I call the co-leader of the Social Democrats, Deputy Shortall.

My question relates to the availability of the flu vaccine and the adequacy of the supplies we have now secured for this coming season. It is extraordinary to think that last year more than 4,300 people were hospitalised with seasonal flu.

That is more than the total number of people who have been hospitalised with Covid to date.

While Ireland works to prevent a second wave of Covid, it is so important that we also put huge effort into ensuring that we reduce the impact of the flu in order to protect capacity in our health service. As the Tánaiste knows, capacity within our hospitals in terms of beds and staff is completely inadequate for normal times. In addition to this, we are faced with a situation whereby, as a result of the requirements relating to infection control and social distancing, it is estimated that between 25% and 50% of capacity within the public health service will be reduced. Furthermore, it is recommended that 20% of capacity be reserved for a second wave of Covid, which is quite likely at this point. That amounts to 60% of what is inadequate capacity being taken out of the system and leaving a mere 40% available. For that reason, it is absolutely essential that huge emphasis is put on reducing the number of flu cases in the coming season. We need to take a lot of steps to encourage wider uptake. I recognise that the Department of Health has announced an expansion of the free scheme for people at risk who are below the age of 69 and for children between two and 12 years of age. As was the case last year, those over 70 are also entitled to the flu vaccine. We must also take steps to improve the level of uptake, particularly among at-risk groups but also among healthcare workers.

For all of these reasons it is essential that we have sufficient supplies of the flu vaccine. Can the Tánaiste confirm the quantity of vaccine that is available for this season and the number of doses this equates to? What is the estimated increase in demand expected to arise from various factors, such as a heightened awareness of the need for vaccination and a greater sense of the importance of protecting one's own health and the need to avoid unnecessary hospitalisation? Last year, 1.1 million flu vaccines were delivered in Ireland. Can the Tánaiste provide an assurance that there are sufficient quantities of the vaccine available to cope with demand this year?

I thank the Deputy for raising this really important issue. She does so at a good time because this is going to be really important as we head into the winter. We are very closely watching what is happening in the southern hemisphere, where countries are now entering the winter flu season. We need to watch what happens there in order to inform what we do here. Everyone knows that the flu comes every winter. What many people probably do not know is that every year somewhere between 500 and 1,500 lives are lost or shortened as a consequence of the flu. It tends to hit particularly badly in nursing homes and residential settings. It affects the elderly and the ill particularly badly and has an impact on our hospitals. Part of the reason for overcrowding, which is a year-round phenomenon, getting much worse in the winter is the flu and other seasonal illnesses.

What we are planning for the winter of 2020-21 is a quantum leap in our response to flu. We can do better in terms of suppressing the flu virus than we have done in previous years, even if there was no Covid. The fact that we have Covid creates the possibility of a second wave happening at the same time as a bad flu season, which would be very serious indeed. We need to act now to reduce the risk of that. This involves making sure that as many people over 70 and healthcare workers as possible have the vaccine this year. For the first time in a long time, perhaps for the first time ever in Ireland, we will be extending the vaccine to children below the age of 12, as well as more at-risk groups.

To answer the Deputy's question, the extension will permit all of those in at-risk groups who are aged six months or older and all healthcare workers to avail of the vaccine free of charge. The extension will also provide access to the vaccine for children aged from two to 12 years, inclusive. That will involve the nasal drop version of the vaccine rather than an injection. The HSE has placed orders for 1.35 million doses of the quadrivalent influenza vaccine for the forthcoming winter. This will be sufficient for a 90% uptake among at-risk groups, including healthcare workers. That is a much higher uptake than we would have had in the past. In addition to those 1.35 million doses, 600,000 doses of the nasal drop vaccine for children have been ordered. That would provide for a 75% uptake among children.

To give the Deputy an indication of what the position was like in previous years, the uptake among people over 65 was 68.5%. We need to do much better than that. There must be a big campaign around this. For healthcare workers in hospitals, the rate of uptake was just over 50%. In the community, it was less than 50%. That is a really big problem. We are planning for an uptake of 75% among children. Typically, in countries that provide the flu vaccine for kids, the rate of uptake is in the region of 50%. The rate in the UK is around that mark and in Finland it is 20%. We will have enough on our plate in order to do better than any other country. We should aim to do better than any other country because this will be a real risk in the next few months.

I thank the Tánaiste. I welcome the fact that there will be a promotional campaign to improve uptake. That is especially important among healthcare workers, as the Tánaiste stated. He referred to a quantum leap, which would be very welcome. Can he clarify the figures? Leaving aside the nasal drop doses for children, there will be 1.35 million doses of the quadrivalent vaccine. I understand that last year the figure was between 1.1 million and 1.2 million. This does not seem to cater for a significant increase from last year's numbers. Again, what is the Government's estimate of the demand for doses of the vaccine in the coming flu season? The Tánaiste said that the HSE has placed orders. That is not quite the same as securing additional supplies. Can he assure us that sufficient supplies will be secured before the start of the flu season?

I thank the Deputy. The figures I have been given refer to 1.35 million doses of the quadrivalent vaccine. That will be sufficient for a 90% uptake among at-risk groups, including healthcare workers. There are 600,000 doses for children between two and 12 years of age, which equates to a rate of 75%. I will double-check those figures.

What is the estimate of the demand?

I do not know if there is an estimate for demand, but there is enough to provide for a 90% uptake.

Have the additional doses been secured?

No.

Is the Tánaiste confident that they will be secured and will be available before the onset of the flu season?

As the Deputy will know, the flu vaccine for the northern hemisphere is formulated based on what the flu looks like in the southern hemisphere, because it starts there and spreads to the northern hemisphere. It may be the case - I might be wrong - but I suspect that the vaccine has not yet been formulated, let alone produced. It would not, therefore, be possible for us to have secured a vaccine that has not yet been produced. However, we are aware that there will be increased demand this year and that other countries will be looking to get the vaccine. I am confident that we will be able to secure those doses. The Deputy is right to raise the question, however, because we need to make sure that we do.