VaccinesA significant change to the childhood immunisation schedule is to be debated at the September meeting of the immunisation advisory committee of the Royal College of Physicians in Ireland (RCPI), The Irish Times has learned.
The committee, which the Department of Health relies on for advice on which vaccines to include in national programmes, is due to consider a proposal that a hepatitis B jab be added to early childhood vaccinations. At present infants are immunised against tetanus, diphtheria, whooping cough, haemophilus and polio at two, four and six months. The vaccine is administered by GPs using a five-in-one combined vaccine.
The introduction of hepatitis B would not involve an additional jab for babies, nor is there a large cost difference between five-in-one and six-in-one vaccine preparations. A six-in-one vaccine is already licensed by the Irish Medicines Board.
Until now the State has adopted an "at-risk" approach to vaccination against hepatitis B infection. Only individuals considered at high risk are immunised. These include healthcare workers and people travelling to areas where hepatitis B is highly endemic, such as Asia and eastern Europe.
According to Dr Kevin Connolly, consultant paediatrician at Portuncula Hospital, Ballinasloe, and a member of the RCPI immunisation advisory committee, the meeting will be dedicated to discussing the introduction of hepatitis B vaccine for infants.
Asked what factors were likely to influence a decision in favour of adding hepatitis B, Dr Connolly said: "It is a safe vaccine that is used in lots of countries around the world. The vaccine is already available as a combination with existing vaccines and its addition would fit in with the current schedule for immunisation."
He also pointed to its proven efficacy in preventing hepatitis B, an infection with considerable morbidity. "It is the only anti-cancer vaccine, effective in preventing liver cancer, we have," he added.
Confirming that it was "decision time" for the committee, Dr Connolly said the "sole interest" for the group of experts was the health of children. "We will not recommend change just because a vaccine is available. We must ensure that the balance of benefit over risk is strongly in favour of introducing hepatitis B vaccine."
The question of an association between hepatitis B vaccine and multiple sclerosis arose in France some years ago but several studies have shown no link between the jab and the development of the debilitating neurological condition.
The Republic is regarded as having a low prevalence of hepatitis B infection. Less than 1 per cent of the population are known to carry the virus. However, figures from the Health Protection Surveillance Centre (HPSC) show a recent increase in the incidence of infectious hepatitis. The number of cases has risen from 187 in 2000 to 538 in 2004, a rate of 13.5 cases per 100,000 of the population.
The World Health Organisation (WHO) estimates that over 2 billion people have been infected with hepatitis B virus. Of these, 360 million people have a chronic infection and act as a reservoir for the disease.