Dáil Éireann Debate, Wednesday - 21 January 2026
270. Deputy Pádraig O'Sullivan asked the Minister for Health if she will include enhanced flu vaccines for older people in the procurement process for the next flu season, as recommended by the NIAC; and if she will clarify whether both types of enhanced flu vaccine routinely available in other European countries, including adjuvated and high dose vaccines, will be considered for inclusion in this tender. [4519/26]
Amharc ar fhreagra271. Deputy Pádraig O'Sullivan asked the Minister for Health whether she will request that the NIAC update its recommendation on enhanced influenza vaccination for older persons, given the large number of hospitalisations for flu this season, and the fact the existing recommendation has not been updated since 2021. [4520/26]
Amharc ar fhreagraI propose to take Questions Nos. 270 and 271 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.
NIAC 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.
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 experienced a significant influenza A wave with medium-level impact in terms of hospitalisations. 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 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.
The HSE has operational responsibility for the procurement process for flu vaccines. I understand that this process will commence shortly and that the tendering process for flu vaccines for winter season 2026/2027 will include enhanced flu vaccines, for the older age group, as recommended by NIAC.
