Covid-19: Vaccination of Children

Chris Green Excerpts

Tuesday 21st September 2021 Westminster Hall

[Miriam Cates]

I agree with my hon. Friend: there are some very difficult issues around parental consent and the vaccine, and whether any child can know enough about the potential benefits and risks. This is going to be a very difficult question for schools, health authorities and parents. I will say more about that later on.

[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.

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[Chris Green]

Does my hon. Friend recognise that the Government, in their approach to lockdown, are creating some of the problems they believe make the situation worse? Weight Watchers and other organisations have said that people coming to them have put on an average of about 6 to 8 lb in weight, and are therefore physically more vulnerable now to covid and other health problems than they were before the pandemic.

[Miriam Cates]

My hon. Friend is absolutely right and I am sure we can all empathise with those who have put on some lockdown pounds. A study, I think last week, showed that countries where over 50% of the adult population is overweight have experienced 10 times the death rate. A really effective way of reducing our risk in future would be to divert some of the money we are spending on testing asymptomatic people into drives against obesity and for exercise. That is an excellent point.

Even now, as adults, we are able to move freely from home to work, to Parliament and to the pub with no restrictions, yet children are still subject to asymptomatic testing, and many are being forced to wear masks in school and are missing out on important opportunities. We cannot expect our children to face greater restrictions than we ourselves are willing to bear. As a mother, I have despaired as I have watched the impact of those restrictions on my children and others. The stories that I have heard from constituents, particularly the parents of disabled children and those with additional needs, are horrifying. Millions of families have had to endure this. I pay tribute to UsforThem, which is working tirelessly to stand up for children and campaign for their lives to be allowed to return to normal.

What has saddened me most is the negative attitude to children that seems to have pervaded so much of our public discourse—especially the view that teenagers have behaved irresponsibly throughout the pandemic. That view is just not borne out by evidence. A study by King’s College London shows that, despite half of adults saying that young people have been selfish by ignoring restrictions, all age groups have been “remarkably compliant” and perceptions of selfishness are driven by “fake stereotypes”.

We seem to have forgotten what it means to be a child. We have forgotten that playing with other children, taking risks, feeling valued and enjoying physical contact with others are vital to healthy development. As a society, I fear that we are becoming a bit like Grandma from Roald Dahl’s “George’s Marvellous Medicine”:

“‘You know what’s the matter with you?’ the old woman said, staring at George over the rim of the teacup with those bright wicked little eyes. ‘You’re growing too fast. Boys who grow too fast become stupid and lazy.’

‘But I can’t help it if I’m growing fast, Grandma,’ George said.

‘Of course you can,’ she snapped. ‘Growing’s a nasty childish habit.’”

Things did not end well for Grandma, and things do not bode well for us if we fail to understand the nature and importance of childhood. Children are not disease spreaders, they are not a buffer for our healthcare system, and they are not an economic inconvenience. They are a blessing, they are our hope for the future, and their nurture and welfare should be our primary responsibility.

I am heartened by the care that has so far been taken by the JCVI, the chief medical officer and Ministers to reassure children and parents about the decision to vaccinate our young people, but looking forward we must recommit to putting the genuine and long-term interests of our youngest and most vulnerable citizens at the front and centre of policy making and prioritise their welfare as we recover from the pandemic.

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[Chris Green (Bolton West) (Con)]

It is a pleasure to follow the hon. Member for Strangford (Jim Shannon), who made so many important points. I also appreciate and thank my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates) for leading on the debate; I know many people right across the country are grateful for it, because this is an area of immense concern as their children are being vaccinated or not, as the case may be.

The country has gone through a difficult time over a long period. Who would have thought in March last year that we would be in this position now, debating whether 12-year-olds would be vaccinated to deal with this disease? At the beginning, there was very little certainty or scientific understanding of what we were facing. The scientific understanding has carried on apace; there has been a huge global effort to increase it, and on the medical side there has been a huge advance in how we treat people.

Covid is far less dangerous now than it was at the beginning, and we need to be clear about that, including when we look at the Government’s statistics on how deaths and other concerns are presented. To this day, they still show the overall death rate as including those deaths in the first and second waves. That makes us believe that we have not rolled out an effective vaccines programme and that doctors and people in hospitals are not far more effective at treating the disease itself. We are in a far better position, and that must be more clearly understood.

Initially, in January this year and December last year, the vaccine roll-out was pitched as protecting the most vulnerable: those who are old and those who have particular health challenges. Then, before we knew it, the ages were coming down and down. We got to age 18, and at the same time it was not a single vaccination, but a double vaccination that would give people the necessary protection. Now we are in the position of giving a booster vaccination to people in the near future. Initially it is being proposed for the over-50s, but will that come down as well?

