Meningitis B Vaccine

David Winnick Excerpts

Monday 25th April 2016 Westminster Hall

[Mr David Winnick (Walsall North) (Lab)]

It is a pleasure to follow the hon. Member for Bath (Ben Howlett), who has given a comprehensive account of this important subject. The debate was initiated by those who signed the petition, which received more signatures than any other petition that has reached the House of Commons, so it is obviously right and proper that we should have this debate.

I rise to speak about one of my constituents. I want to briefly mention what happened in a tragedy experienced by my constituents Mr and Mrs Timmins, who lost their beloved son, Mason, at the age of seven. Mason had been vaccinated against meningitis C, but in 2013 he tragically contracted meningitis B. The red rashes that I understand are usually associated with this disease did not appear. Mrs Timmins said she heard her son coughing and then he started to be sick. He fell seriously ill that day and, tragically, by midnight he was brain dead.

That day, the parents had rushed their son to the doctor, who immediately recognised that he had meningitis B and gave injections accordingly, and then he was taken to hospital. I do not think there is any criticism of the health service, but Mr and Mrs Timmins, understandably, are of the very strong view that all children should have the meningitis B vaccination. Indeed, Mrs Timmins arranged for her three-year-old daughter to be vaccinated privately. The family are of the view that had Mason had the vaccination earlier, he would have survived. We do not know that—there is no guarantee about anything—but I am speaking because of their strong feeling that that would have been the case.

Afterwards, to publicise what had occurred and so that it would not be a one-off obscure case that no one knew about, the parents released pictures of their son in his final moments, which can be found online. In the circumstances, I believe they were right to do so.

I am not a medical person. I do not have the medical knowledge to know whether what is being urged by Mr and Mrs Timmins and so many other parents is right. I do not know whether the reluctance to give the vaccination is because of cost, so I shall listen carefully to the Minister. However, I do know—I do not think there is any disagreement among Members of Parliament —that if children can be saved from the fate suffered by Mr and Mrs Timmins’ son, action should be taken along the lines that they urge.

So I shall listen carefully to the arguments, but I—and I believe many hon. Members—cannot accept the view that no action should be taken for reasons of cost. The debate is very important. Children have lost their lives and parents are grieving. We want to know what can be done to avoid the situation so tragically faced by my constituents.

--- Later in debate ---

[Jane Ellison]

I am coming to that point, but I thank the hon. Lady for her intervention.

As it stands, on the evidence and advice that I have received, I cannot support extending the men B vaccination programme to older children, but I emphasise that the JCVI keeps under review the evidence relating to all vaccination programmes, and I know that it will consider all the points made in this important debate. If the committee’s advice changes, I will consider it as a priority. The JCVI also keeps the eligibility criteria under review. I wrote to the chair on 17 March this year, following the evidence session with parents, asking the committee to review the cost-effectiveness evidence for one to two-year-olds, which Professor Pollard mentioned in his evidence to the committees. I await formal advice on that. Again, if the JCVI’s advice changes, I will consider it as a priority.

Many of the contributions made by hon. Members in this debate have queried whether the cost-effectiveness methodology used by our experts is right for immunisation programmes. The shadow Minister drew out that point, as did others, including my hon. Friend the Member for Bath (Ben Howlett), who led the debate on behalf of the committees. As some hon. Members said, an independent expert group—the Chair of the Health Committee gave it its full title, but I will call it CEMIPP for ease—is considering the cost-effectiveness methodology for immunisation generally. It includes factors such as peace of mind, cost of long-term social care for surviving children and how prevention is taken into account, all of which have been mentioned in this debate, as well as the issue of discounting.

The CEMIPP review is considering whether current discount rates are appropriate for vaccination in general, and it will report in the summer. I will consider any recommendations on that, although obviously I cannot pre-empt decisions in this debate. As I indicated to the Chair of the Health Committee when she made her contribution, I look forward to receiving the report in the summer. I have committed to publishing the report, and I do so again. If it is of interest, I will also provide the Petitions and Health Committees with a written briefing summarising the report and the Government’s proposed next steps when we get it.

