Covid-19: Vaccination of Children

Angela Eagle Excerpts

Tuesday 21st September 2021 Westminster Hall

[Dame Angela Eagle (in the Chair)]

Before we begin, I encourage Members to wear masks when they are not speaking. This is line with current Government guidance and that of the House of Commons Commission. Please also give each other and members of staff space when seated, and when entering and leaving the Chamber.

[Miriam Cates (Penistone and Stocksbridge) (Con)]

I beg to move,

That this House has considered the vaccination of children against covid-19.

It is a pleasure to serve under your chairmanship, Dame Angela. I thank the Backbench Business Committee for granting this important debate, and draw Members’ attention to the three e-petitions that relate to this topic, which have amassed more than 100,000 signatures between them.

Vaccination has transformed public health over the last two centuries. As a science teacher, I remember teaching students about the amazing work of Edward Jenner, who famously developed the smallpox inoculation. Two hundred and fifty years later, vaccinations have again ridden to our rescue with the rapid development and roll-out of covid vaccines across the UK. The phenomenal success of the vaccination programme can be seen clearly in the data. Of the 51,000 covid-related deaths from January to July this year, 76% were of unvaccinated people, and a further 14% had received only a single dose. Just 59 deaths—0.1%—were of double-vaccinated adults with no other risk factors, and 92% of adults now have covid antibodies.

Those figures are a ringing endorsement of the Joint Committee on Vaccination and Immunisation’s strategy to recommend vaccination based on the medical benefits and risks to the individuals concerned. The Government have repeatedly defended both this strategy and the independence of the JCVI, and resisted calls to prioritise the vaccination of teachers or police officers over those at higher risk of serious illness. That was the right approach, and the UK has led the world in falling rates of deaths and hospitalisations.

It was therefore surprising, to say the least, when the Government put political pressure on the JCVI to quickly reach a decision about the vaccination of children. On 3 September 2021, the JCVI announced that it was unable to recommend the mass vaccination of healthy 12 to 15-year-olds. The reason was that, although there are marginal health benefits of covid vaccination to children based on the known risks of the vaccine, there is considerable uncertainty regarding the magnitude of the potential harms, such as the long-term effects of myocarditis.

Paediatrician and JCVI member Adam Finn wrote in The Sunday Times that a high proportion of myocarditis patients showed

“significant changes of the heart. It is perfectly possible that these changes will resolve completely over time. But it is also possible that they may evolve into longer-term changes.

Until three to six months have passed, this remains uncertain, as does what impact on health any persistent changes may have.”

According to the JCVI, for every 1 million healthy children vaccinated, two intensive care unit admissions will be prevented, and three to 17 cases of myocarditis caused. With two doses, that rises to between 15 and 51 cases—finely balanced, indeed.

There is no rush to roll out the vaccine to children. We know that children are not at risk from covid; teachers are no more at risk than the rest of the population; the vast majority of vulnerable adults have been vaccinated; over half of children already have antibodies; and there is no evidence that schools drive transmission.

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[Chris Green (Bolton West) (Con)]

The advice being given out on consent forms states that you get to see your family doctor. However, when I and my hon. Friend the Member for Winchester (Steve Brine) challenged the former vaccines Minister, my right hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), on the ability of families to access their family doctor to get advice about vaccines, he could not and would not give an assurance that families could have that advice. Is not such access necessary, especially if the Government are stating on the vaccine form that you do have that access?

[Dame Angela Eagle (in the Chair)]

Order. Before I call Miriam to continue, Members ought to realise that when they say “you” they are referring to the Chair. Can we please try to get the formalities right? I know that it is less important on Zoom, but we are now back.

[Miriam Cates]

My hon. Friend is right. It is widely known that access to GPs is challenging at the moment, and that presents challenges in this situation. It is widely understood that if a child can consent, contrary to parental consent, that is not a tick-box exercise; it is a matter for a medical professional to assess whether the child is competent to consent. If there are problems accessing GPs, there are clear issues here.

There is no rush to roll out the vaccine, and there is no evidence that schools drive transmission. Indeed, recorded covid cases are now at their lowest level since June, despite schools having been open for two weeks. It is also unlikely that vaccinating children will have a major impact on infection rates in the population as a whole, with the JCVI saying that

“the committee is of the view that any impact on transmission may be relatively small, given the lower effectiveness of the vaccine against infection with the Delta variant.”

However, instead of accepting the JCVI’s assessment and waiting for more evidence to emerge, the Government asked the chief medical officer urgently to review the decision based on the wider benefits to children, including from education. Last week, the CMO announced that he would recommend child vaccinations on the basis of these wider benefits.