The point I am making is that we have not been given any certainty over what the Government and their advisers deem to be success. It seems as though, because the system has not been given clarity about what success is, it carries on and on and the next group, the next group and the next group receive the vaccination. However, we know that in the first and second waves the connection between transmission, hospitalisation and death was strong. We know from Government data that, in the third wave, the connection between transmission, hospitalisation and death is fundamentally broken; it is nothing compared with what it was at the beginning. Our approach to covid therefore ought to reflect those facts.

[Sir Desmond Swayne (New Forest West) (Con)]

I recall the pervasive disapproval that attached to my family when my children were at school and it became apparent that my wife was refusing to use the powerful chemical solution for the control of nits. When we come to schools being collectively vaccinated, the decision of some parents or children not to be vaccinated will undoubtedly be a matter of common knowledge—there is certainly the danger of that. Does my hon. Friend share my concern that it will be difficult to prevent that general disapproval and all that may flow from it from being attached to parents or children who have decided not to be vaccinated?

[Chris Green]

My right hon. Friend makes exactly the right point. In school settings, it will be incredibly difficult to do this, and it will be variable. It will depend on the culture of the school and the school leadership. Some schools will be open and objective, and will say, “We will respect you, the family, for the decisions you make on behalf of your family,” but I am pretty certain that other schools will have a very difficult and challenging atmosphere for those 12-year-old children and their families if they do not comply.

I think that is a very dangerous route for us to go down and will cause so much pressure. That leads on to an immensely important point. Traditionally in the United Kingdom, our approach to vaccinations has been one of non-compulsion. Our vaccination take-up across the board has been very high because people trust the vaccination programme and that these things, which we can take voluntarily, are there for our own good. We do not need coercion to take them; they are there for our good so we will take them. What repercussions will we face in years to come now that there is a toxification due to the imposition of these vaccines?

What, furthermore, do we see? We see that the first and second waves had a huge impact on us, but the third wave is far less impactful. All our vaccines are effective against all variants of concern. We see compulsory vaccination in the care sector, no doubt shortly to be rolled out into the national health service, and therefore after that to other sectors in society. We see the establishment of the idea of vaccine IDs and domestic ID cards. There is a pause at the moment in England, but those causes are being advanced in Scotland and Wales. In many ways, we can objectively say that we are almost through the worst of the pandemic, yet the more draconian or authoritarian measures are being introduced at this stage. It is perverse.

[Miriam Cates]

My hon. Friend is making an excellent speech. He makes a very good point about trust in vaccinations, because we have an outstanding system of child vaccinations in this country, with very high uptake and no compulsion at all. That is predicated on the fact that parents know that those vaccines are without doubt in their children’s best interests. Polio, measles and all those other diseases are child killers and life-altering. Even if the risks are low, they are considerably higher than the vaccine. Therefore, understanding and trust are vital. Does he agree that it is very important to have transparency around the concerns now so that parents make a free decision and it does not impact on the outstanding roll-out of other vaccines that are very much in our children’s best interest and vital for continued public health?

[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.

[Andrew Lewer (Northampton South) (Con)]

Thank you for chairing this debate, Dame Angela. I thank my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates) for securing a debate on this immensely important topic and for speaking so convincingly.

Despite what has been said, the JCVI’s recommendation on the mass vaccination of children aged 12 to 15 is clear. “The margin of benefit” in vaccinating healthy 12 to 15-year-olds is “too small” to support such a policy. That was the conclusion reached when the question was asked, as it should be in the case of medical decisions, about what would be in the best interests of our children’s health.

Throughout the pandemic we have continually been told of the importance of following the science. I warmly welcome my hon. Friend the Member for Erewash (Maggie Throup) to her ministerial position, but will she explain why we are now disregarding the science and the experts who clearly said that it is not necessary nor advisable on the basis of the evidence we have for that cohort to receive a covid-19 vaccine? Given “fake news”, some people seize on any lack of clarity or inconsistency to be anti-vax, which I am not, and that is a real risk when the Government override trust, as my hon. Friend the Member for Bolton West (Chris Green) delineated so well.

If it is because of extraneous factors that have been mentioned in recent days, such as protecting children’s mental health and ensuring they miss no more school, it must be said that both of those problems have their root in Government decision making. School closures are a political choice. Testing regimes are at the bureaucratic insistence of the Department for Education. The fear that some children might have of dying from covid-19 has come from a created climate of fear, because the evidence shows that both children who are perfectly healthy and those who have underlying health conditions face a mortality rate from covid-19 of two in every 1 million. Children are therefore not at risk of death or serious illness from covid-19. In fact, most children are asymptomatic or experience a mild illness. Given that most vaccines do not prevent transmission and that those most at risk due to age or underlying health conditions have been double-vaccinated, this recommendation is not only unnecessary, but could be dangerous. We should be protecting our children and not taking unnecessary risks with their health in favour of some vague notion of perceived benefit to wider society.

