Jerry Buttimer (Fine Gael)
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I welcome the Minister of State, Deputy Butler, to the House and thank her for taking this Commencement matter. The matter I raise is the issue of the monkeypox vaccine, the lack of supply of vaccines and of a programme of vaccination, and the disappointing lack of communication with the gay community. It is causing huge anxiety. I appreciate that this is not the Minister of State's area of responsibility but I thank her for being here today.

The issue of the supply of vaccines is a challenge not just for Ireland but for the wider world. If we look across the world to parts of Europe, our near neighbours, and to North America, we see that vaccination programmes have been rolled out quite successfully. I ask the Government, the Department of Health, the HSE and the National Immunisation Advisory Committee, NIAC, to put in place now - in the autumn of 2022 - a comprehensive vaccination programme. I hope the Government will acknowledge that the vaccination programme is necessary but is incomplete. At the moment we have an initiative targeted at a small cohort of men in the gay community. It is not expansive enough and it does not cover the wider community but it needs to do so.

In tandem, the messaging from the Government, the HSE and NIAC has been very disappointing. It has been uncertain. The whole issue of the vaccination programme and the messaging has been slow and uncertain. We need to have a promotional campaign and messaging for the MSM community. I say this as a member of the gay community. I am conscious that many people may think monkeypox is a sexually transmitted infection, STI, which it is not. It is much more than that.

For many of us, it seems that we are going back to the 1980s, when we had another epidemic called HIV, and the way we were treated then. I do not want that to happen now and to have a situation where we have people pigeonholed or victimised. We need a whole-of-government approach in which clarity and accessibility are pivotal and part of what the Government does for the gay community. I accept the Minister of State's bona fides have always been extraordinary. I know she will go back to the Minister for Health following my genuine attempt to have a comprehensive vaccine roll-out. It feels as though the gay community has been forgotten about again by the Government.

I wish to ask about access to the vaccine. I am aware that Ireland is part of the EU-wide approach to the vaccine. Where stands Ireland now with regard to vaccine supply? What is the status of our order? What is the approach of the Government and the HSE to a post-availability increase in supply of the vaccine in the context of the target audience? Who will be allowed to get the vaccine? When can it happen? Have we a roadmap? As other countries have done with the intradermal route in terms of administration of the vaccine, have we put in place an operation to change the issuing of the vaccine so we can administer more doses to more people? It really is about defining where we are going to be in ten weeks or in ten days as opposed to where we are now, which is a very disappointing place.

I look forward to the Minister of State's reply and thank her for being here. This is a matter of extreme importance. We cannot go back to where we were in the 1980s. It is about ensuring we have a whole-of-government approach to the provision of the vaccine and to supply at a European level.

Mary Butler (Waterford, Fianna Fail)
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I thank Senator Buttimer for giving me the opportunity to speak to this issue and provide an update on the monkeypox vaccination programme. I acknowledge his genuine contribution on this matter. I believe I might have some information that might not be in the public domain.

Since the notification of the first case of monkeypox in Europe, Ireland has moved quickly to respond to the disease outbreak. The Department of Health and the HSE have implemented a broad range of public health measures to control the outbreak and continue to engage and raise awareness in respect of the disease. I take on board what Senator Buttimer said, namely, that the message is disappointing and that there is a lack of communication. He feels a promotional campaign is required.

Following the World Health Organization's declaration of a public health emergency of international concern, a strategic advisory group, chaired by the interim Chief Medical Officer was convened to provide oversight and advice on the surveillance and management of monkeypox at national level, as well as the ongoing strategy to contain the outbreak. The work of the multidisciplinary group builds on the significant work already undertaken by the HSE and the ongoing work of the HSE's national crisis management team.

