Marc Ó Cathasaigh (Waterford, Green Party)
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The issue I want to raise relates to the flu vaccine, particularly in the context of its availability to GPs and pharmacies throughout the country. I am sure all Deputies have been contacted about this matter. I have been talking to my local pharmacist in Tramore and he stated that he is fully up to date in terms of his returns for the vaccine. He has a waiting list of 200 people. He has already identified those he wants to prioritise in terms of underlying health conditions but he is in a position where he cannot order any additional vaccine. As far as he is concerned, this is the first time in his career that he has been unable to make an order to have vaccine in stock in his pharmacy.

There are a number of issues which arise. The first of these relates to the release of the final 50,000 doses of the flu vaccine. I understand that 1.35 million doses were ordered this year. There is the unresolved issue of 600,000 doses, the returns of which may not have been kept up to date. In the context of the latter, it must be acknowledged that pharmacists and GPs are extremely busy. We should not leave them shoulder any of the blame for perhaps not submitting the administrative work in time in order to release the additional 50,000 doses. Those final 50,000 doses have to be released as a matter of urgency.

There is also the issue of making more doses available. Having Covid and the flu at the same time is health threatening. Is there availability within the international market for us to get our hands on additional doses so that we can facilitate the release of the 50,000 doses that are still in the country and deal with the increased demand for the flu vaccine this year?

Ruairi Ó Murchú (Louth, Sinn Fein)
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I thank the Minister of State, Deputy Byrne, for stepping up and taking this matter. Obviously, it would make more sense if someone from the Department of Health could have been present. If he does not have the answers, I ask the Minister of State to ensure that we get them directly from the Minister for Health. Hopefully, the Minister of State has them.

We all understand that, due to the Covid pandemic, a determination was made to ensure that we would have sufficient supplies of the flu vaccine, particularly for people at risk. That was the cohort of people who would be older and also those who working in front-line healthcare situations, etc. I would like clarity on the figures. We have heard that approximately 1.4 million doses of flu vaccine were bought but the number could be closer to 1.35 million. Seven hundred thousand applications have been made for reimbursement through the primary care reimbursement service. There was a communication problem whereby we believed 600,000 doses had been lost but we now are led to believe that they were delivered and either have not been administered or the applications for reimbursement have not been made. We still have the question of the 50,000 doses that are left.

We have all heard about the difficulties of pharmacies and doctors getting stocks of vaccine. I have heard it in my town of Dundalk. We need to ensure that this is not a difficulty. Doctors and pharmacies, I am led to believe, have been given guidelines to ensure that only at-risk patients or those who would be at risk will get the flu vaccine. How are we ensuring that these guidelines are adhered to?

We need to look at the means by which we could buy more vaccine. What has become clear is that we have insufficient stocks, particularly in view of the circumstances in which we find ourselves. We need to identify a solution as possible.

Thomas Byrne (Meath East, Fianna Fail)
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I thank both Deputies for raising this issue. I, too, am aware of it. I am certainly glad that they have raised the matter because it gives the Government an opportunity to set out what has been done in what has been a massive operation to administer the flu vaccine this year. In fact, what has been done is completely unprecedented.

Of the 1.35 million doses of the flu vaccine available this winter, 1.3 million have already been distributed to GPs, pharmacists and other vaccination sites since early October. The Minister apologises for not being here, but he has informed me - to answer Deputy Ó Murchú's point - that all of those deliveries were properly recorded. In addition, 420,000 doses of the live attenuated influenza vaccine for administration to children between two and 12 years were also distributed. As we are now nearing the end of the supply, the HSE wrote this week to GPs and pharmacists to indicate that the final 50,000 doses would be held back until greater clarity could be achieved on how the doses already distributed have been used.

GPs and pharmacists, as the Deputies have acknowledged, have been incredibly busy this year and have done tremendous work. I thank them for increasing the number of vaccines administered in very difficult circumstances. Already, GPs and pharmacists have submitted almost 80% more claims than in the same period last year, including 35% more in respect of those over 65. That is very positive. Nonetheless, given the particular circumstances prevailing, it is important that the HSE has as clear a picture as possible before allocating the final 50,000 doses available for use in order to ensure that they can be targeted where they will have the biggest impact in line with the priorities as set out by the WHO for this year's vaccination campaign. That picture depends on claims from GPs and pharmacists but also on information from hospitals, nursing homes and other relevant locations. The distribution of the final 50,000 doses will start at the end of this month.