[Chris Green]

Does my hon. Friend share my concern that initially the Government’s perspective was that we need a double vaccination for both protection and longevity of protection, yet 12 to 15-year-olds will receive only one dose, giving them relatively short-term protection? That is not consistent with the general stated aims of the vaccine programme.

[Andrew Lewer]

My hon. Friend very capably highlights yet another inconsistency. It is important to remember that any child who gets seriously ill or, heaven forbid, dies from a vaccine does so because of a policy decision and not a disease.

Turning to parental responsibility, many constituents who are parents have expressed their deep unease at the Government’s recommendation, and even more so that under the ill-advised Gillick principle children will be able to consent to taking the vaccine against their parents’ wishes. The Gillick principle has been cited as something that is set in stone and could never be changed, and as a sort of legal precedent as if this House, which exists to make law, could not override it, as many other things have been overridden apparently quite straightforwardly in the last couple of years.

The Gillick principle—it is unfortunate it is named after her given her background—means that children will be able to consent to taking the vaccine against their parents’ wishes. It has long been accepted in this country and in the thinking of my political background and heritage that children under the age of 18, and certainly under 16, should be the responsibility of their parents, that they should be guided and protected by them, and that parents, as adults, will make decisions in the best interests of their children. Only in exceptional circumstances should agents of the state interfere in that relationship and override a parent’s wish for their child.

I am deeply concerned by the increasing trend away from the Gillick principle. Just last week, we saw the High Court hand down a deeply concerning judgment that children under the age of 16 will be able to consent to taking puberty blockers without the need for parental permission. We are descending rapidly down a slippery slope. It is a mistake to allow children to circumvent parental control, especially when the long-term consequences of the vaccines are not yet clear. There has been limited research and data collected on the efficacy and safety of these vaccines for children.

I have been contacted by local teachers in my constituency of Northampton South who are receiving concerned emails from parents accusing schools of implementing this policy. I want it to be clear that this is a Government proposal and schools will have no liability in carrying out injections. I also want clarification from the Minister that vaccines will not be administered by school staff.

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[The Parliamentary Under-Secretary of State for Health and Social Care (Maggie Throup)]

I thank my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates) for securing this important and timely debate on the vaccination of 12 to 15-year-olds against covid-19. She quite rightly highlighted the importance of vaccine roll-outs and the programmes that we have had for many decades, and I thank her for that.

Before I respond to the various questions and points raised by hon. Members, I pay tribute to my predecessor, my right hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), for his efforts in successfully delivering the vaccine programme, with more than 93 million doses administered in the UK and more than four fifths of adults receiving the protection of two jabs. I aim to build on that very solid foundation in my new role.

I also put on record that I am very grateful to everyone who has played a crucial role in the success of the vaccine roll-out, from our brilliant scientists, clinical trial participants, the armed forces, NHS England, frontline healthcare workers, vaccine volunteers and local and central Government. Our jabs have already prevented more than 112,000 deaths, 230,000 hospitalisations and more than 24 million infections. They have built a vast wall of defence for the British people.

Earlier this year, our medicines regulator, the MHRA, approved the Pfizer and Moderna vaccines for 12 to 17-year-olds. The MHRA authorisation decision confirmed that vaccines are safe and effective for this age group. On this decision, the Joint Committee on Vaccination and Immunisation recommended vaccination for 12 to 15-year-olds with serious underlying health conditions. In August, the committee advised an initial dose of the vaccine for all healthy remaining 16 and 17-year-olds. The JCVI then looked at whether we should extend our offer of vaccination to all 12 to 15-year-olds. It concluded that there are health benefits to vaccinating this cohort, although they are finely balanced.

However, the JCVI’s remit does not include the wider impacts of vaccinations, such as the benefits for children in education or the mental health benefits that come from people knowing that they are protected from this deadly virus. The JCVI therefore advised that the Government might wish to seek further views on those wider impacts from the UK’s chief medical officers across all four nations. The Secretary of State and the Health Ministers from the devolved nations accepted that advice. Our CMOs consulted clinical experts and public health professionals from across the United Kingdom, such as those from the Royal College of Paediatrics and Child Health. I trust that that reassures my hon. Friend the Member for Northampton South (Andrew Lewer), who raised concerns about professional advice.

We received advice from the four chief medical officers, and it was made publicly available and deposited in the Library for Members to read in full. The unanimous recommendation of the UK’s chief medical officers is to offer all remaining 12 to 15-year-olds a first dose of the Pfizer vaccine, with further JCVI guidance needed before any decision on a second dose. The CMOs have been clear that they make this recommendation based on the benefits to children alone, not on the benefits to adults or wider society.

