Seanad debates

Friday, 23 April 2021

Nithe i dtosach suíonna - Commencement Matters

Vaccination Programme

10:30 am

Photo of Martin ConwayMartin Conway (Fine Gael)
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I welcome the Minister of State, Deputy Troy, to the House. As this is my first time addressing him formally since his appointment, I formally congratulate him and commend him on the work he has done so far.I have tabled this matter because I am concerned about the roll-out of the human papillomavirus, HPV, vaccine. Those concerns have been shared by the family of Laura Brennan. Members will recall the fantastic work in promoting the uptake of the HPV vaccine Laura Brennan did before her death. It was phenomenal work, the result of which was that the level of uptake of the vaccine reached 82% in the 2019-20 academic year. We are all fully aware of the immense challenges that have been posed by the Covid-19 pandemic but this vaccine is extremely important. It is critical to the future health of girls and boys. A lot of advancement has happened and the fact that the vaccine is being offered to boys in first and second year, as well as girls, is extremely welcome and take-up has been successful.

The pandemic caused difficulties, particularly in the delivery of the programme within schools. It is well-recognised that giving the vaccine in schools has resulted in a significantly higher uptake. We need to think outside the box. We have had vaccine capacity in some of the Covid-19 vaccine centres over the past number of months, and probably will have in the future. There is absolutely no reason the HPV vaccine could not be offered in those settings. Many trained vaccinators have still not been redeployed to the Covid-19 programme and while they are waiting to take up those roles, perhaps they could be redeployed into roles giving this particular vaccine.

The pharmacists in this country are willing and able to deliver the vaccine but that has not happened. Perhaps the Minister of State has some news for me in that regard. It is terrible that Laura Brennan's family has to go on the radio and campaign to keep highlighting this issue. It should be a matter of form that every possible resource is used to deliver this important vaccine.

There are other issues about which I am concerned. It has been brought to my attention that some parents of young people had a certain hesitancy about taking up the vaccine but, having done further research, realised, as we all do, that it is important to take it. When they then went to try to source the vaccine privately, they were quoted figures between €400 and €600. Receiving this vaccine should not be cost punitive. There should be some little fee, perhaps €40 to €60, which would represent a 90% reduction on the €400 to €600 that is being quoted. We need to encourage people to take the vaccine and if, for whatever reason, they opt to do so privately, we should meet them along the way and encourage them, not put obstacles in their way. That is a significant cost to any family and many families would not be in a position to pay it.

The Minister of State might update me on where we are with 2021-22 academic year, as it approaches. He might also tell me is there any thinking outside the box within the Department in terms of using the resources that are there at the moment and using future resources. What is being done to facilitate a catch-up programme? Will he also address the punitive cost for people who decide to source a vaccine privately and may have been too late to avail of the public roll-out?

Photo of Robert TroyRobert Troy (Longford-Westmeath, Fianna Fail)
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I thank the Senator for bringing this matter to the floor of the Seanad. I apologise on behalf of the Minister, Deputy Stephen Donnelly, who cannot be here. I too acknowledge the good work that the Brennan family are doing in their advocacy and highlighting the positivities of this vaccination.In 2009, the national immunisation advisory committee, NIAC, recommended HPV vaccination for girls of 12 and 13 to reduce their risk of developing cervical cancer as adults. In September 2010, the HPV vaccination programme was introduced for all girls in the first year of secondary school. In 2013, NIAC recommended that the HPV vaccine should also be given to boys. On foot of NIAC's recommendation, the Department of Health asked HIQA to undertake a health technology assessment to establish the clinical effectiveness and cost-effectiveness of extending the current immunisation programme to include boys in the first year of secondary school. A policy decision was made to extend the HPV immunisation programme to include boys, starting in September 2019, with the introduction of a 9-valent HPV vaccine.

The ages at which vaccines are recommended in the immunisation schedule are chosen by NIAC to give each child the best possible protection against vaccine-preventable diseases. As the HPV vaccine is preventative, it is intended to be administered, if possible, before a person becomes sexually active, that is, before a person is first exposed to HPV infection. Therefore, the gender-neutral HPV vaccination programme targets all girls and boys in the first year of secondary school to provide maximum coverage.

The roll-out of the school-based immunisation programme, which includes HPV vaccination, is the responsibility of the HSE. It is important to note that the school-based immunisation programme for the 2019-20 academic year has been completed and that the uptake rates in respect of the HPV vaccine for that academic year were 82% for the first dose and 77% for the second. This is the highest rate of uptake under the HPV vaccination programme since 2015-16, and it is particularly encouraging because it was the first year that boys were included in the programme. It shows that the provision of the vaccine in the community clinics did not adversely affect uptake.

The programme for the academic year 2020-21 was paused during the first few months of 2021 due to school closures and the redeployment of staff of the Covid-19 immunisation programme. The inputting of uptake information for the school-based programme has also been delayed due to the redeployment of administrative staff. However, community healthcare organisations have reported that the vast majority of second level schools had their first dose of the HPV vaccine delivered between October 2020 and December 2020. The uptake rate for the first dose of the HPV vaccine in the 2020-21 academic year is 63%, and this figure is expected to increase because data input on the vaccine uptake is ongoing. Plans are now being developed by the HSE for the recommencement of the vaccination programmes, including the second dose of the HPV vaccine. Some areas have already recommenced these programmes and are in the process of arranging school visits.

I thank Senator Conway for raising this matter today. I assure him that, on foot of his recommendations, I will relay the suggestions he has made on the floor of the Seanad to the Minister for Health, Deputy Donnelly. In talking about capacity in our Covid-19 vaccination centres, we should note that while the Covid vaccine roll-out is going well, capacity issues are not just sorted yet. Obviously, the priority is to use those centres for what they were designed. I undertake to relay to the Minister the suggestions made today.

Photo of Martin ConwayMartin Conway (Fine Gael)
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I thank the Minister of State for the update and I acknowledge the progress that has been made but I seek further clarity on a meaningful catch-up programme to get the figures up to what they should be, bearing in mind that we are in a pandemic, and on the role pharmacists throughout the country can play in delivering the HPV vaccine to young girls and boys aged 12 and 13. Where people have to go private to get the vaccine for their children, the cost, between €400 and €600, needs to be borne by the State. A total cost at least 90% less than the current one needs to be considered.I appreciate the Minister of State, Deputy Troy, coming into the House today and hope he will pass on those points to the Minister. We will revisit the issue in a few months.

Photo of Robert TroyRobert Troy (Longford-Westmeath, Fianna Fail)
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I thank Senator Conway. I reassure him that I will raise this matter with the Minister, Deputy Donnelly. I reiterate that the academic year 2019-20 saw the highest uptake of the HPV vaccination programme since 2015 and 2016. That is a positive and encouraging development. It goes without saying there have been challenges in this latest academic year but the HSE is committed to offering the recommended immunisation to school-aged children with as little disruption as possible. That has recommenced and I hope it will be concluded successfully before the end of this academic year.