This year's flu vaccination campaign will see significantly more people receive the vaccine in Ireland than ever before. Assuming that the current trends carry through, at least 350,000 more individuals in at-risk groups will receive the vaccine this winter than last. In addition, over 100,000 children have already received the vaccine that has been provided without charge for the first time. This will increase significantly in the coming weeks.

Deliveries of the vaccine from the manufacturer were not as quick as we would have liked due to the challenging international market and the unprecedented times in which we are living. It is also true that the demand is there. People are answering the call to get vaccinated. The level of demand is unprecedented. This is the case everywhere, in Europe and beyond. In that context, it is unlikely, the HSE and the Minister believe, that additional supply will become available. This reinforces the message that in view of the finite supply of the vaccine, it is important that even the increased quantities which we have this year are targeted where they will have the greatest impact, benefiting the individuals concerned and helping to reduce the pressure on the health system.

Marc Ó Cathasaigh (Waterford, Green Party)
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I am disappointed we are going to be unable to source extra vaccines. This is perhaps approaching the issue slightly tangentially but perhaps we need to leverage what we do have in a better way. The Minister of State made reference to the children's vaccine which is still available. It is free at the point of use and I am advised that there is plenty of it available. Perhaps the Government needs to think about an awareness-raising campaign on this. The flu often finds a reservoir among our younger population, which Covid thankfully does not. Let us leverage what we have and communicate better that this is available and free at the point of contact. This will hopefully allow us to break the chain of transmission and maybe help protect some of the older and more vulnerable people within our communities by stopping the spread in transmission of the virus. That might be something we can think about going forward.

Ruairi Ó Murchú (Louth, Sinn Fein)
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I agree that it is somewhat worrying that we might not be able to source a greater level of flu vaccine, particularly if that leads to a situation in which we cannot ensure all those at risk can actually get the vaccine. We need to ensure, once again, that doctors and pharmacies are operating to the guidelines of giving it only to those at risk. We also need to do anything possible to ensure we can get any stocks that do become available. We welcome the fact that a task force on the Covid-19 vaccine has been set up under Mr. Brian MacCraith. We have also had the very good news that the Pfizer-BioNTech vaccine is 90% effective. We need to ensure we learn from any mistakes we have made on this, that we carry out all the due diligence and that we ensure we can administer to everyone on the basis of need. We also need to ensure there is an all-Ireland response, particularly given the conditions of living on this island.

Thomas Byrne (Meath East, Fianna Fail)
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I thank the Deputies. It is a crucially important issue and I am glad to see people talking positively about vaccines because there are, quite frankly, a lot of cranks out there on the Internet who are just rubbishing anything at all to do with vaccines without looking at the science and indeed, in the case of the Covid vaccine, without waiting for the clinical trials to be completed, which has not happened yet.

Both Deputies raised the issue of ordering more flu vaccine. The Minister asked me to advise Members that vaccines are ordered well in advance. This year the HSE placed its order in February. The HSE order for 2020-21 season was 20% greater than it that for the previous year and 35% greater than the uptake for winter 2019-20. These figures do not include the additional 600,000 doses for children, which would bring the additional number of doses of vaccine available this year to almost 75%. The numbers we are getting vaccinated are thus unprecedented. However, given the demand on the international market for the influenza vaccine, the Minister feels it is not realistically possible to procure more doses at this point. Steps are being taken at the moment by the HSE to ensure vaccinations are delivered to those most in need and where they will have the greatest impact, in light of the international market conditions and of the fact we have unprecedented numbers getting the vaccine. The full amount, up to 1.35 million, will have gone out by the end of this month.

On the two to 12 years of age category, the programme is ongoing and I use this opportunity really to encourage parents who have not yet done so to contact their GP or pharmacist to arrange a vaccination. The last thing parents want is a child who could have been vaccinated against flu coming home with flu-like symptoms and the whole family having to isolate for a couple of weeks as a precaution. The vaccination is there, it is available and children under 12 years should get it. I again thank the Deputies for raising the issue.