National Immunisation Programme

Baroness Twycross Excerpts

Thursday 18th January 2024 Grand Committee

[Baroness Twycross (Lab)]

My Lords, I thank my noble friend Lady Ritchie for securing this debate. I declare an interest as the chair of the London Resilience Forum and vice-president of the Encephalitis Society, a charity that advocates the use of vaccines for prevention of encephalitis.

Like my noble friend, I feel very strongly about vaccination and access to it. I would not normally use my own life story to back up a point in a debate but it feels appropriate to do so on today’s subject. As a teenager, I got mumps. It was very mild and nobody was particularly concerned. In those days it was treated as another childhood sickness that it was helpful for children to pick up at some point. The routine vaccine was introduced just a few years later as part of the MMR suite of vaccines, but it was not available at that time. Over the course of the few weeks after my mild dose of mumps, I became increasingly ill, and after several weeks of acute illness I was diagnosed with viral encephalitis, an inflammation of the brain. I am one of the lucky people who has contracted encephalitis but had a good recovery, with very few lasting effects. In the worst-case scenario, encephalitis can kill or cause brain damage or severe long-term disabilities.

Had MMR been available to me as a child, I would not have had this serious illness, which severely impacted my health throughout my teenage years and into my early 20s. Childhood vaccines save lives, limit disabling side-effects and prevent serious illness, but we do not yet have all the vaccines available that could do this.

We know that chickenpox can also lead to viral encephalitis or other complications, including death. I am delighted that the JCVI now recognises the life-saving potential of the varicella vaccine. I pay tribute to all those who have been campaigning on this issue over many years, including Professor Benedict Michael from Liverpool University, to whom I had the pleasure of speaking about this issue earlier this week. As noble Lords are probably aware, the varicella vaccine is routinely used in other countries, such as the USA, where it has been part of a suite of childhood vaccines since the 1990s. Other developed countries use it, including Italy and Israel. As the chair of the JCVI, Professor Sir Andrew Pollard, has said:

“Adding the varicella vaccine to the childhood immunisation programme will dramatically reduce the number of chickenpox cases in the community, leading to far fewer of those tragic, more serious cases”.


I understand that one of the arguments used previously against the introduction of the varicella vaccine has been a general belief in the UK that having some chickenpox circulating in the population provides greater immunity to older people at risk of shingles or shingles encephalitis from the virus. We should have evidence-based medical interventions. There is no evidence of higher rates of shingles or shingles encephalitis in older people as a result of childhood vaccination against varicella over the past 30-plus years in the States. Now that older and more vulnerable people are routinely offered a vaccine against shingles, which I welcome, this herd immunity argument should be discarded as the outdated argument that it is and confined to the past. Does the Minister agree with this position, and that chickenpox parties, which, shockingly, still take place, belong to the Victorian era and should also be confined to the past?

Can the Minister tell us whether and when the Government are planning to introduce the varicella vaccine? If he cannot, can he say when the Government are likely to take a decision on this issue? If the vaccine is added to the suite of childhood diseases that parents and guardians are encouraged to take up on behalf of children, how will the Government increase public health messaging to ensure that they understand exactly why this is needed?

Tragically, it is not just new vaccines that require public health messaging. In recent days we have heard of measles outbreaks in the West Midlands. We know that vaccine take-up is not uniform across social demographic groups. Can the Minister say how the department is addressing this and making sure that the current outbreak does not disproportionately impact specific groups?

Regrettably, the false claims about MMR are still causing vaccine hesitancy among some parents, and a whole generation of children, who are now young people, are undervaccinated. I raised the low take-up of MMR in London with the Minister last year and am grateful for his response at the time. I was pleased to hear from the UKHSA in London about work that is being done to ensure that MMR vaccines are available to students.

I appreciate that the Minister may not have this information to hand, but will he commit to looking into this work to ensure that this type of initiative is taking place across the country? Are there similar initiatives for other groups of adults who may have missed out? Will he commit to making sure that every effort is made to push back on the continued false claims or rumours about the MMR vaccine?

My noble friend mentioned the RSV vaccine. As noble Lords will be aware, this virus is the major cause of babies and young children having to be admitted to hospital, with more than 33,000 admissions every year, including 20 to 30 avoidable and tragic deaths of otherwise healthy children. Can the Minister commit to a timeline for introducing the vaccine for this age group? We know that RSV affects older people too and leads to an estimated 175,000 GP visits, 14,000 hospital admissions and 8,000 deaths among people aged over 60 in the UK every year. These are not insignificant numbers.

The House of Lords Library Note helpfully outlines the range of vaccines currently available. Missing from this list is the Covid vaccine, which over the past few years has saved innumerable lives and reduced the already frightening number of people suffering from long Covid. We know from recent reports that by June 2022 only 44% of the population had taken up their recommended number of jabs and boosters. In the early stages of the vaccine programme, a huge amount of cross-sectoral effort went into tackling disproportionate uptake in the face of considerable organised disinformation about the vaccine. What learning have the department and the NHS taken from that effort during the pandemic? How can and will that be applied to ensure that take-up improves to prevent future serious impacts of Covid, where possible, including preventing avoidable deaths? Will the Minister tell us when we will know what the long-term plans are for continuing to offer Covid vaccinations as part of a suite of vaccines offered to older and vulnerable people? Are the Government planning to include vaccines against RSV for these groups? Returning to the Covid vaccine, I ask: will the Government allow and perhaps encourage the commercial provision of Covid vaccines in future, as is the case with the flu vaccine, which is readily available in pharmacies?

My final point is on investment in science and technology. I think we are all proud of the ground-breaking work of British scientists in the fight against Covid. It was an unprecedented achievement in terms of the speed of the development and delivery of a new vaccine, as my noble friend Lady Ritchie stated. Can the Minister say what planning the department is undertaking to ensure that we use this generation’s success to inspire the next generation of epidemiologists and what investment it is planning to do this? How is he working with colleagues in other relevant departments to ensure this is possible? As I am sure noble Lords have gathered, this is an issue I feel very passionately about. I look forward to hearing the Minister’s response to this debate.