Sesonl influenz vccintion progrmme country profile: Irelnd 2012 13 Seson Bckground informtion Influenz immunistion policy nd generl fcts bout Irelnd Volume indices of GDP per cpit in 2011 nd 2013 (EU- 28=100) Source: Eurostt Helth costs s % of GDP 2011 Source: Eurostt b Totl popultion of the country, 2011 Source: Eurostt c Popultion 65, 2011 Source: Eurostt c Popultion with chronic medicl conditions <65 yers, 2006 Source: ECDC (bsed on methodology by Fleming nd Eliot, 2006) d Number of live births in 2011 e 130 7.5% 4 574 888 531 563 (11.6% from the totl popultion) 358 000 (8.3% from the totl popultion) 74 033 (1.6% from the totl popultion) Ntionl sesonl influenz recommendtions (e.g. ge nd trget group recommendtions nd guidelines) URL link to Immunistion Guidelines for Irelnd Ntionl Action Pln (NAP) s requested by EC URL link to NAP Recommendtions vilble http://www.hse.ie/eng/helth/immunistion/hcpinfo/guide lines/immunistionguidelines.html Adopted http://www.immunistion.ie/en/hottopics/text_17237_en.html EUROSTAT links: GDP per cpit 2013 (ccessed 15.12.2014): http://ec.europ.eu/eurostt/sttisticsexplined/index.php/gdp_per_cpit,_consumption_per_cpit_nd_price_level_indices b Helth expenditures 2011(ccessed 15.12.2014): http://ec.europ.eu/eurostt/sttisticsexplined/index.php/generl_government_expenditure_on_socil_protection_nd_helth c Totl popultion nd those > 65 yers of ge 2011(ccessed 15.12.2014): https://ec.europ.eu/censushub2/intermedite.do?&method=forwrdresult d Popultion with chronic medicl conditions 2006: http://www.ecdc.europ.eu/en/publictions/publictions/0808_gui_priority_risk_groups_for_influenz_vccinti on.pdf (Fleming, D.M. nd A.J. Elliot, Estimting the risk popultion in reltion to influenz vccintion policy. 2006 My 15; 24(20):4378-85) e Number of live births in 2011(ccessed 15.12.2014): http://ec.europ.eu/eurostt/tgm/tble.do?tb=tble&init=1&lnguge=en&pcode=tps00111&plugin=1 1
Sesonl influenz vccintion recommendtions nd pyment mechnism for vccintion Overll popultion Vccintion recommendtions (popultion groups trgeted by vccintion) Helthy children nd dolescents Older popultion groups: 50 yers of ge Chronic medicl conditions No recommendtion No recommendtion : - Pulmonry diseses, - Neurologic diseses, - Crdiovsculr diseses, - Renl diseses, - Heptic diseses, - Hemtologicl disorders, - Metbolic disorders, - Immunosuppressed individuls, - HIV/AIDS, - Morbid obesity, - Long-term spirin use (children <15 yers). Pregnncy-relted vccintion (including post-prtum women) : - For ll pregnnt women t ny stge during pregnncy. Postprtum women if not vccinted during pregnncy recommended only for those with chronic medicl condition. Helthcre workers Other occuptionl groups Popultion groups in closed communities : - For ll helthcre workers : - For those working in veterinry services; - Poultry nd swine industry workers; - For fmilies rising swine, poultry or geese; - Abttoir nd zoo workers. : - For residents of long- term cre fcilities; No recommendtion: - For prisoners; - For children in dy cre centres Household contcts or crer of: No recommendtion: - Infnts <6 months of ge; - Immunosuppressed individuls; - Individuls with chronic medicl conditions; - 65 yers of ge. NITAG recommends vccine for those 50 yers but the ntionl influenz progrmme specifies 65 yers, ntionlly. 2
Pyment mechnism for vccine nd its dministrtion for the popultion groups trgeted by sesonl influenz vccine For vccine Overll popultion n n Helthy children nd dolescents n n Older popultion groups ( 50; 65 yers of ge) ; For those ged 50-64 yers without helth risk or employment recommendtion the individul must py for vccine Chronic medicl conditions groups (by group) Pregnncy-relted vccintion (including postprtum women) Helthcre workers (including stff of long-sty cre fcilities) Other occuptionl groups Popultion groups in closed communities Household contcts or cre givers n: Not pplicble No co-pyment for vccine nd vccine dministrtion. Service Executive) Service Executive) Service Executive) Service Executive) Service Executive) For dministrtion ; For those ged 50-64 yers without helth risk or employment recommendtion the individul must py for vccine dministrtion Ntionl helth service(helth Out of pocket Ntionl insurnce scheme: helth contributions re pid to the insurnce fund nd then for this contribution there is pckge of services received. It is not by defult tht you receive the services if you do not py the insurnce contributions. Ntionl helth service: txes re pid by citizen or resident of the country nd this person is covered by the helth service. Out of pocket: not reimbursed, pid by receiver of vccine. 3
