I propose to take Questions Nos. 814, 817, 903, 922, 971, 1000, 1002, 1007, 1039, 1116, 1269, 1270, 1282 and 1349 together.
As part of Ireland's response to the pandemic (H1N1) 2009 the National Public Health Emergency Team, following advice from the Pandemic Influenza Expert Group recommended that vaccination against pandemic influenza would be provided to all citizens. Following reports of narcolepsy among children and adolescents who were vaccinated with Pandemrix in Ireland, a National Narcolepsy Study Steering Committee was established to conduct a retrospective population based study in relation to the Irish data. This Committee comprised expertise in the areas of epidemiology, neurology, paediatrics and paediatric neurology.
The study found that there was a 13 fold higher risk of narcolepsy in children/adolescents vaccinated with the pandemic (H1N1) 2009 vaccine compared with unvaccinated children/adolescents. The development of narcolepsy following pandemic vaccination is not a uniquely Irish issue. The results from the Irish data concur with those observed in Finland and Sweden.
As of 16 January 2017, the Health Products Regulatory Authority (HPRA) has received 81 reports with clinical information confirming a diagnosis of narcolepsy in individuals who were vaccinated with Pandemrix (80) and Celvapan (1). The majority of these reports relate to children/adolescents (latest numbers).
My Department, the HSE and the Department of Education and Skills continue to work together to provide a wide range of services and supports for those affected by narcolepsy following the administration of pandemic influenza vaccine.
The HSE's Advocacy Unit acts as liaison with service and support providers and other Government Departments to facilitate access to required services. It is in regular contact with individuals affected and regularly meets with representatives of the SOUND (sufferers of unique narcolepsy disorder). Regional co-ordinators have been appointed to assist individuals by providing advice, information and access to local services.
The ex-gratia health supports include clinical care pathways to ensure access to diagnosis and treatment, multi-disciplinary assessments led by clinical experts, counselling services for both the individuals and their families, discretionary medical cards for those who have been diagnosed have been provided to allow unlimited access to GP care and any prescribed medication, ex-gratia reimbursement of vouched expenses incurred in the process of diagnosis and treatment, including travel expenses for attending medical appointments; physiotherapy, occupational therapy assessments, dental assessments and dietary services all on a needs basis.
Work is underway on the proposed Centre of Excellence for Narcolepsy based in St James's Hospital which will cater for all people diagnosed with narcolepsy, including those diagnosed with narcolepsy after receiving pandemic influenza vaccine. In relation to the queries raised by the Deputies, as these are service issues, I have asked the HSE to reply to you directly.