Bernard Allen
Question:303 Mr. Allen asked the Minister for Health when he plans to set up the Irish nationwide HIB meningitis vaccination programme.
Written Answers. - Hib Meningitis Vaccination Programme.
My Department introduced a new immunisation programme with effect from 1 October 1992.
This new immunisation programme against Haemophilus Influenza Type B — or Hib as it is commonly called — is designed to offer protection to infants from the age of two months against Bacterial Meningitis, which is one of the severest of the communicable diseases in young children.
On the recommendation of the National Drugs Advisory Board, the vaccine will be offered at the ages of two, four and six months, and I have advised the health boards to commence, a new integrated schedule of primary childhood immunisation, with the Hib vaccine to be administered with DPT and Polio at age two and four months and on its own at age six months.
In addition, for a limited period, children over 13 months up to four years of age will be offered one dose of the vaccine. This is designed to protect children in the age group in which about 90 per cent of cases of Hib-related Bacterial Meningitis occur.
The new programme is being introduced in Ireland against a background of a continuing high level of bacterial meningitis. About 185 cases of this disease have been reported this year to date. About half of the cases of bacterial meningitis are normally caused by Hib Meningitis. This particular infection has a mortality rate of about 5 per cent and may cause permanent damage to the central nervous system in about 10 per cent of persons who survive the acute infection.
I feel that it is important for me to stress, however, that not all of the cases of bacterial meningitis which occur are caused by Haemophilus Influenza Type B. Other causes of bacterial meningitis are meningococial meningitis and pneumocal meningitis but infections due to Hib are a significant cause of bacterial meningitis in children aged under four years. Hence it was imperative that we introduce this vaccine into this country at the earliest possible opportunity.
The epidemiology of Hib infection in Western Europe and the USA, as described in large incidence studies in those countries, indicates that one in 600 children develops some form of Hib disease before their fifth birthday. As I mentioned, the most significant Hib disease is Meningitis and paediatricians and epidemiologists consider that the prevalence of Hib here is similar to that in other countries. Therefore, if we eradicate Hib Meningitis, we can hope to half the incidence of Bacterial Meningitis in this country. While the major benefit arising from this would obviously be a significant improvement in child health. Clearly, this would also be of considerable importance in economic terms in savings to the health services relating to the treatment and care of persons who suffer from the disease, both in the short and longer terms. It is estimated that about 10 per cent of persons who survive the disease suffer permanent neurological damage, such as deafness and mental handicap.
The vaccine being used in our programme has been shown to give very good protection against the disease. Over 20 million doses of this vaccine have been used worldwide and no serious adverse reaction have been reported. While it only prevents that form of Bacterial Meningitis which is caused by Hib, in countries where it has been used — such as Finland and Iceland — they have practically eradicated Hib Disease in young children.
As I mentioned at the outset, the vaccine will be given in the routine childhood immunisation schedule and this is to ensure that babies are protected before 11 months of age which is the period of greatest risk of contracting the disease.
The programme is being promoted by the Department and the health boards and towards this end, the health promotion unit has prepared two leaflets aimed at parents and health professionals. 200,000 copies of the leaflet for parents and 5,000 copies of the one for health professionals are being circulated through maternity hospitals, health centres, general practitioners, pharmacies and the health promotion unit itself.