Meningitis B Vaccine

Catherine McKinnell Excerpts

Monday 25th April 2016 Westminster Hall

[Ben Howlett]

I thank the hon. Gentleman for his intervention. He is quite right to pick up on the fact that the long-term costs to families need to be taken into account when the JCVI makes its decision about whether to extend vaccinations; I will come on to that issue later. It is quite clear that without the support of many of our constituents—those who fundraise and do so much work to help support families in need—those families would be in a much more challenging situation.

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

I commend the hon. Gentleman on leading this debate. He gave the very powerful constituency example of Harmonie-Rose. We heard evidence from the parents of Faye Burdett, who made it very clear how fast the disease can strike, and how vital it is that meningitis is treated as quickly as possible to minimise damage. Does the hon. Gentleman agree that, as we heard in evidence, children under the age of five have difficulty communicating the symptoms that they are experiencing, and that is one of the factors that should be taken into account very carefully when considering extending the vaccination programme to those in that age group? They cannot communicate, which delays the delivery of the medical treatment that they so vitally need.

[Ben Howlett]

I thank the hon. Lady for her intervention, and I agree. Without giving away what I am about to say, I think that the evidence is quite clear on that, and I hope that the JCVI will look at that in due course. The fact is that Harmonie-Rose and many other children see their lives dramatically changed, or even cut short, by this tragic and awful disease, and it is time that we did something about it, here and now.

The petition that led to the debate was started by Lee Booth, who was told that his eight-month-old child was too old to qualify for the meningitis B vaccine. Lee was quite rightly uneasy about that, as the group most susceptible to contracting the disease are babies under the age of one. I am sure that we were all pleased when the Government made the unprecedented announcement that from September 2015 all newborn babies would be given the vaccine, making the UK the first country in the world to make that provision.

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[Ben Howlett]

I met GlaxoSmithKline and we had a conversation on the issue. There needs to be a long-term conversation in the here and now with GlaxoSmithKline about the pricing of a catch-up programme. We heard an awful lot of evidence about that, and JCVI needs to take it into consideration. As part of that, I lend my support to those campaigning for a full review of the cost-effectiveness methodology for immunisation programmes and procurements, or CEMIPP, its understanding of life benefit, and what it takes into consideration when making a judgment call on life benefit. That has a huge impact on how JCVI makes its decisions. I hope that a review would have a wider benefit for all those children who might be put at risk.

From September 2017, we will start to receive information from the current vaccination programme of babies under the age of one, and we can begin to assess the success of the new approach. In September 2016, we will get early preliminary data on the early introduction of the vaccine. That will hopefully help JCVI readdress its decision on extending the vaccine to those aged up to five. As the UK is the first country to use the meningitis B vaccine, it is understandably difficult to predict its effects when administered on a large scale. The data will be incredibly useful in helping to formulate a plan from September 2017, but it is important to remember that while we sit waiting for the data, children are contracting the disease, with life-changing consequences. Sadly, in some cases they are dying. Families going through that trauma will not be comforted by the fact that from 2017 we will have a better idea of what to do.

It is the opinion of many research organisations that while we wait for the data, we should prioritise protecting the most vulnerable from contracting the disease through a one-off catch-up programme for children under the age of five. They are the age group at the next highest risk of meningitis B infection. That one-off campaign would put many minds at ease and help the future eradication of the disease. The current vaccine only has a two-year shelf life, so it makes sense for the UK to use the vaccines while it can, to catch all those under the age of five. The evidence that we heard showed that the number of cases falls substantially after the age of five. While it is always uncomfortable to set a cut-off age, that would be a sensible one to introduce in the here and now.

At the heart of every successful immunisation campaign is uptake of the offer. Information shows that uptake for the under-ones is strong; that is unsurprising given what the papers are publishing, and the sad stories of families who have suffered the devastating effects of their child contracting the disease. We must ensure that uptake is continually high and does not negatively affect the uptake of any other vaccinations, especially if a one-off catch-up programme is undertaken.

[Catherine McKinnell]

This is an opportune moment to highlight one of the other points that came out of the evidence we took in Committee: while vaccination is vital, public awareness is a huge concern for everyone. It is not only parents who need the best possible awareness of the symptoms; medical staff need it, too. Perhaps that awareness is not high enough. It would be good to hear from the Minister what the Government will do to ensure that public awareness and awareness among medical personnel is the best it can be, to ensure that the disease can be treated as quickly as possible.