Vccintion coverge (%) Vccintion coverge rtes Vccintion coverge (%) in popultion groups trgeted by sesonl influenz vccintion the from 2008 09 to the 2012 13 influenz seson by method of dt collection (dministrtive nd /or survey) Popultion group Influenz seson 2008 09 2009 10 2010 11 2011 12 2012 13 Admin. Surv. Admin. Surv. Admin. Surv. Admin. Surv. Admin. Surv. Overll popultion n n n n n n n n n n Children/dolescents n n n n n n n n n n Older popultion groups: 65 yers of ge Chronic medicl conditions groups (ged 18-64yers) 70.1 NA 53.8 63.5 63.8 NA 56.3 NA 56.9 59.9 NA NA NA 28.9 NA NA NA NA NA 28.4 Pregnnt women - - - - NA NA NA NA NA 22 Helthcre workers NA NA NA 26.5 NA NA 18 NA NA 28 Stff in long-sty cre - - - - - - 13.5 NA 15 NA fcilities b Residents in long sty cre fcilities b n: Not pplicble NA: Not vilble - - - - - - 88 NA 73 NA VENICE strted to collect vccintion coverge dt for pregnnt women fter the A(H1N1)pdm09 (2010-11 influenz seson). b VENICE strted to collect vccintion coverge dt for stff nd residents in long-sty cre fcilities for the influenz seson 2011-12. Figure 1. Sesonl influenz vccintion coverge mong those 65 yers of ge from the 2008 09 to the 2012 13 influenz seson 80 70 60 50 40 30 20 10 0 2008-09 2009-10 2010-11 2011-12 2012-13 Influenz seson Irelnd EU trget 2014-15 (75%) 4
Vccintion coverge (%) Vccintion coverge (%) Vccintion coverge (%) Figure 2. Sesonl influenz vccintion coverge mong those with chronic medicl conditions in the 2009 10 nd the 2012 13 influenz sesons 80 70 60 50 40 30 20 10 0 2008-09 2009-10 2010-11 2011-12 2012-13 Influenz seson Irelnd EU trget 2014-15 (75%) Figure 3. Sesonl influenz vccintion coverge mong pregnnt women in the 2012 13 influenz seson 25 20 15 10 5 0 2010-11 2011-12 2012-13 Influenz seson Note: VENICE strted to collect vccintion coverge dt for pregnnt women fter the A(H1N1)pdm09 (2010 11 influenz seson). Figure 4. Sesonl influenz vccintion coverge mong helthcre workers in the 2009 10, 2011 12 nd the 2012 13 influenz sesons 30 25 20 15 10 5 0 2008-09 2009-10 2010-11 2011-12 2012-13 Influenz seson 5
Vccintion coverge (%) Figure 5. Sesonl influenz vccintion coverge mong residents nd stff of long-sty cre fcilities, 2011 12 nd 2012 13 influenz sesons 100 80 60 40 20 0 Residents 2011-12 2012-13 Stff Note: VENICE strted to collect vccintion coverge dt for stff nd residents in long sty cre fcilities for the 2011 12 influenz seson. Methods to monitor vccintion coverge, sfety nd effectiveness Monitoring of vccintion coverge during the 2012 13 influenz seson Method used to monitor influenz vccintion coverge Combintion of dministrtive nd survey methods used Method used (dministrtive, survey) to monitor vccintion coverge by popultion group Administrtive Adults ged >65 yers old; Helthcre workers; Residents of long term cre institutions. Survey Adults ged >65 yers old; Individuls with medicl/risk conditions; Pregnnt women; Helthcre workers. Detils on dministrtive method used (medicl records vs. immunistion registry; mnul vs. electronic) by popultion group Medicl records Immunistion registry Mnul Electronic Mnul Electronic Helth cre workers; Residents of long term cre institutions; Helth cre workers : some No hospitls/fcilities my hve own system for HCWs /residents- but not t regionl or ntionl level; Adults ged >65 yers old. No Numertor ssessment Phrmceuticl dt Administrtive dt Frequency of numertor ssessment Aggregte collection of number of vccines distributed (ntionl purchser); Pyment/ reimbursement clims For HCWs nd residents in long term cre it ws collected twice during influenz seson in 2012-2013 seson; for elderly the dt is requested t monthly intervls from ntionl pyment gency for those entitled to this service. 6
Denomintor ssessment by popultion groups nd dt source Popultion group Helth cre workers Residents of long term cre institutions Entire popultion Children nd dolescents Dt source for popultion group Bsed on denomintor dt provided from units providing dt on numertor Bsed on denomintor dt provided from units providing dt on numertor n n Adults Individuls with medicl/risk conditions (clinicl risk groups) Pregnnt women Essentil public sector workers Prisoners Eductionl institutions Other n: Not pplicble Detils for survey method used for the 2012 13 influenz seson Type of the survey Survey mode Smpling strtegy Smple size Household By telephone Non probbility smpling; Quots 1 700 Scientific studies conducted for vccintion coverge; vccine sfety nd vccine effectiveness https://www.hpsc.ie/hpsc/a- Z/Respirtory/Influenz/SesonlInfluenz/Publictions/InfluenzVccintionPublictions/File,4511,en.pdf Dt collected t the ntionl nd t the regionl level Vccine sfety monitoring (dverse events following immunistion AEFV) Dt linkge with immunistion registry Yes No Cse bsed dt including ge, sex nd suspected symptoms should be reported Mndtory Detils collected Sttus of reporting AEFV reported to Helth Products Regultory Authority (HPRA) http://www.hpr.ie/ Monitoring of influenz vccine brek-through infections in vccinted individuls Dt collected There is no such system Dt linkge with immunistion registry Detils collected Brek-through infection is defined s lbortory-confirmed influenz infection >14 dys fter sesonl influenz vccintion in the current seson (i.e. vccine filure). 7
