The low rates of Irish pregnant women vaccinated against flu

Image copyright Getty Images Image caption Abortion is illegal in Ireland. Abortion is available only if the pregnancy poses a serious risk to the mother’s life

Every week Health Minister Simon Harris meets the country’s top medical and epidemiological advisers to try to bring them into line with World Health Organisation guidelines on vaccine use.

But what about when it comes to pregnant women and an estimated 40% of the country’s mothers-to-be and their unborn babies are currently unvaccinated?

That issue is not something the authorities are addressing as the Irish government struggles to recruit enough staff to supply its clinics with new flu vaccines.

Eamon Ryan, Director of the Irish Flu Vaccine Project in University College Cork, explains: “One of the problems is that we’re not managing to get staff out to clinics in the regions to spray pregnant women – so pregnant women we feel are at the greatest risk.”

In November, the Irish Vaccine Advisory Service (IVAS) revealed that 5,100 pregnant women in the country did not have full postnatally (after conception) immunised against flu. That represents a 25% decrease on the previous year.

The doctors and scientists charged with identifying and responding to the current shortfall were represented at the World Health Organisation’s Fall Meeting in Geneva earlier this week.

Ireland has always prided itself on the high levels of vaccination among its people, compared to Europe, the USA and Australia. In the 2013-14 flu season, 18.2% of the population were protected.

However, as well as low vaccination rates in pregnant women and racial and ethnic disparities in cervical cancer vaccination rates, the IVAS also documented how one of the greatest barriers to immunisation in the country were regional clinic locations.

That, says Dr Ryan, is a “huge issue because half of the infection occurs in rural areas”.

He explains: “When people think of ‘the border regions’ that’s clearly where the incidence has increased, in the western part of the country, but it’s in both urban and rural areas.”

Currently, the national government immunisation programme in Ireland works in conjunction with IVAS, with 30 centres at present across counties Northern Ireland, and the east, southern and western parts of the country, delivering the vaccine in pregnancy.

However, Dr Ryan says “we’ve said in the past we’d like to be outside of IVAS [to] bring services back up to international standards”.

As a result, he says IVAS’s number of clinics will shrink from 30 to 20 to five to five in total.

That, the IVAS has said, is “an essential step towards ensuring that all pregnant women in the areas of highest influenza risk get their infant hepatitis B vaccine when they are due for their flu vaccine”.

But a number of months after agreeing to this step, only two clinics are now offering the one vaccine for babies – a vaccine against hepatitis B.

For those who can’t travel to Dublin – or who live in rural areas and don’t have access to a clinic near them – the prognosis is far worse. The IVAS suggests that every pregnant woman in the country “should complete a year’s protection programme” by the end of January 2018.

Image copyright Getty Images Image caption Dr Ryan says ‘we’ve said in the past we’d like to be outside of IVAS to bring services back up to international standards’

In a statement, the Health Service Executive said: “The government is committed to strengthening the effective and high-quality vaccination services offered to pregnant women and their unborn babies.

“The government recently amended the Health Service Executive’s procurement processes to enable the delivery of vaccines to be centrally re-exported in order to target additional funds in line with the WWW immunisation project.”

However, Dr Ryan, says in the seven years he has been working on this topic, he has heard absolutely nothing since.

“The department are trying to introduce the best possible influenza vaccines available, so I’m really puzzled that we’re not able to address the problem.”

You can listen to Health Correspondent Stephanie Innes’ programme in full here, as well as our top three documentaries of 2017.

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