[Ben Howlett]

We both heard the evidence that we need to increase awareness of meningitis B. Just because someone has had the vaccination, it does not mean that they are 100% certain not to contract the virus. We have to ensure wider awareness, not just among clinicians, but in nurseries and schools. That will ensure that the issue is higher up their agenda. I have seen some of the highly successful campaigns run by the Department of Health, and I hope we can support the Department in pushing more of those campaigns in the future.

We heard evidence about the importance of vaccinating young children, but Meningitis Now and the Meningitis Research Foundation point out that vaccinating teenagers could be the key to protecting the whole population from meningitis B, knocking out the infection at source before it can spread. That is because teenagers may be responsible for a high proportion of disease carriage. During our evidence sessions, we discussed at length the evidence to back that up. Vinny Smith, the chief executive officer of the Meningitis Research Foundation, explained that the bug lives in the noses and throats of people, particularly teenagers, but it does not live in everybody. The idea is that the key carrier group is targeted with a vaccination campaign that would hopefully protect the most at risk groups.

That targeted immunisation programme could be the solution when it comes to eradicating the disease. However, in-depth research has not yet been done on how effective that would be. It is hoped that the programme would severely reduce contraction of the disease, but it is unclear. What is clear is that a better understanding is at least three years away. We need to get the research process started as quickly as possible. It could benefit those young children who have not been vaccinated by reducing the chances of exposure. It is clearly too soon to advocate the immunisation of all teenagers, given that evidence is still unclear about the effects of immunisation beyond prevention in adolescents. When the research process is under way—I repeat that I hope it starts sooner, rather than later—a short-term option would be to extend the vaccination programme to under-fives who are at a higher risk of contracting the disease.

GlaxoSmithKline, which produces the vaccine, has said that it is prepared to work with the Government to ensure that there are enough vaccines for the catch-up period. The company will be under pressure from other nations looking to focus on their vaccination programmes. The Government need to place an urgent and vocal emphasis on vaccinations, as well as prevention. They would be an important voice in encouraging vaccination producers to have greater confidence in investing in the UK. All the families in the UK who want the reassurance a vaccination would bring would much rather we had a stockpile of vaccinations used in a one-off catch-up programme than for our country to miss out because we were slower on the uptake than our competitors. I hope that the urgency of the discussion is at the forefront of the Minister’s mind.

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[Helen Whately]

I completely agree with my hon. Friend and neighbour in Maidstone. I know she has been contacted by many of her constituents about this issue. We need to ensure that the formula used to calculate whether the vaccine should be introduced includes things such as peace of mind and the level of fear about meningitis. It should also take into account the public preference for protecting children from illness.

[Catherine McKinnell]

The hon. Lady is making an important point. My understanding—I would be grateful if the Minister would clarify this in her response—is that in calculating the cost-effectiveness of the meningitis B vaccination, the JCVI has not fully considered the potential outcome for those children who contract meningitis but survive and the long-term costs for them and their families for the rest of their lives. Such costs are often borne by the state, so, along with the factors that the hon. Lady is outlining, there are other financial costs that have perhaps not been considered fully.

[Helen Whately]

I thank the hon. Lady for that comment. We may well hear from the Minister that some of those extra costs have been taken into account, but when the Select Committee took evidence a few weeks ago we heard from the Meningitis Research Foundation and others that the cost-effectiveness model tends to privilege near-term costs over long-term costs and benefits. It does not look at the long-term lifetime health impacts, positive or negative, from a person having had or not had meningitis.

That brings me to something called the discount rate, which is applied at 3.5%. I have been told that, as a result of that discount rate, the benefits of a vaccine reach zero by the time somebody is 27. People clearly live for much longer than that, so is enough account being taken of the long-term benefits of a vaccination programme when cost-effectiveness is calculated? For instance, it has been calculated that if a 1.5% discount rate were used instead of the 3.5% rate, the answer would be different and a catch-up programme for under-fives would be cost-effective. The NICE guidance states that a 1.5% discount rate can be applied if health benefits would be attained over long periods and for public health interventions. Surely vaccinations should fall under those categories?