Covid-19 Vaccine Update

Debate between Alex Norris and Nadhim Zahawi

Thursday 4th February 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

Thank you, Madam Deputy Speaker. I am grateful to the Minister for advance sight of his statement and for his kind words about my birthday. Of course, the gladdest tidings is the news that more than 10 million people have received their first dose. Once again, our incredible national health service has delivered for us. I visited a site in Nottingham earlier in the week, and that team of the NHS, armed forces, local councils, volunteers and many more coming together was an uplifting and incredible sight.

We welcome today’s announcement about the new clinical trial. It is clear that we will live with covid-19 and its mutations for a long time, so this is the best way to get out in front of it. We were glad also to hear the study results regarding the Oxford-AstraZeneca vaccine reducing transmission and maintaining protection over 12 weeks. As the Minister said, it is clear that vaccines are the way out of this pandemic. Daily cases are beginning to fall, but it is vital that the Government do not repeat previous mistakes and take their foot off the gas just as things look to be getting better. Could the Minister update us on whether he expects similar trial data to be published for the Pfizer vaccine?

The Government seem to be on track to deliver on their promise of vaccinating the top four Joint Committee on Vaccination and Immunisation priority groups by the middle of this month. We really welcome that, and I commend the Minister’s work in that regard, but in a spirit of co-operation, I need to press him on a couple of points about what comes next.

First, regarding data, we are all concerned about the reports of lagging take-up among black, Asian and minority ethnic communities, as well as poorer communities, and I associate myself with the comments about the brilliant work done by our colleagues to fight that. We know that these groups have been worst affected by the pandemic, and we need them to take up the vaccine, but I am conscious that much of what we hear is based on anecdotal stories, rather than hard data at a community level, split by ethnicity. Can the Minister say what data he has on that and when colleagues can get council ward-level data, so that we can all be part of the effort to drive up take-up? As the first phase is coming to an end, can the Minister update us on the number of care home staff who have received their first dose and perhaps what the plan is to encourage those who have not done so to take it up on reflection?

When we get to the beginning of April, those who have had their first dose will be expecting and needing their second one. Can the Minister give an assurance that there will be enough supply to ensure that everyone who is due their second dose gets it, as well as, obviously, to manage those who are due their first? The Foreign Secretary would not offer that commitment on behalf of the Government recently. I hope the Vaccine Minister will be able to.

Colleagues have raised with me the fact that constituents who have received a national letter and called 119 to book are not routinely being offered local primary care network-based options. Can the Minister confirm that that should not be the case and that he would welcome hearing examples of where that is happening so that we can change it?

The Opposition fully supported the Government in prioritising those at greatest risk of dying—those in the first four categories—but as we move to categories 5 to 9, it is reasonable to ask the JCVI about including key workers. Data has shown that those who work closely with others and are regularly exposed to covid-19 have higher death rates than the rest of the population. By prioritising those workers alongside the over-50s and 60s, and people with underlying health conditions, we can reduce transmission further, protect more people and keep the vital services that they provide running smoothly, which includes reopening schools. Putting the politics of this to one side, we raised this suggestion over a week ago now. Will the Minister say whether he has had those conversations with the JCVI, or whether he will at least commit to asking it to look at how that suggestion might work?

It is HIV Testing Week. Those living with HIV are in category 6. If their doctor knows their HIV status, they will have their opportunity as planned. However, some choose, perfectly legitimately and for some profoundly important reasons, to access their healthcare through other means, such as an HIV clinic. Their doctor might therefore not know their status and they may well be missed. In this specific case, will the Minister commit to looking at a possible workaround? Allowing HIV clinics to connect those individuals directly would be one way, but we would support any effective way of doing that.

Finally, given that it is World Cancer Day, what consideration has the Minister given to vaccinating household members of the clinically extremely vulnerable, to give another layer of protection to blood cancer patients and other CEV people, an argument strongly supported by the reports that transmission is reduced by these vaccinations?

To conclude, this programme really is the light at the end of the tunnel. Our NHS has delivered, and we must support it to continue to do so by making the right policy decisions.

[Nadhim Zahawi]

I am grateful to the hon. Gentleman for his constructive way of engaging with the vaccination deployment programme. On trials, we have two running currently, both with Public Health England. The Vivaldi trial is testing residents of care homes, who were in category 1 of the JCVI categories. The second is Siren, which is testing frontline health workers, who are in category 2. As Jonathan Van-Tam, the deputy chief medical officer, has said, we will know the infection and transmission data from those trials in the next few weeks. Of course, the Oxford data is very promising—it needs to be peer reviewed—but those trials will also capture the Oxford vaccine, because obviously that came on site in January.

On the priority list, the JCVI looked very closely at both black, Asian and minority ethnic and, of course, other considerations, including by profession, and came down clearly on the side of age as the deciding factor in people’s risk of dying from covid. This is a race against death, hence the nine categories, which we are going through, and we will continue to do so. A number of professions will be captured in those categories. Of course, those with extremely severe illness will be captured in the category for the severely extremely vulnerable, and others will be captured in further categories down the phase 1 list.

