIAC is a committee of the Royal College of Physicians of Ireland which comprises experts from a number of specialties, including infectious diseases, paediatrics and public health. The meningitis C vaccine was introduced in Ireland in 2000 to the infant immunisation schedule at two, four and six months of age. In 2014, the NIAC updated guidance relating to meningitis C vaccination. The committee recommended that two doses of meningitis C vaccine be given in early childhood and that an adolescent dose be given at 12 or 13 years of age.

In 2015, the NIAC recommended that the meningitis B vaccine be included in the primary childhood immunisation programme if the vaccine could be made available at a cost-effective price. Meningitis B disease is most common in babies under the age of one, of which the scheduling of the administration of the vaccine under the immunisation programme takes account. The change recommended by the NIAC took effect from 1 December 2016 and the meningitis B vaccine is now given at two, four and 12 months of age. Ireland was the second country in Europe to make the meningitis B vaccine available free of charge as part of its national immunisation programme. There are no plans to introduce a catch-up programme for older children.

A total of 89 meningococcal cases were notified in 2018. Some 11 cases of meningitis have been notified to the Health Protection Surveillance Centre since the last week of December, with three deaths notified among these cases. The 11 cases notified compare with five cases for the same period last year. Importantly, the HSE has noted that this does not represent an outbreak but instead reflects the known increased incidence of the disease in winter and early spring. Provisional data on the strain types identified indicate that different strains of the disease are circulating. In the cases of the three deaths, two different strain types were identified, neither of which was meningitis B.

In June 2018, the chair of the NIAC wrote to the Department to advise that it is engaged in a review of the epidemiology of meningococcal disease in Ireland and that it will develop recommendations based on these findings. The Department awaits the outcome of the NIAC’s deliberations. Parents are strongly advised to ensure their children are immunised according to the vaccination programme. Information on the disease and the immunisation program are available on the HSE’s website.

Thomas Byrne (Meath East, Fianna Fail)
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Nowhere in the Minister of State's reply, nor anywhere in the public commentary of the Minister for Health has the reason for not providing the vaccine been given. Rather, the Government is standing over what it says is the advice given to it and providing no further comment or answers.

Approximately ten years ago, there was a review of patient safety in Navan hospital. Other Deputies from Meath and I met senior representatives of the HSE to discuss the issue. We were given assurances that there was a severe issue with a consultant that had to be addressed. A number of years later, there was a High Court case relating to that consultant. All was forgotten about the issue and the consultant's good name was upheld. As a result of that case, I question everything. It is not disrespectful to professionals to question their advice. It can subsequently be accepted, but it should be questioned and interrogated, which is what parents are asking us to do in the Dáil. In the reply the Minister of State provided, he has not answered the concerns or given a reason that people will find satisfactory.

I appeal to those parents whose children qualify for the vaccination but have not received it to get it. We on this side of the House urge them to do so.

Ten years ago, there was a review of patient safety in Navan hospital. Other Deputies from Meath and I met senior people in the HSE to discuss the issue of patient safety. We were given assurances that there was a severe issue with a consultant

I appeal to those parents whose children qualify for vaccination but are not already vaccinated to get the vaccine. On this side of the House, we urge them to do so.

Finian McGrath (Dublin Bay North, Independent)
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I acknowledge the genuine anxiety of my colleagues and the issues they raised relating to evidence, early childhood and the catch-up programme. Deputy Thomas Byrne spoke about the fears of the public, and I will raise his concerns with the Minister and the Department of Health.

There is anxiety among the public as a result of the recent media coverage of meningitis. In today's world where people have access to multiple sources of information, it is difficult to prevent a message designed to inform members of the public from becoming a catalyst for fear and anxiety, which is unfortunate. I will ask the HSE to consider what measures should be put in place for future communications about meningitis and other diseases to ensure a balance is struck between advising and informing the public, on the one hand, while minimising fear and anxiety on the other.

I reiterate that none of the recent deaths has been attributed to meningitis B. Like my colleagues, I urge parents to ensure their children are fully vaccinated against meningitis B and C, as per the immunisation programme. I will bring the Deputies' concerns to the Minister, his Department and the HSE.