Michael Healy-Rae (Kerry, Independent)
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184. To ask the Minister for Health his views on a matter (details supplied) raised in a media broadcast; and if he will make a statement on the matter. [21821/18]

Michael Healy-Rae (Kerry, Independent)
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190. To ask the Minister for Health if he will address a matter (details supplied); and if he will make a statement on the matter. [21851/18]

Simon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 184 and 190 together.

Cervical cancer is the fourth most common cancer in women worldwide. Mortality from cervical cancer in Ireland is above the European average. In 2018 more than 90 Irish women will die from cervical cancer. According to the World Health Organisation, which has reviewed international evidence, there is a strong association between HPV infection and the development of cervical cancer and that HPV vaccination is effective in preventing the development of cervical cancer. There are over 100 types of HPV and around 40 types of HPV can infect the genital tract. Some of these are low-risk types which cause genital warts, while others are high-risk types that are associated with the development of various cancers such as cancer of the cervix, vulva, vagina, anus, penis and throat. Ninety nine percent (99%) of cervical cancer is caused by persistent infection of certain high risk types of HPV.

The introduction of HPV immunisation has had a significant impact in many parts of the world. Countries with high vaccine uptake rates have seen the highest impact:

- In Scotland where 90% of girls have been vaccinated since 2008 there has been a 90% fall in HPV infections in vaccinated girls;

- Precancerous growths of the cervix have been reduced by more than 50% in countries such as Australia, Sweden and Scotland;

- Finland recently published the evidence that HPV immunisation protects against invasive HPV-associated cancer.

There are 2 licensed HPV vaccines available in Ireland. Gardasil is the vaccine used by the HSE in the School Immunisation Programme. It protects against HPV types 16 and 18 which cause seven in ten cases of cervical cancer, and types 6 and 11 which cause the majority of genital warts. Gardasil has been authorised for use across the European Union since 2006 and has been used in over 25 European countries, the US, Canada, Australia and New Zealand. To date over 227 million doses have been distributed worldwide. In Ireland over 730,000 doses of the vaccine have been distributed and more than 238,000 girls have received the full vaccine course.

The Health Products Regulatory Authority (HPRA) is responsible for monitoring the safety and quality of all medicines including vaccines that are licensed in Ireland. The HPRA and the European Medicines Agency (EMA) continually monitor adverse events to vaccination. HPV is one of the most closely studied and monitored medicinal products.

All medicines, including vaccines are subject to on-going review and evaluation of all available data from a range of sources, including systematic scientific literature review, to consider any impact that their data may have on the overall assessment of the benefits and risks of a medicinal product. Taking into account the totality of the available information, the benefits of the HPV vaccines continue to outweigh their risks. The safety of these vaccines continues to be monitored at EU level through the EMA and its expert committees, which includes representatives from member state competent authorities such as the HPRA.

In recent years the spread of inaccurate information on social media concerning the safety and effectiveness of the HPV vaccine has had an impact on uptake rates.

One of the most important things we can do is to provide accurate and credible information to enable parents to make a fully informed decision concerning HPV vaccination. The HSE National Immunisation Office developed a HPV website (hpv.ie) which has been endorsed by the WHO. The focus must remain on increasing uptake rates as the best way of reducing cervical cancer, and I would encourage the parents of all eligible girls to ensure that their daughters receive this important life-saving vaccine.

You will recall that there was an extensive debate on the safety of the HPV vaccine and its efficacy in preventing the development of cervical cancer in this House on 28 March last in which a motion was passed unanimously which recognised that the human papillomavirus (HPV) vaccine protects young girls from developing a cervical cancer when they grow up, supported the campaign to encourage parents to avail of the HPV vaccine for their children in their first year of secondary school, and which called for the programme to be extended to include boys.

The Health Information and Quality Authority is undertaking a health technology assessment (HTA), at the request of the Department of Health, on extending the national immunisation schedule to include HPV vaccination of boys. This HTA will establish the clinical and cost-effectiveness of providing the vaccine to boys and I await the completion of the HTA later this year.