The 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. Therefore, the immunisation schedule will continue to be amended over time.
In 2009 the NIAC recommended HPV (human papillomavirus) vaccination for all 12-13 year old girls to reduce their risk of developing cervical cancer when they are adults. In September 2010 the HPV vaccination programme was introduced for all girls in first year of secondary school. Gardasil is the vaccine used by the HSE in the School Immunisation Programme and is provided free of charge to girls in first year of secondary school.
During the 2019/20 school year, girls attending secondary school can still join the HPV girls only programme with appointments offered in HSE mop up clinics. It must be noted that vaccinated women and girls may still be at risk from other high risk types of HPV that can cause cervical cancer and will therefore need to continue to have regular cervical smear tests.
As you are aware, NIAC recommended that the HPV vaccine should also be given to boys. On foot of NIAC’s recommendation, my Department asked the Health Information and Quality Authority (HIQA) to undertake a health technology assessment (HTA) to establish the clinical and cost-effectiveness of extending the current immunisation programme to include boys in the first year of secondary school.
HIQA completed the HTA in December 2018, recommending that the HPV immunisation programme be extended to include boys. A policy decision was made to extend the HPV immunisation programme to include boys starting in September 2019 with the introduction of a 9-valent HPV vaccine. However, the HIQA report published in December 2018 did not recommend an HPV catch-up programme for older boys for several reasons:
- Vaccinating boys in the first year of secondary school provides the best possible protection against HPV infection;
- Boys are already benefitting from the indirect herd protection provided by the girls' HPVvaccination programme which started in 2010.
The ages at which vaccines are recommended in the immunisation schedule are chosen by NIAC in order to give each child the best possible protection against vaccine preventable diseases. As the HPV vaccine is preventative it is intended to be administered, if possible, before a person becomes sexually active, that is, before a person is first exposed to HPV infection. Therefore, the gender neutral HPV vaccination programme targets all girls and boys in first year of secondary school to provide maximum coverage. All vaccines administered through the School Immunisation Programme are provided free of charge.
My Department will continue to be guided by NIAC's recommendations on any emerging evidence on this issue in the future.