To date, the Health Protection Surveillance Centre has been notified of 173 confirmed cases of monkeypox in Ireland. Anyone, regardless of their sexuality, can get monkeypox if they are in close physical contact with a case. However, the epidemiological picture to date in Ireland remains similar to that seen in other countries where cases are predominantly in the gay and bisexual men who have sex with men, gbMSM, community. To help prevent and reduce infections in gbMSM community, the Department of Health and the HSE have implemented a proactive communications programme. As Senator Buttimer will be aware, at this time, supplies of monkeypox vaccines in Ireland and in the EU are limited. Ireland, along with other EU countries, is actively exploring options to increase our medium to long-term supply of vaccines. The Department of Health and the HSE have been working closely with the European Commission's Health Emergency Preparedness and Response Authority, HERA, to secure additional vaccine doses. The first supply of vaccines procured by HERA and donated to member states has been received by Ireland. HERA has provided a boost to member states' vaccination programmes by announcing that it has secured an additional 170,000 doses from the manufacturer with delivery available before the end of the year. This brings the total number of vaccines secured for member states to more than 330,000 doses.

The vaccination programme in Ireland is based on advice from the national immunisation advisory committee, NIAC. The vaccine is currently being offered to close contacts after a risk assessment and to some healthcare workers who may be at risk of exposure through their work. Following updated NIAC advice, the vaccination programme is being expanded on a phased basis to vaccinate those at high risk of infection before they are exposed to the virus. The HSE estimates that approximately 6,000 people may be at heightened risk of monkeypox infection. The first phase of the vaccine programme, which is under way, is offering the vaccine to 600 people. A proposed second phase, using the new intradermal method of administration, is expected to allow for vaccination of 40% to 50% of the estimated number in need. The HSE is finalising a range of operational issues before beginning the second phase of the vaccine roll-out.

I have listened intently to Senator Buttimer's genuine contribution. I will bring his comments back to the Minister and the Department.

Jerry Buttimer (Fine Gael)
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I thank the Minister of State for her response. I appreciate what she said, but what we have heard is quite similar to what we got last August. Let us roll out the vaccine programme and look at the intradermal method of administration and how we can extend it more broadly. The Minister of State referred to the intention to vaccinate "those at high risk of infection before they are exposed to the virus". It is important that we administer the vaccine across the community. We know vaccines work. We have seen that with Covid and other vaccines. They do work. We are part of the European approach. I welcome the increased provision. The intradermal method is one we should be exploring more. I hope it will be part of the consultation process. Will the Minister bring back to the Department, NIAC and the HSE that more gay men must be on the steering group and involved in the administration, campaign and promotional programme for the vaccine.I welcome the increased supply but it is important that we recognise that we are way behind other countries. While the response is encouraging with regard to the numbers, it is also disappointing. I thank the Minister of State for being here. I hope the Minister, Deputy Stephen Donnelly, will engage further with us. As one of the seven members of the Oireachtas LGBT community, I would be happy to meet the Minister to discuss this with him. I thank the Acting Chairperson for her patience. I thank the Minister of State, Deputy Butler, for being here. I know it is not her area of responsibility, but in fairness to her, she has always been a strong advocate and leader for us in the gay community. I thank her sincerely for that.

Mary Butler (Waterford, Fianna Fail)
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I thank the Senator. The Department of Health and the HSE will continue to work with the European Commission and the manufacturer to secure sufficient doses to enable us to vaccinate all of those recommended by the National Immunisation Advisory Committee, NIAC. The Senator is right about how, when we look at the last two and a half years, the Covid vaccine was rolled out to all communities. Based on current indications about global supplies of vaccines, Ireland is likely to have increased vaccine supplies later this year and next year. The aim is to ensure that people at risk are offered a vaccine at the earliest opportunity.

However, it is important to emphasise that vaccination is only one part of our response to prevent monkeypox infection. Since the initial outbreak, significant work has been undertaken to raise awareness about the disease. There has been extensive public engagement with local community representative groups. I take the Senator's point about having more gay man on the working steering group. The Minister for Health met the gay and bisexual men who have sex with men, gbMSM, representative groups and the HSE to discuss the outbreak and engagement events continue to be held around the country. The Senator said it would be nice if his group in the Oireachtas could engage directly with the Minister. I will bring that request to him.