Dáil Éireann Debate, Tuesday - 13 January 2026
2312. Deputy Ken O'Flynn asked the Minister for Health whether her Department considered the procurement of an enhanced influenza vaccine for the 2025–2026 flu season; the advice received from the HSE and the National Immunisation Advisory Committee in this regard; the evidence base relied upon in deciding not to procure such a vaccine; and if she will publish the clinical, cost-effectiveness, and policy assessments underpinning that decision. [75075/25]
Amharc ar fhreagra2313. Deputy Ken O'Flynn asked the Minister for Health the estimated additional cost, in absolute and per-patient terms, of procuring an enhanced influenza vaccine for persons aged 65 years and over for the 2025–2026 flu season; how this cost was weighed against projected hospital admissions, bed-day usage, and emergency department demand associated with influenza; and whether a formal cost-benefit or health-impact assessment was carried out. [75076/25]
Amharc ar fhreagra2314. Deputy Ken O'Flynn asked the Minister for Health whether her Department assessed the potential impact of not procuring an enhanced influenza vaccine on winter infection rates, hospital overcrowding, and emergency department capacity during the 2025 Christmas period; and if so, to outline the findings of that assessment and the mitigation measures put in place. [75077/25]
Amharc ar fhreagra2316. Deputy Ken O'Flynn asked the Minister for Health whether budgetary constraints influenced the decision not to procure an enhanced influenza vaccine for the current season; whether a specific budget line was sought or refused for that purpose; and how influenza vaccination policy is prioritised within overall winter-planning and hospital-capacity frameworks. [75079/25]
Amharc ar fhreagraI propose to take Questions Nos. 2312 to 2314, inclusive, and 2316 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.
The Influenza Vaccination Programme provides a free flu vaccine to those most vulnerable to the effects of the flu. Every year the WHO reviews global surveillance data and recommends the specific influenza strains that manufacturers should include in the season's vaccines based on the flu strains that are considered most likely to circulate. Vaccine production takes several months and this allows the manufacturers sufficient time to have vaccine available in time for the start of the flu season. All licensed influenza vaccines included for the 2025/2026 season comply with WHO and NIAC recommendations.
In 2024, HIQA carried out a Health Technology Assessment, or HTA, on enhanced flu vaccines. The HTA noted that studies on the effectiveness of enhanced flu vaccines are limited due to the small number of studies and a paucity of data over multiple seasons. Due to the variability of seasonal influenza, a single study may misrepresent the 'on average' vaccine effectiveness.
Based on the limited data available, the HTA found that switching from a standard to an enhanced flu vaccine for those aged 65 and older would likely reduce the burden of flu. Whether such a switch would represent a good use of public monies would depend on the price of these enhanced vaccines compared with the standard flu vaccine.
Overall, ECDC reported low to moderate relative vaccine effectiveness for the adjuvanted influenza vaccine against laboratory confirmed influenza and against laboratory confirmed influenza related hospitalisation. They concluded that the evidence of the relative vaccine effectiveness of enhanced influenza vaccines compared to standard vaccines is still limited and that further studies are needed to allow more substantial conclusions on the potential benefits of enhanced influenza vaccines.
It should be noted that the UK is experiencing a significant influenza A wave with medium-level impact in terms of hospitalisations up to 29 November 2025. This is in context of a programme using enhanced influenza vaccines. Australia also offered enhanced influenza vaccines and experienced a severe flu season.
In Ireland amongst both hospitalised influenza cases with severe acute respiratory infection and ICU admissions due to influenza this season, where influenza vaccination status was known, 73% had not received the current season influenza vaccine.
For those in recommended groups, the influenza vaccine currently offered as part of the Influenza Vaccination Programme reduces the risk of serious illness and death from influenza. Ensuring high vaccine coverage is a priority for the Minister as it is the key public health intervention that is required to reduce severe illness from influenza, RSV and COVID-19 over the winter period. Strong surveillance, immunisation programmes and healthcare system readiness including Infection Prevention control are key to protecting public health.
While Ireland performs well compared to other countries in Europe, achieving high vaccine coverage in older age groups, it is essential that all those in recommended groups continue to be supported and encouraged to avail of the influenza vaccine.
The HSE was asked to commence a tender process to determine if the enhanced vaccines could be purchased at a price that was cost effective and from within their existing budget. The HSE carried out an analysis of the tenders received and on 4 February 2025, advised my Department that neither of the enhanced vaccines for older people met the criteria set out in the HTA for net monetary benefit compared to standard flu vaccine.
The HIQA HTA estimates increasing costs of procurement of the enhanced influenza vaccines at between approximately €4 million and €19 million per year. Actual costs are commercially confidential and are not known until tenders are evaluated each year.
The healthcare budget is finite. Decisions regarding increased spending in one area could impact the provision of other health technologies and treatments within the healthcare system. Therefore, cost-effectiveness must be considered in any decision-making process. The introduction of an enhanced vaccine can be reconsidered when the cost effectiveness is more favourable.
