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Healthcare Policy

Dáil Éireann Debate, Thursday - 16 July 2020

Thursday, 16 July 2020

Questions (183)

Jennifer Murnane O'Connor

Question:

183. Deputy Jennifer Murnane O'Connor asked the Minister for Health his plans for the elimination of HPV-related cancers within a generation here; the strategies that need to be implemented in the coming 12 months, acknowledging that the introduction of a catch-up programme for boys in sixth year for the HPV vaccine will accelerate this public health goal; and if he will make a statement on the matter. [16437/20]

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Written answers

Cancer screening is one very important aspect of cancer prevention, and another is HPV vaccination.

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 to 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.

The 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' HPV vaccination 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.

In relation to cancer screening CervicalCheck made the technical transition to HPV cervical screening on 30 March. This means that any test taken after this date is an HPV cervical screening test with follow-up cytology if required.

The move to HPV Cervical Screening means that Ireland joins a small group of nations that employs the best-in-class testing to screen their populations for cervical cancer. Other countries include Australia, England, the Netherlands and Wales.

This improved testing methodology, along with the continued roll-out of HPV vaccinations, means that Ireland can look forward to a significant reduction in the incidence of cervical cancer cases over the next 10-20 years.

The Government’s goal is to bring about the eradication of HPV-related cancers in Ireland. A well organised screening programme, when combined with HPV vaccination for boys and girls, will help assist us in achieving that goal. The Programme for Government commits to supporting the CervicalCheck Screening Programme and promoting the uptake of the HPV vaccine.

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