Vccine procurement nd delivery Influenz vccine procurement nd delivery, 2012 13 influenz seson Number of doses Purchsed Distributed Used 749 992 702 027 659 596 Type of vccine/product Nme Trget groups Used GlxoSmithKline; Snofi Psteur Trivlent inctivted non-djuvnted vccines (TIV) Older dults (e.g. 60/65 yers); Those with medicl condition/s; Pregnnt women; Residents of long sty cre fcilities; Helth Cre Workers; Other occuptionl groups; Other trget group: GSK product ws procured by phrmcies for privte ptients (we re informed) Trivlent inctivted djuvnted vccines (TIV) Trivlent live ttenuted nsl vccine (LAIV) Qudrivlent ttenuted nsl vccine (LAIV) Qudrivlent inctivted non-djuvnted vccine (QIV) Snofi Psteur product procured by ntionl gency; we believe tht GSK (Flurix) ws procured privtely by some phrmcies for privte ptients. Promoting sesonl influenz vccintion Promoting sesonl influenz vccintion during the 2012 13 influenz seson Promotion ctivities with the generl public nd helthcre workers Generl public Source of informtion (if yes) No Yes Yes Yes Yes Popultion over 65 Pregnnt women Chronic medicl conditions Helthcre workers Rdio; TV; Newsppers; Leflets; Posters; Website Rdio; TV; Newsppers; Leflets; Posters; Website Rdio; TV; Newsppers; Leflets; Posters; Website Rdio; TV; Newsppers; Leflets; Posters; Website; Professionl medicl societies; Ntionl medicl publictions 8
Use of ntivirl gents for tretment nd chemoprophylxis of influenz Recommendtions vilble Recommendtions nd/or guidelines (policy document) on ntivirl use Use of ntivirl gents for tretment nd chemoprophylxis of influenz during the 2012 13 influenz seson Use of ntivirls for tretment for in-ptients nd out-ptients who re t higher risk of developing influenz complictions For in-ptients who: - hve severe, complicted influenz-like illness (ILI); - hve progressive influenz-like illness; - require hospitlistion due to influenz-like illness. For out-ptients who re t higher risk of developing influenz complictions on the bsis of their ge or underlying medicl conditions: - Children < 2 yers; - Adults ged 65 yers; - Individuls belonging to risk groups. - Women who re pregnnt or postprtum (within 6 weeks fter delivery). - Residents of nursing homes nd other chronic-cre fcilities. - Children < 5 yers; No Recommendtion Use of ntivirls for post-exposure prophylxis For fmily or other close contcts of person t higher risk for influenz complictions who hve not been vccinted with influenz vccine t the time of exposure; For unvccinted helthcre workers with occuptionl exposure nd who did not use personl protective equipment t the time of exposure Use of ntivirls for pre-exposure prophylxis For individuls who re t high risk (e.g. severely immunosuppressed ptients) for influenz-relted complictions who cnnot otherwise be protected during times when high risk for exposure exists Use of ntivirls for control of influenz outbreks For individuls in long-term cre fcilities/cre for immunocompromised individuls if not vccinted or if the circulting influenz strin does not mtch the vccine strins For unvccinted helthcre stff who provide cre to individuls t high risk of developing complictions in long-term cre fcilities/ cre for immunocompromised ptients if not vccinted or if the circulting influenz strin does not mtch the vccine strins For ll helth cre stff regrdless of whether they received n influenz vccintion if the circulting influenz strin does not mtch the vccine strins Prisoners No recommendtion Eductionl institutions Antivirl resistnce surveillnce system Existence of ntivirl resistnce surveillnce system No recommendtion There is n ntivirl resistnce surveillnce system in plce 9
Country profiles re bsed on the Sesonl Influenz Vccintion in Europe report produced by the Europen Centre for Disese Prevention nd Control (ECDC) nd the Vccine Europen New Integrted Collbortion Effort III (VENICE III). The dt re from the sesonl influenz vccintion survey for 2012 13 seson in EU/EEA countries. During the vlidtion process in June 2015, minor chnges were introduced in some country profiles. Therefore, dt my be different to those vilble in the report. 10