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120,000 doses of children's flu vaccine destroyed due to low uptake, despite 'heavyweight' promotion campaign

The flu vaccine was free for children in Ireland for the first time in 2020.

File photo of a child using nasal spray
File photo of a child using nasal spray
Image: Shutterstock/Andy Shell

Updated Mar 16th 2021, 6:30 AM

120,000 DOSES OF the flu vaccine for children were destroyed after the uptake rate among this age group was lower than anticipated in Ireland.

The HSE purchased 600,000 doses of the Live Attenuated Influenza Vaccine (LAIV) for children aged 2-12 years old ahead of the most recent flu season.

The HSE confirmed to TheJournal.ie that 480,000 doses of the vaccine (delivered via a nasal spray) were distributed, but 120,000 were destroyed by the manufacturer because they expired in January and February.

It is not clear if all 480,000 doses distributed were administered as the overall number of doses given is not yet available.

From October to December 2020, the flu vaccine was free for children in Ireland aged two to 12 – the first time the vaccine was free for this age group.

Despite a promotion and information campaign by the HSE, uptake for the vaccine was lower than expected.

The HSE also purchased 1.9 million doses of the Quadrivalent Influenza Vaccine (QIV) for adults (delivered via an injection) for administration during 2020-2021 flu season.

The QIV vaccine will expire in June and July 2021.

A spokesperson for the HSE said they could not comment on how much the organisation paid for the vaccines “as it is commercially sensitive”.

The spokesperson said the number of people who got the influenza vaccine for the 2020/2021 flu season “is not yet available”, but added that demand was “unprecedented”.

‘Unclear why uptake was low’

Efforts were made by the HSE and the Department of Health during late autumn and winter in a bid to increase the uptake rate of the flu vaccine among children.

Correspondence released to TheJournal.ie under the Freedom of Information Act shows that Health Minister Stephen Donnelly was concerned about the low uptake rate of the vaccine among children aged two to 12 years.

Officials at the department were unsure of why there was a low uptake rate despite the fact “a heavyweight TV campaign” on the rollout aired for six weeks, as well as other promotion efforts.

In an email sent on 27 November 2020, David Noonan, a Principal Officer at the Department of Health, wrote to a number of colleagues in the department about the uptake rate.

Noonan wrote: “We’ve been speaking with the HSE (National Immunisation Office) about this, and discussing the matter internally with our own Communications team as well.

“The first thing to say is that it’s not clear why uptake has been so low. There has been a fairly strong communications campaign, both in general media and in parent-focussed media.

“In addition, GPs have been messaging their patients in relation to the children’s vaccine directly encouraging them to take it up. However, the numbers remain low.”

Noonan wrote that the department would continue to promote the vaccine but added: “At this point, however, I have to say that we cannot be confident that the uptake will be increased significantly.”

Expanding rollout to older children

Noonan said an alternative approach being considered was “to broaden the criteria for vaccination to all children up to 17, inclusive”, noting that a proposal to this effect would be sent to Minister Donnelly.

“This will have the virtue of at least increasing usage of the vaccine stocks,” he wrote.

Screenshot 2021-03-15 at 16.21.47 Source: Department of Health

In an email sent on 1 December, a press officer in the department recommended that the vaccine also be made free for all children aged 12-17.

Aoife Gillivan told her colleagues that she had discussed the matter with the HSE and “it is understood that there are plenty of doses available for both at risk groups and the wider u-17′s”.

“It’s better to have no more vaccine left at the end of Dec, then 130,000 doses left on the shelf. These doses go out of date so a big announcement will help take up,” Gillivan wrote.

Screenshot 2021-03-15 at 16.23.35 Source: Department of Health

The free vaccine rollout was expanded to include all children up to the age of 17 in mid-December in a bid to increase uptake levels and waste fewer doses.

Donnelly announced the measure via a press release, telling parents:
“We are all doing what we can, this year more than ever, to protect the health of our families. Getting the flu vaccine is another way to look after your children’s health.

“Children are more likely than adults to get very sick from the flu, and they also may pass on the virus for a longer period of time than adults.

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“By arranging for them to get a free flu vaccine, you will help to protect your children from a potentially serious illness. You will also help others in your family and community by reducing the potential to spread the flu.”

Shortly after this, a letter from the department’s Chief Medical Officer Dr Tony Holohan and Chief Nursing Officer Rachel Kenna was sent to parents encouraging them to get their children vaccinated against the flu.

The letter noted: “We know that the best way to protect all our children from seasonal influenza is to ensure they receive the influenza vaccine.

“Vaccines are safe and go through a rigorous regulatory process before being recommended for use. The children’s dose of the influenza is administered via a nasal spray and only takes a few minutes. Contact your GP in order to make an appointment and get your child vaccinated.”

However, despite these efforts, 120,000 doses of the vaccine bought by the HSE were destroyed by the manufacturer.

Learning lessons

When asked about the low uptake rate of the vaccine among children, despite the availability of free vaccines, a spokesperson for the HSE said the LAIV vaccine for children was “newly introduced in Ireland for the 2020/2021 season”.

“Experience from the UK has shown that uptake of the vaccine increased year on year since its introduction.

“Preliminary data based on claims from GPs and Pharmacists to the PCERS (Primary Care Eligibility & Reimbursement Service), show increased uptake in people aged 65 years and older when compared to previous seasons,” the spokesperson said.

The spokesperson said the HSE would seek lessons from the most recent flu season when preparing for the next rollout.

“Prior to each influenza season, available data and experience from the previous influenza season is reviewed and plans made to target measures to increase uptake as required,” they said in a statement.

The most recent HPSC report indicates there is still no evidence of influenza viruses circulating in the community in Ireland.

The lack of flu cases in Ireland this winter has been attributed to a change in behaviour as people adhere to Covid-19 guidelines such as mask-wearing, better hygiene and less social interaction.

About the author:

Órla Ryan

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