I certainly think it would be wrong to change the JCVI recommendation, because categories 1 to 9 account for 99% of mortality. When we get into phase 2, we would welcome a debate and, of course, will ask the JCVI about including professions such as teachers, shop workers and police officers, who through their work come into contact with much greater volumes of the virus than others do, and it will advise us accordingly.

On BAME and ethnicity, the NHS now collects such data, and we are publishing it. We are doing an enormous amount of work not only across Government, but with the NHS, to ensure that we bring in local government so that we can begin to share data. I would welcome us working much closer with local government and the NHS so that we can identify, to the individual level, the people we need to protect as soon as possible.

I put it on the record that I want clinical commissioning groups to share data with MPs. Several colleagues—[Interruption.] Including you, Madam Deputy Speaker; I can see you nodding away vigorously. CCGs should and must engage with local politicians, because MPs get a lot of emails and telephone calls from concerned constituents in the top four most vulnerable categories. Of course, the NHS has plans to publish CCG-level data very soon.

As for care home staff, we had a fantastic response through the care home vaccination programme, which is category 1, and we continue to do more with staff to encourage them to be vaccinated, because we make four visits into care homes. Visit one is for the first dose, visit two is to try to vaccinate those who may have been infected the first time, because people cannot be vaccinated until after 28 days, visit three will be for second doses, and so on. We are getting greater traction with care home staff, but the hon. Gentleman is right to mention that. There is a big focus on helping them to go to hospital hubs and, of course, their primary care networks.

On the second dose, everyone who has had a first dose of Pfizer will get a second dose of Pfizer within that 12-week dosing period. That will begin in March in the usual way that the NHS does vaccinations. Everyone who has had a first dose of Oxford-AstraZeneca will get a second dose of Oxford-AstraZeneca within 12 weeks as well.

The hg is right to ask about people wanting the option of going either to a national vaccination centre or to the PCN. If right hon. and hon. Members have particular cases, please point them to us and we will do everything we can to ensure that that is facilitated.

The hon. Gentleman rightly highlighted HIV clinics. I will take that matter away and see whether there is a workaround for those who want to have that information remain private from their GP. We will see what we can do.

This is World Cancer Day, and there is now real excitement in the scientific community in the UK about the messenger RNA vaccine, because people can begin to think about vaccines for cancers as well. However, the hon. Gentleman raises an important point about those who care for the clinically extremely vulnerable, and we want to ensure that we deliver the JCVI phase 1 and then very quickly reach the rest of the population.

Covid-19: Vaccinations

Debate between Alex Norris and Nadhim Zahawi

Monday 11th January 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

I am grateful to the Minister for advance sight of his statement.

We meet today at a challenging moment in the handling of the pandemic. We have growing infection rates, we are in lockdown, businesses are shut and schools are closed, and tragically more than 80,000 people have already lost their lives to this awful virus. The vaccine provides us with a light, a glimmer of hope, and a way to beat the virus, saving lives and getting us back to normal.

The Government succeeded in the development of a vaccine—investing in multiple candidates has paid off handsomely—but a vaccine alone does not make a vaccination programme. Given the Government’s failures with the test and trace system and the procurement of personal protective equipment, it is right that we scrutinise the plans carefully.

The plan is quite conventional: aside from the new big vaccination centres, it uses traditional delivery mechanisms operating within traditional opening and access times. The Opposition have some concerns about that, as we believe that exceptional circumstances call for an exceptional response. At the No. 10 briefing earlier today, 24/7 access was said to be something that people would not be interested in, which surprised me; I would like to hear from the Minister the basis for that view.

Similarly, there is the mass deployment of community spaces and volunteer mobilisation unprecedented in peacetime. It is the Government’s prerogative to choose their approach, but I am keen to hear from the Minister assurance that the plan as written and set out today will deliver on what has been promised: the top four priority categories covered by the middle of next month. On a recent call, the Minister said that the only limiting factor on the immunisation programme would be the speed of supply. Will he publicly reaffirm that and confirm that this plan will make maximum use of the supply as he expects to get it?

I think we would all agree that our frontline NHS and social care heroes deserve to be protected. At the beginning of the pandemic, our staff were left for too long without adequate personal protective equipment, and we must not repeat that with the vaccine. Protecting them is the right thing to do, reflecting the risks that they face, but it is also pragmatically a point of emphasis for us, because we need them to be well in order to keep doing the incredible job that they are doing.

We are currently missing about 46,000 NHS staff for covid reasons. The health and social care workforce are in category 2 in the plan, but there does not seem to be a national-level emphasis on inoculating them immediately. There seems to be significant variation between trust areas. Will the Minister commit today to meeting our demand that they all get their vaccines within the next fortnight? We very much welcome the clear and simple metrics that he is going to publish each day so that we can follow the successes of the programme, but as part of that, will he commit to publicising the daily total of health and care staff vaccinated, so that we can see the progress being made against that vital metric, too?

