Dáil debates

Wednesday, 18 November 2020

Saincheisteanna Tráthúla - Topical Issue Debate

Vaccination Programme

2:25 pm

Photo of Brian StanleyBrian Stanley (Laois-Offaly, Sinn Fein)
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The school vaccine programme is of huge concern. The 2021 programme has been suspended in community healthcare organisation, CHO, 8 and the midlands areas of Laois, Offaly, Longford and Westmeath. It is not happening. It was fully suspended from 9 November and never really got started this year. It would normally kick off in this semester and carry through into next year for the 2021 programme. Children in both primary and secondary school have not been vaccinated as normal since then, even though the front-line community nurses are there and are available to proceed with the programme, which is puzzling. My information is that there is a plentiful supply of the vaccine for all the required immunisations for schoolgoing children, both in primary and secondary school. It is widely accepted that these vaccination programmes are essential to prevent measles, mumps and rubella along with cervical cancer and other medical conditions that arise in later life.

We all understand that earlier in the year the health services had to do extraordinary things and it will have been necessary to suspend the immunisation programme for a period of time during that first lockdown in March, April and May, in particular. Public health nurses were redeployed to carry out other Covid-19 related work and were flexible, and we commend them on that. However, the situation is now different and has changed. My information from the ground is that there are dozens of community Covid-19 testers who are available and trained up to take Covid-19 swabs. There is no need, therefore, to hold back public health work that would normally carry on. The school vaccination programme is proceeding apace in other regions I have checked in, such as Carlow and Kilkenny, for example. Why is the same not happening in Laois, Offaly, Longford and Westmeath, which are included in the HSE designated area of CHO 8? This is an essential front-line service that is preventative in nature. It can be operational and available very quickly.

I often stand up here and I will complain about shortcomings in the health services and we all want reforms in this area, but there are some good things about the health services. These school vaccination programmes have been one of those good things down through the decades. It is a huge body of work that is undertaken by the front-line staff, mainly by the community health nurses. A huge volume of vaccinations are carried out every year with the co-operation of the schools. It is one of the things that is done well and effectively in the health service. My understanding from schools is that they want to have it done. They sincerely wish to have the children available for that and parents who I have spoken to also say they are concerned about the suspension of the programme.

It is supposed to be recategorised by the HSE. The HSE gave a reply of sorts to a query of mine about it being recategorised from what it called priority 1 to priority 2. It needs to be priority 1. We need to keep essential health services going during this pandemic as we move out of level 5 and back to, it is hoped, level 3 or level 2. What can be done about this to get it moving again?

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Deputy Stanley for giving me the opportunity to update the House, on behalf of the Minister, Deputy Stephen Donnelly, on the schools-based immunisation programme in the midlands. We know from international literature that the highest uptake is obtained if immunisations are delivered in schools. It is vital, therefore, that children have an opportunity to avail of their immunisations in this way.

We are all too aware of the disruption that has been caused globally and here in Ireland due to the pandemic and, unfortunately, the schools-based immunisation programme has not escaped interruption. Due to the closure of school buildings in mid-March as a result of the Covid-19 pandemic, the schools-based immunisation programme was suspended. At that time, approximately one-third of students in junior infants still had outstanding vaccines. The visits to second level schools had only just commenced for the second dose of the HPV and the meningococcal vaccines. Therefore, about 90% were outstanding.

To address this issue, all CHO areas provided clinics for the outstanding immunisations to school-aged children in catch-up clinics over the summer months. Children who were unable to attend the catch-up clinics were offered additional chances to receive the immunisations in the academic year 2020 to 2021. Regrettably, the schools-based immunisation programmes, which were scheduled to begin in September 2020, were deferred in the counties covered by the midlands, including Louth, Meath, Laois, Offaly, Longford and Westmeath. This was due to staff being redeployed to support testing, contact tracing, and the public health departments.

I am pleased to advise that the HSE has reviewed the situation and a recovery plan has been prepared for school immunisation for 2020 and 2021. It is intended that the schools-based immunisation programme will resume in the coming weeks. In addition, it is important to note that those who are targeted for school immunisation in 2020 and 2021 will have their necessary vaccinations fully completed by summer 2021.

Photo of Brian StanleyBrian Stanley (Laois-Offaly, Sinn Fein)
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There is some positivity in that reply, which is welcome. Since I started raising this issue, there has been huge concern around it. Parents have been at the forefront of sharing their concerns with me on this. The Minister of State mentioned in his reply that it was necessary to suspend the programme. I accept that and anyone with common sense would say that back in the earlier part of the year, it was all hands to the pump in terms of dealing with Covid-19, and those working in the health services and the Department of Health in administering that deserve our credit for the heroic work they have carried out. They have saved people's lives and they have managed in very difficult circumstances.

I accept that while some clinics were provided in CHO 8, it is also widely accepted that schools are the best place to have this administered because there is a captive audience. The Minister of State will accept that where children are in school, there will be a better take-up of the programme because the children are present and because it is happening on the one site. There is no reason for this not to kick off in the midlands counties again. The Minister of State mentioned that it will resume in the coming weeks. He might give me an indication of when that will be and if it will happen before Christmas.

One particular concern I have is on the vaccine for cervical cancer that boys and girls get. That is the way it is administered according to my information. My concern is that there are two jabs for that and that they have to be given six months apart to first year pupils. It is important that the first jab of that HPV vaccine is administered as quickly as possible to allow the second jab to be given later on in the year.

That is of primary concern. We must ensure that girls are not left exposed to cervical cancer later in life.

2:35 pm

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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Deputies Cowen and Flanagan have raised this issue as well. Vaccination is recognised as one of the most cost-effective and successful public health interventions that exists. The World Health Organization, WHO, estimates that 2 to 3 million deaths a year are prevented by vaccination, and a further 1.5 million could be avoided if global coverage of vaccinations improved. I thank Deputy Stanley for his kind remarks. We are all supportive of the schools-based immunisation programmes and recognise that the uptake of these vaccines is higher when delivered in schools.

However, we must acknowledge the significant challenges that have been encountered in delivering the programme this year. The HSE has been striving to overcome these challenges and put in place alternative arrangements to ensure that the schools-based immunisation programme can continue to be delivered as soon as possible. The HSE is committed to continuing to offer the recommended immunisations to school-aged children, with as little disruption as possible. I will pass on the Deputy's concerns regarding the cervical vaccine to the Minister for Health, Deputy Stephen Donnelly. We will be keeping abreast of developments regarding the recovery plan and the resumption of the schools-based immunisation programme in the coming weeks.