Roderic O'Gorman (Dublin West, Green Party)
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1562. To ask the Minister for Health if she will provide an update on the assessment currently underway for the RSV immunisation 2026-2027 season and beyond; if there is a commitment to retain the RSV vaccine for infants; if there are plans to expand eligibility for the free RSV vaccine to include older adults; and if she will make a statement on the matter. [30208/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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A Health Technology Assessment on RSV immunisation for infants and adults is currently being undertaken by the Health Information and Quality Authority (HIQA).

The primary objective of this HTA is to provide advice to my Department, and the HSE, to inform a policy decision on the most appropriate RSV immunisation strategy for infants and or adults aged 65 and older. HIQA’s assessment will assess the clinical effectiveness, cost effectiveness and budget impact of alternative strategies for the immunisation of infants and adults aged 65 years and older against RSV. This HTA will also consider the organisational, resource, ethical, patient and social implications associated with these alternative strategies.

A draft report will be made available in due course for public consultation prior to being finalised and submitted as advice to inform decision-making by my Department.

The outcome of the HTA will inform the development of any longer-term programme and future decision making on the matter of RSV immunisation in Ireland.

Roderic O'Gorman (Dublin West, Green Party)
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1563. To ask the Minister for Health the estimated full-year cost of offering the RSV vaccine to people aged 65 years and older; the cost of offering the vaccine specifically to those with a chronic respiratory disease aged 65 years and older; and if she will make a statement on the matter. [30209/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The Health Information and Quality Authority HIQA published a rapid Health Technology Assessment (HTA) on immunisation against respiratory syncytial virus (RSV) in Ireland on 13 August 2024.

The rapid HTA provided an initial estimate of the cost of immunising different groups of infants and older adults for the 2025-2026 RSV season. It found that the cost of immunising infants would range from €3.9m to €19m depending on the approach taken. The rapid HTA found that the cost of vaccinating older adults would be much higher due to the large number of people involved. Offering the vaccine to everyone aged 65 years and older was estimated to cost €146 million.

As the number of older people who are hospitalised due to RSV is relatively small, the potential cost savings to the HSE from reducing hospital admissions was estimated to be small (between €0.9m and €1.2m).

The rapid HTA noted that to calculate these estimates, it was necessary to assume prices for these drugs, based on known Irish and international prices. If the price of any of these drugs is in fact higher than estimated, the costs of immunisation will also be higher. Aside from the cost of providing immunisation to these infant and older adult groups, the HTA noted that there would also be additional costs associated with organising any RSV immunisation programme.

HIQA has now progressed to undertaking a full HTA on RSV immunisation for infants and adults which will contain more detailed information on cost-effectiveness and budget impact.

The outcome of the full HTA will inform the development of any longer-term programme and future decision making on the matter of RSV immunisation in Ireland.

Roderic O'Gorman (Dublin West, Green Party)
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1564. To ask the Minister for Health the estimated cost of providing the enhanced flu vaccination specifically to people aged 65 years and older with a respiratory condition such as asthma in the 2025/2026 flu season; and if she will make a statement on the matter. [30210/25]

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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The National Influenza Vaccination Programme ensures that those most vulnerable to the effects of influenza have access to the flu vaccine, free of charge. By providing vaccination to those most at risk, and those most likely to require admission to hospital should they contract influenza, the programme aims to prevent, as far as possible, the need for influenza-related hospital admissions, as well as to reduce the overall spread of influenza in the community.

HIQA has carried out a Health Technology Assessment (HTA) which notes that while studies on enhanced flu vaccines are limited, based on the available data, offering an aQIV or a high dose flu vaccine to those aged 65 and over would likely reduce the burden of flu. It further noted that whether this change would be a good use of public funding depends on the price of the vaccine.

There is currently no disease register in Ireland, so in order to estimate the cost of providing the enhanced flu vaccination specifically to people aged 65 years and older it is necessary to use the HIQA HTA on enhanced flu vaccines for those aged 65 years and older. The assessment did not consider separately the subgroup of older adults with respiratory conditions. The HTA uses 800,000 people as the population for those aged 65 years and older and eligible for the vaccine.

Relative to the standard influenza vaccine, the one-year incremental budget impact of procuring the adjuvanted flu vaccine for all those aged 65 years and older was estimated at €3.8 million, while for the high-dose flu vaccine it was estimated at €18.9 million. The wholesale cost of these vaccines was not known as they were not available on the Irish market at the time. Costs were therefore estimated based on published prices in Europe. The budget impact estimates were highly sensitive to changes in the relative cost of the vaccines. HIQA therefore advised that these relative costs should be a key consideration in a decision to offer an enhanced vaccine.

My Department asked the HSE to commence a tender process to determine if the enhanced vaccines could be purchased at a price that was cost effective. The HSE has advised that neither of the enhanced vaccines for older people met the criteria set out in the HTA for net monetary benefit compared to standard flu vaccine.

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 position and has determined that the introduction of an enhanced vaccine for the older age groups can be reconsidered when cost effectiveness is more favourable.