The Influenza Vaccination Programme provides a free flu vaccine to those most vulnerable to the effects of the flu. The HSE is responsible for the implementation of the Influenza Vaccination Programme, in line with Department of Health policy and funding, which includes procurement of the flu vaccines in line with EU and National Procurement rules.
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.
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 the 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 and was over twice the price of the standard flu vaccine.
The HIQA HTA estimates increasing costs of procurement of the enhanced influenza vaccines at between approximately 4 and 19 million euros/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.
