Dáil Éireann Debate, Tuesday - 1 March 2022
636. Deputy Alan Kelly asked the Minister for Health if he will provide an update on the vaccine coverage rate for the HPV national immunisation programme for the 2020/2021 and 2021/2022 academic year; his plans for a catch-up programme including any targets set for 2022, 2023 and 2024; and if he will make a statement on the matter. [10919/22]
View answer637. Deputy Alan Kelly asked the Minister for Health his plans to extend the free HPV national immunisation programme to women treated for CIN2+ lesions as recommended by the National Immunisation Advisory Council in May 2021, which could reduce the incidence of recurrence by up to 40%; if he will indicate his target date for the extension of this programme and implementation of the recommendation; the funding that he intends to allocate to implement this recommendation; and if he will make a statement on the matter. [10920/22]
View answer638. Deputy Alan Kelly asked the Minister for Health if he has requested the National Immunisation Advisory Committee to consider the clinical effectiveness of providing the HPV vaccine to males up to the age of 25 year in a similar manner to his request relating to women up to the age of 25 years; if not, the reason and if he plans to; the involvement of the HIQA in this process; and if he will make a statement on the matter. [10921/22]
View answerI propose to take Questions Nos. 636 to 638, inclusive, together.
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. The 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 National Immunisation Advisory Committee (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 their first year of secondary school.
In June 2017, on foot of the NIAC’s recommendation that the HPV vaccine should also be given to boys, 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. This started in September 2019 with the introduction of a 9-valent HPV vaccine.
The ages at which vaccines are recommended in the immunisation schedule are chosen by the 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. As part of the HTA to establish the clinical and cost-effectiveness of extending the current immunisation programme to include boys, it also examined the potential for a catch-up programme for boys up to sixth year in school. It concluded that such a programme would not be cost effective, and it was not introduced at that time. All vaccines administered through the School Immunisation Programme are provided free of charge.
In July 2018, NIAC recommended the HPV vaccine for people living with HIV up to and including 26 years of age and for all gay, bisexual and other men who have sex with men (gbMSM), including gbMSM living with HIV, up to and including 45 years of age. A policy decision was made to implement this recommendation and the vaccine is available through many STI and HIV clinics.
As you will be aware, my Department has asked NIAC to consider the clinical effectiveness of providing the HPV vaccine to:
- girls and boys in secondary school who were eligible to receive HPV vaccine in 1st year but who did not receive it; and
- women up to the age of 25 years who have left secondary school and who did not receive the vaccine when eligible.
If NIAC conclude that there is sufficient evidence to support providing the HPV vaccine to one or both groups, HIQA will undertake a cost-effectiveness assessment on that basis.
Once this work has been completed, my Department will consider the recommendations made by NIAC and HIQA following which my Department will make future policy decisions in this area.
On the issue of NIAC recommendations more generally, I can advise that currently, there have been no decisions made to extend the HPV national immunisation programme to include those receiving treatment for CIN2+ lesions on foot of the NIAC recommendation. My Department will, of course, continue to be guided by NIAC's recommendations on any emerging evidence in the future.
In relation to HPV vaccine uptake rates, the National Immunisation Office have advised that the latest available figures show a 76% uptake for dose 1 and 65% uptake for dose 2 in the 2020/2021 academic year. It should be noted that some areas are yet to input some, or all, of their data for both dose 1 and 2 so these figures are expected to increase.
The World Health Organisation has a HPV uptake rate target in place of 90% to eliminate cervical cancer. I can confirm that Ireland is committed to achieving this objective of a 90% uptake rate.