I can confirm that the Government accepted this recommendation. We are now moving forward with the same sense of urgency that we have had at every point in our vaccination programme. I am delighted that a 14-year-old in Essex yesterday became one of the first children in the country to receive a covid-19 vaccination in school.

[Chris Green]

Will my hon. Friend set out exactly why it is recommended for adults to have two doses and perhaps later a booster dose of the vaccine, but for children it is a single dose?

[Maggie Throup]

I thank my hon. Friend for his intervention, and I reassure him that the evidence is continually being observed and recorded. Further advice will be taken on whether a second dose is needed for the younger age range. Evidence is being gathered all the time.

I appreciate that there are questions about how the process of consent will work in circumstances where parents and children disagree. I reassure my hon. Friend the Member for St Ives (Derek Thomas) that, as with all vaccinations for children, parental consent will be sought. The consent process is being handled by each school in its usual way and provides sufficiently for parents to give their consent. Children aged 12 to 15 will also be provided with information, usually in the form of a leaflet for their own use and to share and discuss with parents prior to the date on which the immunisation is scheduled.

Parental, guardian or carer consent will be sought by the school age immunisation service prior to vaccination, in line with other school vaccination programmes. That service will carry out the vaccinations, and I trust that that reassures my hon. Friend the Member for Northampton South. The school age vaccination service has vast experience of dealing with a number of other vaccine roll-outs in secondary schools, such as the human papillomavirus vaccine and the three-in-one teenage booster that protects against tetanus, diphtheria and polio. The clinicians who work on these roll-outs are very well equipped and very well versed in dealing with vaccines in schools.

In their advice, the four CMOs have said it is essential that children and young people aged 12 to 15, and their parents, are supported in whatever decisions they take, and that they are not stigmatised for accepting or not accepting the vaccination offer. Individual choice should be respected. It is the opportunity to be vaccinated that is on offer, in a fair and equitable manner.

To those who remain undecided, I say this. The MHRA is the best medical regulator in the world. It has rigorously reviewed the safety of our vaccines, and it only authorises those that it concludes are safe. Vaccines for children and young people are no exception. We continue to have a comprehensive safety surveillance strategy in place across all age groups to monitor the safety of all covid-19 vaccines that are approved for use in the UK.

I will now address some of the interventions and questions from hon. Members. My hon. Friend the Member for Penistone and Stocksbridge asked a number of questions. I reiterate that the CMOs sought advice from experts in the field; it was not just the information they had themselves. It is only right that, based on that advice, 12 to 15-year-olds are able to take up the offer of the vaccine in a fair and equitable manner.

My hon. Friend asked about disruption to education from the programme. NHS England already has plans in place for the mop-up programme, which is not likely to be on school sites, to minimise disruption to education and the rest of the immunisation programme.

[Maggie Throup]

I thank my hon. Friend for that intervention. It is important that we do whatever we can—use whatever we have in our toolbox—to make sure that children are able to continue with their education, and vaccination is one part of that. I know my hon. Friend is passionate, as am I, about making sure that children get a full education, and that the pandemic does not affect their futures. My hon. Friend raised several other questions and, if she will allow me, I will write to her in response to any I do not answer in my speech.

My hon. Friend the Member for Lincoln (Karl MᶜCartney) raised questions about guidance for schools on the vaccination programme. How the programme will work has been set out very clearly, including in the formation of the consent process, most recently updated on 17 September 2021. I would like to reassure my hon. Friend, who highlighted the three words “do no harm”, that robust monitoring arrangements are in place for the vaccination of 12 to 15-year-olds, and that further data will be available shortly.

I join the hon. Member for Leicester West (Liz Kendall) in absolutely condemning the threats and intimidation of headteachers, school staff and anybody who enters school premises. That is a big issue, and my advice is that headteachers who have received such intimidation should rapidly contact the school age immunisation service, which is well versed in addressing it. They should not be afraid to speak to the police and the local authority too. I assure her that that issue is extremely high on my priority list, which, as she can imagine, is getting longer.

It is important that we remember that our teenagers have shown great public spirit at every point during the pandemic, and I thank them for that. They have stuck to the rules so that lives can be saved and people kept safe, and they have been some of the most enthusiastic proponents of vaccines.

[Chris Green]

Certain drug companies are now looking to get approval for vaccinations for five-year-olds. Does the Minister rule that in or out in the United Kingdom?

[Maggie Throup]

My focus at the moment is on ensuring the effective roll-out of the programme for 12 to 15-year-olds. We must ensure that the booster programme is rolled out effectively, and encourage the last few people who have not yet had the vaccine—I think it is about 5 million—to take up that offer.