Covid vaccines should cost below €60 and given to over-80s to be cost-effective,  health watchdog says

There is a higher uptake in covid vaccines among the over-80s than younger age groups, Hiqa said. File picture: Dan Linehan

Covid-19 vaccines should be priced below €60 per dose to be cost-effective in twice-yearly shots for vulnerable over-80 year-olds, Hiqa has said.

Hiqa was asked to assess the cost and benefits around vaccination to help decide who would get free vaccines from 2027 onwards.

On Monday, it advised the Department of Health: “Since 2023, the absolute risk of severe covid-19 disease has continued to decline in all age groups.

“However, some groups continue to be at higher risk of severe disease compared with the general population.” 

The virus continues to have a serious effect on older people, and this can also lead to pressures for their family in supporting them and the health services, Hiqa found.

Last year, 260 people died with covid-19 and more than two-thirds were aged 80 years old or older.

Hiqa focused on the economic cost of funding vaccines for people aged 60 and older.

“The cost effectiveness of the modelled strategies was found to be highly sensitive to both the assumed price of the vaccine and the incidence of covid-19,” it said.

These factors should be taken into account in any decision-making and in negotiations with vaccine manufacturers, Hiqa advised. 

It said: “For example, if the price of the vaccine is less than €60 per dose, offering vaccination to adults aged 80 years and older twice a year would be considered cost-effective.” 

Looking at the vaccine, Hiqa said this was “safe and effective” and showed a greater effectiveness against severe disease. However, it noted effectiveness wanes over time.

“A large evidence base demonstrates that covid-19 vaccines have a favourable safety profile,” Hiqa said.

The review shows uptake of the vaccine dropped every year since 2023 across GPs, pharmacies and the HSE vaccination teams.

However, people over-80 are the exception to this, with Hiqa noting a higher uptake among this group compared to people aged 60 to 79.

As time passes, people have more protection from covid-19 because of having had infections already or getting vaccinated. This has led to fewer covid-related deaths, the review said.

Hiqa's deputy director of health technology assessment Dr Patricia Harrington said across Europe, policies had been updated around vaccination in the years since the pandemic hit.

“This has included restricting funded access to those considered to be at highest risk of severe disease, such as older adults, those residing in long-term care facilities for older adults and those living with immunocompromise,” she said.

Hiqa said if there were changes to the vaccination programme then people should be told about this in advance.

It also advised outreach programmes to reach groups who could benefit from the vaccine.