New position paper offers strategic guidance on adult immunisation

As public health needs evolve, so too must our approach to immunisation

Vaccination is one of the most effective public health tools, offering protection not just for individuals, but also contributing to the overall health of our communities. By immunising adults against diseases like influenza, pneumonia, and shingles, we can significantly reduce the incidence of these illnesses, particularly among vulnerable groups such as the elderly and those with chronic conditions who are at higher risk of severe complications. With our population growing and ageing, and chronic diseases becoming more prevalent, vaccines will play an increasingly vital role in safeguarding public health.

Moreover, adult immunisation plays a crucial role in preventing outbreaks of vaccine-preventable diseases. As we have seen in recent years, diseases that were once thought to be under control can resurface if vaccination rates decline. Indeed, over recent months, the World Health Organisation (WHO) has reported the positive detection of polio virus in wastewater samples from Spain, Poland, Germany, and the UK. While no human polio cases have been detected to date, these reports reiterate the importance of avoiding immunity gaps in the population.

Keeping people out of hospital

One of the strongest arguments for prioritising adult immunisation is its ability to keep people out of hospitals. Influenza, Covid-19, and respiratory syncytial virus  continue to strain our healthcare system each year. Yet, influenza vaccination uptake among those aged 60 and older is just 66 per cent so far this year, with significant regional variation – ranging from 74 per cent in Wexford and Wicklow to only 42 per cent in Roscommon. By investing in adult immunisation and improving vaccine uptake, we can ease the burden on hospitals, allowing resources to be used more effectively and ensuring hospitals can focus on other critical health needs.

Combating antimicrobial resistance

Another reason to prioritise adult immunisation is its role in combating antimicrobial resistance (AMR), a growing public health threat in Europe. The European Centre for Disease Prevention and Control estimates that 35,000 people die each year in Europe from infections caused by antibiotic-resistant bacteria, with AMR costing the EU and EEA approximately €11.7 billion annually. Reducing antibiotic consumption by 20 per cent is a key target in addressing this challenge. Vaccines are a vital tool in this fight, as they reduce the incidence of infectious diseases and, consequently, the need for antibiotics. According to a 2024 WHO report, optimal use of currently available vaccines – achieving 90 per cent coverage – could prevent up to 106,000 deaths globally and reduce antibiotic use by 142 million daily doses each year.

The economic case for vaccination

The economic case for adult immunisation is equally compelling. Vaccination is not only a cost-effective intervention, but also a smart investment in public health. The return on investment for vaccination programmes is well documented; a 2024 report from the Office of Health Economics estimated that full implementation of the national immunisation committee recommendations for influenza, pneumococcal disease, herpes zoster, and respiratory syncytial virus would together generate a return of €23 for every €1 spent.

A roadmap for action

Earlier this month, a position paper entitled Vision and Strategic Approach to Adult Immunisation in Ireland was published. Developed by EY Ireland in partnership with GSK, this paper recommends the development of a comprehensive stand-alone national immunisation strategy which promotes a life course framework and adopts a whole-of-government approach to immunisation. The paper outlines several key themes and recommendations that can guide the future approach to adult immunisation in Ireland.

By fostering an environment of transparency and engagement, we can encourage more adults to take advantage of available immunisations

Firstly, it emphasises the importance of building public trust in vaccination programmes. Effective communication strategies that demonstrate the scientifically proven benefits of vaccines at both an individual and population level are crucial for dispelling myths and misconceptions about vaccines. By fostering an environment of transparency and engagement, we can encourage more adults to take advantage of available immunisations. The paper further recommends a consistent approach to education on immunisation in undergraduate courses and professional development programmes for healthcare providers (HCPs).

Secondly, the paper highlights the need for equitable access to vaccines. Ensuring that all individuals have the opportunity to receive vaccinations is essential for achieving higher immunisation rates. It recommends the designation of immunisation champions in each of the HSE health regions and the development of innovative delivery models that offer multiple entry points to vaccination, including pharmacies, workplaces, hospitals and mobile health clinics. A more coordinated approach to vaccination of immunocompromised individuals is also recommended, including clear guidelines for HCPs.

Additionally, the position paper advocates for a data-driven approach to immunisation, with the establishment of an integrated immunisation information system. It recommends integration of immunisation data into the HSE’s patient app – which will eventually give everyone secure access to their health information – and shared care record. It also calls for the development of a reminder and recall system to prompt individuals for vaccination based on age, medical history, and other criteria. 

Finally, the paper underscores the importance of continuing to invest in future vaccine innovations. As public health needs evolve, so too must our approach to immunisation. A formal horizon scanning process should be established with publication of a regularly updated immunisation roadmap. A faster, flexible process for funding adult vaccines should be created, incorporating consideration of the benefits of immunisation at individual, health service, and societal levels. Key performance indicators should track progress in strategy implementation, while proactive surveillance, resource allocation, and cross-sector collaboration ensure effective outbreak response and preparedness against future threats.

In conclusion, the case for prioritising adult immunisation is clear. This requires a concerted effort from policymakers, healthcare providers, and the community at large. By recognising its vital role in protecting public health, keeping people out of hospitals, combating AMR, and delivering more sustainable, cost-effective healthcare, we can create a healthier, more resilient society.