Respiratory Syncytial Virus: Vaccination Programme

Baroness Merron Excerpts

Tuesday 9th September 2025 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I am sure we are all in agreement in our thanks to my noble friend Lady Ritchie for securing this important debate and for her very thorough and considered introduction. Acknowledgement has also rightly been paid to my noble friend for her campaigning and her raising of awareness of this issue, which has made a real difference, as we have heard. I am grateful to all noble Lords for their helpful contributions and questions, which I will reflect on and share with the responsible Minister: Ashley Dalton MP, the Minister for Public Health.

RSV is a common virus that 90% of children get before the age of two. It is often mild, causing a cough or a cold, but can also be serious—it can sometimes be fatal because it can cause lung infections such as bronchiolitis and pneumonia which make it difficult for babies to breathe and to feed. Watching your baby struggle for breath is alarming for any parent, carer or family member, and far too many know what this feels like as RSV is the biggest cause of winter admissions in children’s hospitals every year.

My noble friend asked about the collection of systematic data. I can confirm that, as with all major infectious diseases, the Government regularly review data collected on the impact of RSV and continuously monitor immunisation programmes, including uptake levels in different groups. I am glad to say all noble Lords have raised this theme, and I will return to it later. Researchers and government epidemiologists provide evidence to the Joint Committee on Vaccination and Immunisation and the JCVI’s advice is of immense and direct importance to any decision.

In June 2023, the JCVI—as noble Lords have said—recommended programmes to protect babies against RSV, and in September 2024 this Government introduced vaccinations for all pregnant women from 28 weeks. But last year the JCVI highlighted how very premature babies may not benefit from this new programme, either because they are born before their mothers are vaccinated or because there is limited time for the protection to be passed down to them during pregnancy after their mothers have been vaccinated.

I am glad to say that this debate gives me an opportunity to update your Lordships’ House on the key changes the Government have made recently to deliver equity in RSV protection, something all noble Lords have emphasised the importance of this evening. Since 2010, the NHS has offered an immunisation called palivizumab to infants at greatest risk of severe RSV illness. This is effective, but it is also expensive, as it requires a monthly injection, which means it has been limited to around 4,000 infants at most risk each winter. I know that the noble Lord, Lord Mott, is very concerned, as am I, about winter pressures, and rightly so.

I am therefore delighted to announce that from the end of this month the NHS will also start offering immunisation to all premature babies born before 32 weeks, as advised by the JCVI. This is the result of the Government working with the NHS and partners to secure a product that is more effective in tackling infant RSV. The new immunisation is called nirsevimab. It provides better protection and requires only a single injection over winter. I am sure that all noble Lords will welcome this development; it shows the improvements and changes we can make by harnessing technology and innovation, and I am glad to be able to share it with noble Lords this evening.

My noble friend Lady Ritchie asked about the steps the Government are taking to ensure protection for all infants going into their first winter, including for babies born prematurely and those whose mothers have chosen not to get vaccinated. Let me say loud and clear that my message is that vaccination during pregnancy is the best way to prevent babies from becoming seriously ill with RSV.

The vaccination programme is expected to have a major impact on RSV this winter, including for the most premature babies. The vaccine is offered from week 28 of pregnancy, and most are given it by week 31. As my noble friend observed, a study led by NHS paediatricians found that the vaccine was 72% effective in preventing hospitalisations in the first six months of life for infants whose mothers were vaccinated more than 14 days before delivery. Every noble Lord who has spoken this evening has rightly counselled against listening to misinformation, which is dangerous and damaging, and I certainly share that view.

The JCVI also noted that clinical trial data shows high levels of immunity in babies born 14 days after the mother is vaccinated. Compared with babies whose mothers are not vaccinated, immunity was also relatively high in babies born less than 14 days after the vaccination. This has informed the JCVI’s advice that babies born before 32 weeks are the group that requires an additional immunisation to protect them during the winter. Again, as with all new programmes, the Government will be closely monitoring the impact of the programme in different population groups.

As we have heard, the maternal RSV programme is only a year old, and already vaccine uptake in pregnant women has increased since the programme began. We want to see many more pregnant women getting vaccinated. Every noble Lord who has spoken this evening rightly asked what is being done to reduce the current variation in uptake of the maternal RSV programme across regions and ethnic groups—and the noble Lord, Lord Kamall, made a helpful comment about his recent meeting with affected groups.

We very much recognise how much more needs to be done, particularly in areas and communities where uptake is lower. That is why we are continuing to implement the NHS vaccination strategy to make vaccinations more accessible, locally tailored and inclusive. To do this, we are transferring the commissioning of vaccination services to ICBs. That will support NHS regions with delivering vaccination services that are properly tailored to the local needs of local populations.

We are also providing better access to vaccinations. For example, we are updating information resources in 30 languages, encouraging maternity services to have early discussions with pregnant women about vaccinations, and ensuring that training is in place so that staff can have the knowledge to address concerns and confidence in the programme. From this month, we are running broadcast and digital media communications to encourage pregnant women to get their RSV, whooping cough and flu vaccines, with greater efforts being made in the communities and geographical areas that have lower uptake.

The noble Lord, Lord Rennard, asked where the update on the UKHSA immunisation equity strategy is. I am glad to be able to tell him that the update was published in July, and it sets out to ensure a whole range of things, which I think will be of interest to noble Lords: there will be more accountable system leadership on immunisation inequities; there will be better access to timely, high-quality data; practitioners and policymakers will be better able to share, generate and use evidence; and there will be better people- and place-based approaches to communications and engagement around immunisation. It is certainly intended that these actions will raise awareness in communities across the country, as we have discussed.

The noble Lord, Lord Mott, rightly referred to winter pressures. I hope that in the way I have described, the reduction of the incidence of RSV will take pressure off the NHS in the winter. We know that flu is very much a recurring pressure. I emphasise to noble Lords that this year’s flu vaccination programme is under way. It began on 1 September for children and pregnant women; and adults aged over 65—which I know not everyone in the Chamber is, but a number of us are —those with long-term health conditions, and front-line health and social care workers can get their flu vaccine from 1 October. Again, I encourage everybody to do so.

The noble Lord, Lord Rennard, asked when the JCVI will consider the immune-suppressed. It has advised that the expansion of the older adult immunisation programme will be guided, as ever, by emerging evidence of disease incidence in different groups, and we will certainly be considering any future advice.

The noble Lord, Lord Kamall, asked about good news stories, so to finish: the reported increase in the uptake of whooping cough vaccines given to pregnant women reached 72.6% because of the communication and the attention given to that. The Government will continue to monitor the impact and the Government are pleased to have made a real and positive impact for babies, parents and others affected by RSV.