That decision is a marked departure from the principle of vaccinating people for their own medical benefit, because those wider issues—educational disruption and concerns around mental health—are the consequences of policy decisions and are not scientific inevitabilities. Children in the UK have already missed more education than children in almost any other country in Europe, despite comparable death rates. Since January 2020, British children have lost on average 44% of school days to lockdown and isolation. That is not a consequence of covid infections in children, but rather a result of policy decisions to close schools and isolate healthy children.

According to the Government’s modelling, vaccinating children could save 41 days of schooling per 1,000 children between October and March. That equates to an average of just 15 minutes of education saved per child over this period—surely an insignificant amount, and negligible when we account for the time it takes to vaccinate and the subsequent days off school to recover from potential side effects. There is a much simpler way to stop harmful educational disruption, and that is to follow the advice of the Royal College of Paediatrics and Child Health and end the mass testing of asymptomatic children. This unevidenced and unethical policy is costing tens of millions of pounds a week—I would be grateful if the Minister could confirm the exact cost—and is continuing to disrupt education. Even the CMO acknowledges that a vaccination programme alone will not stop school closures. Perhaps the Minister could clarify how the Government intend to end educational disruption.

On the potential mental health benefits from reducing the fear of covid, it is not covid infection that is making children fearful; it is the uncertainty, frustration, loneliness and anxiety that they experience as a result of lockdowns and harmful messages such as, “Don’t kill granny.” Children need not fear catching covid, but they have every right to fear policy decisions that cause them significant harm, and sadly we cannot vaccinate against those.

Nonetheless, the decision has been made, and we have to be very clear that the risks to children, both from covid and from vaccines, are tiny. Concerns should now focus on making sure that the necessary safeguards are put in place as vaccination is rolled out. The previous vaccines Minister, my right hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), assured MPs that there will be no differential treatment of children in schools on the basis of their vaccination status. That is crucial, because any suggestion that unvaccinated young people may be denied education or be subjected to social disadvantage will inhibit the ability of both parents and children to make a free and objective decision. While I appreciate Ministers’ commitments, children already face discrimination in some schools over mask wearing and testing.

We must also make sure that travel rules that differentiate between vaccinated and unvaccinated children do not amount to coercion when parents are making a decision. Can the Minister say how we will ensure that there is no discrimination in practice as well as in theory?

Vaccination must be a free and informed decision. Choosing to have or not to have the vaccine are both perfectly reasonable and sensible decisions where children are concerned. We must ensure that correct and impartial information is communicated and, as my hon. Friend the Member for Congleton (Fiona Bruce) said, that there is access to health professionals where necessary. Parental consent must also be respected. Much has been said on this subject, but the heart of the matter is that parental responsibility and authority are foundational to society.

I am optimistic that these protections can and will be put in place. None the less, the way that the decision to vaccinate healthy 12 to 15-year-olds has been made should give us pause for thought. For no other cohort have the Government questioned the JCVI’s advice. Why have we departed from this stance when it comes to children and looked for reasons other than direct medical benefit to press ahead? When there are concerns about the future health of our children, why have we not waited for more evidence to emerge? I fear that this situation, rather than being an isolated incident, epitomises a worrying attitude to children that has been evident since the start of the pandemic.

Throughout the past 18 months, “protect the vulnerable” has been our clarion call. We have rightly made significant efforts to protect elderly people and those who are particularly susceptible to covid, but children, who cannot speak out, do not own property, and have no legal agency, are also very vulnerable. Yet during the pandemic, we have asked this group of vulnerable people to make huge sacrifices to protect the rest of us. The harms of lockdown for our children are significant and, for many, will be irreversible: lost education, missed opportunities, abuse and horrific online harms. The number of children presenting in A&E with acute mental health conditions has risen by 50% since the start of the pandemic.

A climate of fear and uncertainty has robbed children of the structure, routine and security that they need to thrive and has placed on them a heavy emotional burden from inferring that they may be responsible for the deaths of those they love. We have pretended that online learning is somehow a substitute for being in schools, and closed our eyes to the consequences of social isolation for children and young people.

Of course, we should raise our children to take responsibility for their actions, but as adults we should always shoulder the greater burden. We have imposed absurd rules on our young people, right down to deciding whom they can play with at playtime and whether they are allowed to change for PE.

However, we have not seen that much action to urge adults to take responsibility for their own covid risk by, for example, losing weight or exercising—something that would have had a far greater impact on our rates of hospitalisation and death.

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[Karl MᶜCartney]

I picked up on the hon. Gentleman’s comments earlier about being sociable and being back in this place, and I did not want him to sit down having made a speech without being intervened on, as he is probably one of the most social Members across the House. Well done.

[Dame Angela Eagle (in the Chair)]

The sociable Jim Shannon.

