Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1016. To ask the Minister for Health if she will explain the reason the shingles vaccine is not included in the national immunisation programme, despite overwhelming clinical evidence of its effectiveness in preventing a debilitating illness that disproportionately affects older people and immunocompromised individuals. [23307/25]

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1017. To ask the Minister for Health if she acknowledges the severe cost barrier that currently exists, with Irish citizens forced to pay privately up to €500 for a two-dose shingles vaccine that is offered free of charge in numerous EU member states including the Netherlands, Germany, and France, as well as in the United Kingdom under the NHS. [23308/25]

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1018. To ask the Minister for Health to ask whether the Department has conducted or reviewed any health economic modelling on the long-term costs to the State in terms of hospitalisations, nerve damage, and complications from postherpetic neuralgia that arise due to lack of shingles vaccination access. [23309/25]

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1019. To ask the Minister for Health if she accepts that the exclusion of the shingles vaccine from the national immunisation schedule represents a broader systemic failure of the Irish health service to provide preventative care on par with our European counterparts. [23310/25]

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1020. To ask the Minister for Health the specific steps she intends to take to address disparity as regards the shingle vaccine, including timelines for review by NIAC and whether she will commit to full public funding of the shingles vaccine for all persons over 50 or those clinically indicated. [23311/25]

Ken O'Flynn (Cork North-Central, Independent Ireland Party)
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1021. To ask the Minister for Health if she believes it is acceptable in 2025 in a developed EU member state that access to vital vaccines is determined not by public health need but by an individual’s ability to pay, despite the known physical, psychological, and financial toll shingles can take on older citizens and vulnerable groups. [23312/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I propose to take Questions Nos. 1016 to 1021, inclusive, together.

The national immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. It makes recommendations on vaccination policy to my Department. NIAC continues to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease. It also considers emerging evidence and therefore the immunisation schedule will continue to be amended over time.

Once a recommendation from NIAC has been received and considered by the Chief Medical Officer of my Department, a request can be made to HIQA to carry out a Health Technology Assessment (HTA). This assessment looks at the evidence of the effectiveness and safety of the vaccine. It also looks at the value for money, cost, organisational, social and ethical issues of providing a new vaccine. The information is collected and presented in a systematic, unbiased and transparent manner.

NIAC recommends the recombinant zoster vaccine (RZV, Shingrix) for adults aged 65 and older and for adults aged 18-49 who are at increased risk of shingles in Ireland.

My Department asked the Health Information and Quality Authority (HIQA) to carry out a HTA on the herpes zoster vaccine which protects against shingles.

HIQA published this HTA on 19 July 2024. In terms of health economic modelling, the assessment included both a review of international modelling studies and development of a model specifically for Ireland. The cost-utility model took into account GP and hospital care, medication and health outcomes. The model incorporated both the short and long-term impacts of vaccination on health-related quality of life of herpes zoster and its complications, including postherpetic neuralgia.

The HTA notes that most people who get the vaccine will have minor side effects, while serious side effects are very rare. The vaccine is considered safe and effective. However, the immune response lessens over time, so that the protective effect of the vaccine diminishes. The vaccine requires two doses at a cost of €150 plus VAT for each dose, plus a fee to the GP or pharmacy to cover the cost of administering the vaccine. HIQA found that at the current vaccine price, adding shingles vaccination to the routine immunisation schedule for the general population aged 50 years and older would not be an efficient use of HSE resources.

The HTA found that if half of eligible people avail of the vaccine, it would cost €50 million over five years if it was introduced for people turning 65 years. If, on the other hand, it was made available to everyone aged 65 and older, it would cost €218 million over five years.

Immunisation programmes within Europe differ with respect to the type of vaccine, level of public funding, the age group(s) eligible to be vaccinated, and the vaccination of individuals at increased risk of herpes zoster (HZ). The majority of European countries do not fund shingles vaccination.

As outlined, the HTA found that adding the shingles vaccine to the routine immunisation schedule would not be cost effective and would be associated with a substantial budget impact. Given that the healthcare budget is finite and decisions regarding increased spending relating to a change in one area could impact the provision of other health technologies and treatments within the healthcare system, the cost-effectiveness must be considered in any decision-making process.

My department has considered the findings of this HTA and determined that the introduction of the vaccine could be reconsidered when the cost effectiveness of the vaccine is confirmed as being more favourable.