It was reassuring to see pharmacies included in the plan. They are at the heart of all the communities in our country, they are trusted and they already deliver mass vaccinations. It was disappointing and surprising to see them having to take to the front pages of national newspapers last week to get the Government’s attention, but now, with them in the plan, will the Minister reassure the House that he is fully engaged with their representative bodies and that they are satisfied that they are being used properly? The number that has been trailed publicly is of 200 participating pharmacies, but given that there are 11,500 community pharmacies in England, can that really be right? Why are there not more involved, or is that number wrong? If so, could the Minister share with us what the number is? On social care, 23% of elderly care home residents have been vaccinated, compared with 40% of the over-80s more generally. Given their top prioritisation, is there a reason for this lag? What plans are there to close the gap? Is the Minister confident that all care home residents will be vaccinated by the end of the month, as promised?

Finally, there has been a high level of consensus across this place, and certainly between the Minister and me, on misinformation, and we will support the Government in whatever they think they need to do to tackle it. We will have a real sense of the impacts of misinformation as the programme rolls along, particularly as we look at who is and is not declining the vaccine. Will the Minister tell us what he will be monitoring in that regard, and what the early feedback is, perhaps from our own care staff, on who has been saying yes and who has been saying no and what that might mean for the future?

We welcome the fact that the Government have published this plan. We will back them when we think they are right but we will continue to offer constructive ways to improve the process, as I hope I have just done. I hope that the Minister can address the points that I have raised.

[Nadhim Zahawi]

I am grateful for the hon. Member’s backing and support. He asks a number of important questions, and I will attempt to answer them now. Suffice it to say that it would be sensible for us to recognise that test and trace now delivers 85% of those who are tested positive in terms of identifying their direct contacts and the indirect contacts at between 92% and 96%. Over 5 million people have been tested and isolated and are therefore not transmitting or spreading this virus, and 55 million people have been tested. That is a pretty major undertaking, with capacity now touching 770,000 and tests running at about 600,000 a day. From a standing start of about 2,000 a day back in March, that is a pretty remarkable achievement for NHS test and trace.

The hon. Gentleman asked about 24-hour provision. There are two priorities for the NHS, and we have looked really long and hard at this. Priority No. 1 is obviously to target very closely those four most vulnerable categories. Priority No. 2 is to try to get a vaccination to them as quickly as possible, which is about throughput. This is linked because if we were to go to a 24-hour regime, it would be much harder to target the vaccine at those four cohorts. Obviously, when we have limited vaccine volume, we do not want staff standing around waiting for people in centres that are open 24 hours. Also, many of those people are over 80, and we are going into care homes to vaccinate the residents of those homes. The decision to go from 8 to 8 was made because we want to ensure that there is an even spread and very close targeting.

That is linked to throughput—how many vaccinations can we get into people’s arms as quickly as possible? We do not want vaccines sitting in fridges or on shelves. That goes to the hon. Gentleman’s question on the 24 hours, but also the pharmacy question. All the 200 pharmacies that we are operationalising can do 1,000-plus vaccinations a week, so the focus in phase 1, certainly with the first four categories—and, I think, with the total nine categories—is very much on targeting and throughput. The 2,700 sites are the best way that we can target that. Obviously, primary care is very good at identifying those who are most vulnerable or over 80 and, of course, getting into care homes, hence why the NHS plan and the plan we have published today are very much based around those priorities.

As we enter phase 2, where we begin to want to vaccinate as many adults as quickly as possible, we want convenience of course. We want to be able to go into many more pharmacies, so people can walk to their local pharmacy, or GP, and get their jab, when we have limitless volumes of vaccines. We have clearly now got that optioned and it will come through in the weeks and months ahead. That is the reason for that. The hon. Gentleman is absolutely right: the limiting factor continues at this stage to be vaccine volumes. The NHS has built an infrastructure that can deploy the vaccine as quickly as possible, but it is vaccine volumes that will change. With any new manufacturing process, especially one where we are dealing with quite a complex process—it is a biological compound that we are producing—it tends to be lumpy at the start, but it very quickly stabilises and becomes much more even. We are beginning to see that, which is good news.

We are absolutely committed to making sure the health and social care workforce are vaccinated as quickly as possible, and of course we are committed to making sure the residents of care homes are vaccinated by the end of this month—January. I reaffirm that commitment to the hon. Gentleman.

I think the hon. Gentleman’s final question was on data. I am glad that he agrees that it is important, because the Prime Minister’s absolute instruction to us as a team is that we have to make sure we publish as much data as possible as quickly as possible, hence why we have moved to a rhythm of daily data and on the Thursday more detailed publication, which will have regional breakdowns. The NHS is committed as it builds up more data to publish more and more. The nation expects, and rightly wants to see, the speed and the targeting that we are delivering, but I am confident that the NHS has a solid plan. We have the volunteers and the Army—two great institutions of this country—delivering this campaign and with the support of Her Majesty’s Opposition I am sure we will do this.