[Jim Shannon]

I thank the hon. Gentleman for that intervention. Our friendship goes back to when our offices used to be across from each other on the same corridor, and I am very pleased to renew it again in this House.

I believe that we have seen a decline in covid due to the vaccine, and the benefits are clear to see. However, from a child’s perspective the tale is very different, and parental consent, hand in hand with medical guidance in specific cases, must be the way we move forward. I believe that is what we should be doing. I am pleased to have had the debate and I thank the hon. Member for Penistone and Stocksbridge again for securing it. I look forward to other contributions, which I hope will endorse what we have all said.

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[Chris Green]

I absolutely agree with my hon. Friend. Confidence needs to be restored in the wider vaccine programme. There needs to be a renewal of focus, because vaccinations for infants have dipped—slightly, but they have dipped. For older children and teenagers, the wider vaccine programme has dipped more substantially, so we need a significant catch-up in our broader vaccine programme.

We will also see increased concerns as drug companies seek approval to get the age for covid vaccines reduced to five years old. We therefore see the potential for an undefined point at which we can declare our position a success. If we do not have a clear understanding of what success means, will Government advisers say, “We now have approval for drugs to be given to five-year-olds, and that is the next step”? That question is for my hon. Friend the vaccines Minister, whom I welcome to the Front Bench. Will she clarify a couple of points? We here, broader society and health professionals outside the scope of Government can understand the end point. Professor Whitty said that at a certain point we will be able to treat the coronavirus as we treat influenza. What are the objective criteria by which we and others can judge that?

I asked the Minister’s predecessor, my right hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), about the transition point when we as a society understand that we have moved from a pandemic disease where we need restrictions and other lockdown measures, and when we move to an endemic disease where we treat coronavirus as we treat influenza and other diseases, many of which are incredibly dangerous to people who are vulnerable—influenza is very dangerous for vulnerable people. We need to know when coronavirus goes from pandemic to endemic. We need objective criteria, because when the previous vaccines Minister replied to me, I could define what he said as, “We come out of pandemic status tomorrow” or, “We come out in 10 years’ time.” I do not think that is good enough when schools and families need more certainty.

[Dame Angela Eagle (in the Chair)]

I intend to call the Front-Bench speakers at 10.38. I call Andrew Lewer.

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[Derek Thomas (St Ives) (Con)]

Dame Angela, I have worked out from your timings that I get 20 minutes to speak—

[Dame Angela Eagle (in the Chair)]

Order. The latest that I will bring in the Front Benchers is 10.38 am, so you do not have to take the full 20 minutes.

[Derek Thomas]

I am pretty sure I will not. I congratulate the Minister, who until last week was my favourite Whip and is now the vaccines Minister. It is a great honour to do that job, and I am sad we have to come up against this particular policy because across the board the vaccine programme has been remarkable. I congratulate my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates) on securing the debate. The issue is agitating and concerning, and enormous numbers of people, including parents, schools and many others, feel it is a step too far.

I am a Conservative. I joined the Conservative party because of a belief in giving people freedom of choice, the ability to deliver and develop their own destiny, and the opportunity to live full, vibrant and fulfilling lives. I think this particular policy goes right against that, and I feel uncomfortable with it. It feels wrong, and I believe it is wrong to introduce this vaccination programme for children aged 12 to 15, considering all that has been said about consent this morning. Before I get started, may I just say that I feel privileged to be in this room where such great points and speeches have been made, because we care about families, children and how our schools are supported in a very difficult and unprecedented time?

Earlier in the year I went to visit St Clare medical centre in my constituency, which was delivering the vaccine programme with great fervour. It has an amazing system going on. In fact, with other primary care networks in my constituency, it was mentioned in dispatches for the incredible effort it put in to get the vaccine out to the most vulnerable people. My constituency was the fifth in the country in getting the most people vaccinated by the February half term.

I observed the logistical challenge and triumph of rolling out the vaccine programme and talked to the practice manager. She described why the additional workload was acceptable: a massive volunteer army was motivated and mobilised, there was an incredible collaboration of GPs, the NHS and all sorts of organisations that had got behind this, and there was organisation across the primary care networks. She said that all of that extra effort—the long weekends and the massive amount of work that went into it—was possible and worthwhile because it was part of the national effort. It really struck home that people right down at the end of the country, in the most beautiful part, who are often tucked away and not necessarily engaged in national efforts, were so enthusiastic and determined to make this work. West Cornwall primary care networks were mentioned by the Secretary of State at the time for their incredible effort in getting vaccines to people in such a quick and effective way.

