Thursday, 2 March 2017
I wish to raise the issue of the meningitis B vaccine because I believe it is an important issue. The meningitis B vaccine was rolled out last September and it came into operation last December. It was a positive initiative led by the Department of Health.
A vaccination programme at this level is important. It mainly affects people between the ages of one and five years, as well as from 13 to 18 years. These are the two age groups most affected by meningitis B.
The unfortunate side effects of meningitis B are well documented. There are approximately 170 cases in Ireland every year. A total of 10% of these sufferers could face amputation, brain damage and loss of hearing. Unfortunately, 33% of this group face a lower IQ. Clearly, it is a major issue.
I compliment the work of the Department of Health on rolling out this important programme. Similar programmes have been rolled out in other countries, such as New Zealand. Those countries have seen a dramatic reduction in meningitis B over the lifetime of the programme.
My major concern about the programme is that it goes from September onwards. In other words, if a child is born in September, he or she is included in the programme. We need to consider a programme going backwards to pick up the 1.2 million children aged between six months of age and 18 years of age. The Government must invest in such a programme because it has long-term benefits for the State and the population.
The cost of getting the vaccination privately is high. For example, let us suppose a child is less than nine months of age. That child must get three jabs, and it costs €150 per jab plus €30 for the visit to the doctor. That is a significant cost. If the child is over nine months of age, it is down to two jabs at €150 per jab plus €30 for the cost of a doctor's visit.
We are now running a two-tier health service. We are heading for a situation where only those who can afford the vaccination can get it. That is a major concern for the general population. Parents have contacted me with concerns over meningitis. An unfortunate case arose in Cork in the past two weeks. There is broad concern about the disease. The cost issue for young families is considerable. I hope that the Department of Health can put in place a programme to cover the people who are not vaccinated. We have seen catch-up elements as part of other programmes. We need the Minister to look at putting in place a catch-up programme to catch the 1.2 million children in the State who are not tied in to this programme.
We have seen the effects of meningitis. The recent vaccination programme has been a great success, but we need to go from September backwards and tie in all those people who need this vaccination. The vaccination programme is a great programme. We should promote it and recognise what it has delivered. However, we should go backwards and look at the 1.2 million who are not in this loop. If we do not, the knock-on effects will be horrendous.
On behalf of the Minister, Deputy Harris, I thank Senator Lombard for giving me the opportunity to update the House on this important matter. Meningococcal disease is a vaccine-preventable disease which has a high mortality rate if untreated. It is statutorily notifiable in Ireland under the Infectious Diseases (Amendment) Regulations 2016. However, this does not require reporting of individual strains. The annual epidemiological report for 2015, published by the health protection surveillance centre of the HSE in December 2016, indicates that between 1999 and 2012, a marked downward trend in invasive meningococcal disease was observed. In 1999 there were 536 cases and in 2012 there were 66 cases, a decline of almost 88%. In Ireland in 2015, meningococcal B was the pathogen most commonly associated with invasive meningococcal disease, accounting for 57.3% of the 75 notifications that year. Age-specific incidence rates show that the highest rates are in infants less than one year of age. The vaccine used in Ireland is Bexsero. In January 2013 the vaccine received marketing authorisation from the European Commission. The immunisation programme in Ireland is based on the advice of the national immunisation advisory committee. The NIAC is a committee of the Royal College of Physicians of Ireland comprised of experts in a number of specialties including infectious diseases, paediatrics and public health.
In December 2013, the NIAC issued guidelines relating to the use of this vaccination in the control of clusters or outbreaks of meningococcal B disease. The vaccine has been used in accordance with these guidelines, along with other measures, to control outbreaks of the disease.On 23 January 2015 the chair of National Immunisation Advisory Committee wrote to the chief medical officer strongly recommending that meningococcal B, or MenB, vaccine be included in the primary childhood immunisation programme, if the vaccine can be made available at a cost-effective price. In Ireland, both childhood and adult immunisation programmes are delivered by the HSE. The HSE service plan 2016 included additional funding of €2.5 million for the expansion of the primary childhood immunisation schedule. Two changes were made to the primary childhood immunisation schedule and I am happy to inform the House that, from 1 December 2016, all babies born on or after 1 October 2016 are eligible to receive the MenB and rotavirus vaccines.
The HSE national cold chain service has distributed 35,500 doses of the MenB vaccine to date. This is sufficient to vaccinate the children in the cohort born on or after 1 October 2016. Uptake figures are not yet available. Ireland is the second country in Europe to make the vaccine available free of charge as part of its national immunisation programme. There are no plans at this stage to introduce a catch-up programme for older children.
I thank the Minister of State. The last line says it all, in that there are no plans at this stage to introduce a catch-up programme. That is the crux of the issue. First, we have to acknowledge the programme has been put in place and it is very positive that, from 1 October, we have seen a major uptake. The real issue is that, going forward, we have to consider such a catch-up programme. Other countries like New Zealand that have put in place a catch-up programme have seen amazing reductions in meningitis B. One of the key issues is that of planning that catch-up programme and putting it in place. That some 1.2 million people are exposed to this issue makes it a big issue for us all. As I have said previously, I have seen situations in my own part of the world where tragedies have happened. I hope the Department of Health will put a catch-up programme on its agenda. What it really means is that parents and their children can have peace of mind when it comes to meningitis. We have all been in the situation of wondering whether a child has meningitis or not. It is a real worry because, if a child does have meningitis, it is a major issue with far-reaching consequences.
I acknowledge again the Senator's concerns around the catch-up programme for 1.2 million children. As a mother and a grandmother, I am very conscious of the fact that when the word meningitis is mentioned, people have real fears. All of us around Leinster House, whether public representatives or staff, have been touched through our families because, unfortunately, people have contracted this deadly disease. There is now the opportunity for people to have their children vaccinated, although the Senator is correct that there is a cost to this. I believe we need to widen the net. I will bring the Senator's views back to the Minister, Deputy Harris.