A schedule of vaccination against viral illnesses for older people could reduce the prevalence of dementia and stroke by between 20 and 25 per cent, a leading geriatrician has said.
The Oireachtas health committee on Wednesday held a meeting discussing availability and access to vaccines for adults, in particular.
Rónán Collins, consultant in geriatric and stroke medicine at Tallaght University Hospital (TUH), described the State’s approach to vaccination of adults as “reactive, at times”.
“If you look at childhood vaccination, it’s very much a set schedule. It’s laid out in almost a formal policy. I’m not aware of a similar approach to older adults. They’re a bit hesitant and people are not empowered. I think we should learn from what we did for children and apply it to older adults,” he said.
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Asked what vaccines he would include in a schedule for adults, he said a vaccine for respiratory syncytial virus (RSV) would be one.
“I would argue we should have followed Niac’s [national immunisation advisory committee] advice and had an enhanced vaccine. The shingles to me is a no-brainer. And then you might have a look at things like norovirus [winter vomiting bug], at least for people living in community settings,” he said.
Collins, who is also the HSE’s clinical lead for stroke, said the benefits of these vaccines extend beyond only protecting against infection from these diseases.
“Studies have demonstrated that systematic vaccination against flu was one of the cheapest public health measures with potential to reduce the relative risk of stroke by up to 25 per cent,” he said.
“We have growing evidence that vaccination against viral infections such as flu and RSV reduce the risk of developing dementia by as much as 20 per cent.”
Collins believes there is strong “individual and systems rationale” for a programme of vaccination for adults.
“Not only to prevent our healthcare systems from being overwhelmed with seasonal outbreaks of respiratory disease such as flu or RSV, but also in preventing cardiovascular disease and longer term cognitive decline,” he added.
At the same meeting, Active Retirement Ireland reiterated its call for the shingles vaccine to be made freely available to adults aged 65 and older.
Alison Bough, head of policy at the organisation, said the shingles vaccine is only available privately and costs just under €500, which she said “represents a significant financial barrier” to most people.
“That is the central policy issue. Access is not equitable,” she said.
Martin Daly, a Fianna Fáil TD and a GP, said the “poorest, sickest and people who need it most, who will be most at risk, are unable to access this vaccine. It is really regrettable”.
In 2024, the Health Information and Quality Authority (Hiqa) recommended against providing the shingles vaccine for free, stating it was “not cost effective”.
In response to a parliamentary question in March, Minister for Health Jennifer Carroll MacNeill said the introduction of the shingles vaccine to the schedule is being “actively considered for a cohort of immunocompromised individuals”.