During the roll-out of the vaccine programme, Ministers fiercely defended the decisions made by the JCVI. The JCVI determined the priority groups—who would get the vaccine and when—and Ministers refused to intervene. They were determined not to intervene, not even to prioritise teachers as schools opened in September last year. They refused to intervene to prioritise the police when some 10,000 policemen descended on my constituency in Cornwall for the G7. There was great concern about that, but Ministers refused to intervene to allow police officers of all ages to have the vaccine ahead of the priority groups set out by the JCVI. Why now, with the help of the chief medical officers, do the Government reject the advice of the JCVI? That advice states:

“The margin of benefit…is considered too small to support advice on a universal programme of vaccination of otherwise healthy 12 to 15-year-old children”.

It also says that

“any impact on transmission may be relatively small”.

In other words, schools would still be disrupted because the vaccine does not manage transmission. I, along with many others, recognise the wisdom of the JCVI’s advice JCVI in this area. We were surprised when, just weeks later, the Government and chief medical officer seemed to take a completely different course. I was relieved when the JCVI made its case and gave that very sound advice. Like many others, I was then disappointed and concerned that the Government seemed to go against it.

The reason for my concern is that the decision to override the JCVI advice will undermine confidence in the vaccine roll-out programme. Up until now, because of the way the JCVI has operated, the country has welcomed the approach, has supported it and had confidence in it. I wonder whether the Government are actually doing it a disservice by potentially undermining confidence in the roll-out. So far, the great strength of the vaccine roll-out is its voluntary nature, based on sound advice and a national united effort.

My fear is that the decision has been made for seemingly unsubstantiated reasons. There are gaping holes in the argument that it will minimise disruption of children’s education. My fear is that it risks turning a national effort into a tool to pressure children, undermine parents and drive an inadvertent wedge between families and schools. Under a new Secretary of State, the Government’s primary priority should be allowing schools to do what they do best: educating children. I ought to declare an interest as I have three children, who are in school at this very moment—or so I hope.

At the beginning of the year, I secured an Adjournment debate on the experience of schools. They have had a blooming rotten time, with changing advice and all sorts of things coming down from Government; they did not know if they were coming or going. What has really concerned schools, teachers and headteachers is that they have taken on a new role—trying to manage children’s health and parts of their welfare—that they never signed up for. It is not that they are unwilling, but that they do not have the time or resources, and they might even add the expertise, to take on those additional responsibilities when what they want is to educate children and give them the best start in life.

All Members’ constituency offices have supported schools in the bizarre work they have had to do to manage parents on different sides of different arguments when it comes to managing covid in schools. I have had parents who are furious with a school for insisting on face coverings in parts of the school, both before that was the official advice and since; I have also had parents furious with a school for saying children do not have to wear a face covering in the classroom. Those poor headteachers and staff have had to deal with that along with all the pressures of teaching children.

What do we do? We make their job a whole lot more difficult by putting schools at the centre of a decision that most of us in this room do not believe is robust or stands up to what scientists have said. We have asked them to take on the additional responsibility of vaccinating 12 to 15-year-olds, and to manage the various pressures that come with it, when all they want to do—all they thought they were doing—is go back to school in September, catch up and give their children a happy, healthy and wonderful experience being educated. I really feel for our children.

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[Miriam Cates]

The hon. Lady is absolutely right; I am not saying that other countries are not basing decisions on their own evidence. I am saying that the success of our programme was based on the JCVI’s advice and its particular method of offering vaccination based on individual medical benefit, which gave us an incredible advantage that could have allowed us to wait a further six or nine months to make this decision.

[Dame Angela Eagle (in the Chair)]

Prior to the hon. Lady responding, the hon. Member for Penistone and Stocksbridge must remember that she has to put questions.

[Liz Kendall]

Thank you, Dame Angela. I will come back to this point, because several hon. Members have talked about what the JCVI recommended, and I hope I will be able to set out a little more information about what it actually said later in the debate. Before I go on to talk about the evidence—

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[Karl MᶜCartney]

I am conscious there are a few minutes left in this debate, so I want to refer quickly to three more issues. First, the Minister may have noticed that the first speech in support of the Government’s position came from an Opposition Member, who claimed to be speaking on behalf of all Opposition MPs, although there is only one here.

Secondly, a point was made about the seat of the hon. Member for Leicester West (Liz Kendall) and the number of young people who have, I believe, covid, although she did not give the actual number. However, if school children were not tested over the summer, surely they are now being tested in school and the incidence of those with covid will be rising. Therefore, I am being very gracious to both Front Benchers—

[Dame Angela Eagle (in the Chair)]

Order. This is a very long intervention.

[Karl MᶜCartney]

It is, but I am coming to the end of my comments, Dame Angela. I am conscious of that. When I was growing up, there was a very famous pop song called “Don’t Believe the Hype”. Surely that is something we should all be taking notice of.