I want to ask about the national vaccination programme. Yesterday, HIQA issued its health technology assessment on the respiratory syncytial virus, RSV, vaccine stating that it is clinically effective for small babies but that the cost is too much to continue the mass roll-out. Last week, we had officials from the HSE and the Department of Health tell us that they very much believe in the clinical effectiveness of the shingles vaccine but, again, HIQA has stated that it is too expensive. Last winter, HIQA also talked about the clinical effectiveness of the enhanced flu vaccine but, again, cost was an obstacle.

Vaccines are crucial to public health and to reducing health inequality. The shingles vaccine costs over €500. In the context of cost being the issue, of course we need to drive a hard bargain with the pharmaceutical companies. In that context, why was there no reference to vaccines in the framework agreement reached with pharmaceutical companies in March? The latter is a three-year agreement governing the sale of drugs to this country. Is there no emphasis on future vaccines on the part of the Government?

The Department of Health has agreed the scope of the RSV infant immunisation pathfinder programme for 2026-27, which will involve the same eligibility criteria in place for the 2025-26 season. A health technology assessment on RSV immunisation for infants and adults was undertaken by HIQA and was published on 28 April. HIQA stated that the assessment provides robust evidence that RSV immunisation, particularly for infants, can deliver significant health benefits and reduce winter pressures on the health service. I am in favour of vaccination programmes.

The position in terms of the adjuvanted flu vaccine was not as clear-cut. Nonetheless, the Minister is examining that as well in terms of the next winter period.

We will continue to work with HIQA and the HSE to look at the findings, the options and, obviously, the budgetary impacts. Shingrix is extraordinarily expensive, but it is effective.