HIQA Seeks Public Feedback on Proposal for Twice-Yearly Covid Boosters for Over-80s at Cost of €112 Million
The Health Information and Quality Authority is seeking public feedback on a proposal to introduce a twice-yearly Covid-19 vaccination programme for individuals aged 80 and over, at an estimated additional cost of €112 million over five years — a health technology assessment that reflects the ongoing challenge of protecting the most vulnerable members of Irish society from a virus that continues to cause serious illness and death among older age groups.
Background
Ireland's Covid-19 vaccination programme has been one of the most successful public health interventions in the country's history, achieving high uptake rates across all age groups and contributing significantly to the reduction in serious illness and death from the virus. However, as the pandemic has transitioned from an acute emergency to an endemic phase, the question of how to maintain protection for the most vulnerable — particularly the elderly — has become increasingly complex.
The current vaccination strategy involves annual booster doses for high-risk groups, including those aged 65 and over, people with underlying health conditions, and healthcare workers. This approach has been broadly effective, but emerging evidence suggests that the protection provided by a single annual booster may wane more quickly in the oldest age groups, leaving them vulnerable to serious illness in the months between doses.
HIQA, the independent body responsible for health technology assessment in Ireland, has been examining the evidence for a twice-yearly vaccination schedule for those aged 80 and over. The assessment involves a detailed analysis of the clinical evidence for the effectiveness of bi-annual boosters in this age group, as well as an economic analysis of the costs and benefits of the proposed change.
Key Developments
HIQA's public consultation on the proposal was launched on July 15, 2026. The authority is seeking feedback from members of the public, healthcare professionals, patient organisations, and other stakeholders on the clinical and ethical dimensions of the proposed change. The consultation will run for several weeks, after which HIQA will publish its final assessment and recommendation.
The estimated additional cost of a twice-yearly vaccination programme for those aged 80 and over is €112 million over five years. This figure encompasses the cost of the vaccines themselves, the administration costs of running an additional vaccination round each year, and the associated public health communication and logistics. The assessment will weigh this cost against the estimated health benefits — in terms of hospitalisations and deaths prevented — of the more frequent vaccination schedule.
The proposal has been broadly welcomed by geriatricians and public health specialists, who have argued that the current annual schedule leaves the oldest and most vulnerable patients with inadequate protection during the winter months, when Covid-19 transmission is typically at its highest. However, some health economists have questioned whether the additional cost is justified given the competing demands on the health budget.
Why It Matters
The HIQA assessment matters because it addresses a genuine and important question about how Ireland protects its oldest citizens from a virus that continues to cause disproportionate harm to the over-80 age group. While Covid-19 has become less deadly for the general population as immunity has built up through vaccination and infection, it remains a serious threat to the very elderly, who are more likely to develop severe illness and less likely to mount a robust immune response to vaccination.
The cost-benefit analysis at the heart of the assessment is also significant. €112 million over five years is a substantial sum, but it must be weighed against the cost of the hospitalisations and deaths that a more frequent vaccination schedule might prevent. If the evidence supports the clinical effectiveness of bi-annual boosters for the over-80s, the economic case for the investment may be strong.
The public consultation process is also important in its own right. HIQA's decision to seek public feedback on the proposal reflects a commitment to transparency and democratic accountability in health technology assessment — a commitment that is particularly important when the decisions being made involve significant public expenditure and have direct implications for the health and wellbeing of a specific population group.
Local Impact
For Ireland's over-80 population — which numbers approximately 150,000 people — the outcome of the HIQA assessment could have a direct and significant impact on their health and quality of life. Many in this age group have been among the most diligent in following vaccination guidance throughout the pandemic, and the prospect of additional protection through a twice-yearly booster schedule has been welcomed by older people's organisations and advocacy groups.
For GPs and community pharmacists, who have been the primary delivery mechanism for Covid-19 boosters in Ireland, a twice-yearly schedule for the over-80s would represent an additional workload. The Irish College of General Practitioners has indicated it will engage with the HIQA consultation to ensure that the practical implications for primary care are fully considered in the assessment.
What's Next
HIQA's public consultation on the twice-yearly Covid booster proposal will run for several weeks, with the closing date for submissions to be confirmed. The authority will then analyse the submissions received and incorporate them into its final health technology assessment, which is expected to be published in the autumn of 2026. The National Immunisation Advisory Committee will consider HIQA's recommendation and will make a formal recommendation to the Minister for Health, who will make the final decision on whether to implement the proposed change. If approved, the new vaccination schedule could be in place for the 2026/27 winter season.