Several hon. Members have expressed concern about whether the research requested by JCVI into whether a men B vaccination programme for adolescents would be cost-effective will take place and how long it might take. I can confirm that a preliminary study of the meningococcal strains carried by teenagers is now under way and will report in February 2017. It will inform a larger study of the effect of men B vaccination in that group. As the Chair of the Health Committee said, it is about exactly how the impact of the larger group would bed down on the impact of the disease in smaller children. I commit to the House to commission the second, wider study following on from the preliminary study now under way on strains.

I recognise that Members have concerns—again, the hon. Member for Central Ayrshire mentioned this issue—about how long the research is taking. I have had extensive discussions about that, because like hon. Members, I want quick answers. However, things are sometimes difficult to weigh in the balance. Robust scientific studies on which long-lasting and important decisions can be taken take time. My scientific advisers have told me that this is a particularly complex study, and that a previous study had inconclusive findings. We want to get this one right and ensure that we have a definitive answer. I am hopeful that this study could start in December 2017. The House has my complete assurance that we will always go with as much speed as we can while maintaining important robustness, so that we reach answers on which evidence-based policies can be made.

Much has been made about the importance of raising awareness and ensuring quick treatment. As many have said, no matter what the nature of the vaccination programme, there will still be cases, and we need to bear that in mind. Many Members have spoken of the reassurance that vaccinations offer and how they set minds at rest; it came out particularly in some of the evidence sessions. Although it is important that it reassures parents, I take this opportunity to underline and stress that vaccination is not a silver bullet. Even with a vaccination programme up to the age of 11, there would still be men B cases in under-11s, as we think that the vaccine covers only about three quarters of all men B strains and no vaccine is 100% effective.

A number of people have made the point, including the hon. Member for Central Ayrshire in an earlier intervention, about understanding the impact of the programme. No other country has introduced a free vaccination programme.

There is as yet no evidence regarding the real-world effectiveness of Bexsero in preventing meningococcal disease in a population—that is different from the safety issue—because, as has been said, incidence is too low for clinical trials to provide a reliable measure of effectiveness.

In response to points made by my hon. Friend the Member for The Cotswolds, I will say that we should have some indication later in 2016 of how effective the vaccine has been. However, establishing an accurate measure of how effective the vaccine is, how long the protection lasts and what proportion of strains it will prevent will take many years of detailed observation by Public Health England, and that clearly will feed into the ongoing review and the important decision-making process that we have. It is worth making that point.

[Mr Winnick]

I go back to what the Minister said a few moments ago. Of course there is no guarantee with vaccination; everyone recognises that. However, my constituents—no doubt she listened when I spoke about my constituents who tragically lost their child—strongly feel that if Mason, their seven-year-old boy who died, had been vaccinated against this disease, he would have lived. To a large extent, that is the essence of the petition, the debate today and the rest of it. To repeat myself, everyone recognises that there is no guarantee, but there is a question of saving lives.

[Jane Ellison]

Of course, and I have tried to reflect on that important point. Nevertheless, raising awareness and ensuring the quick treatment of meningitis will always remain very important for that reason, so parents and healthcare professionals need to remain alert to the signs and symptoms of the disease, as was brought out in the moving speech by my hon. Friend the Member for Bury North (Mr Nuttall) when he talked about the attentiveness of Charlie’s mum as she monitored his symptoms.

Let me tell the House a little about what we are doing to raise awareness among healthcare professionals. Public Health England produces a range of training materials for immunisers, which includes information on the various programmes. It also collaborates with the charities in this area to support their work to improve healthcare worker knowledge, including through the development and distribution of resources aimed at each type of healthcare professional. It runs teaching and training events, and cascades briefing notes through networks. NHS England also does work to provide tools to help GPs to recognise meningitis. A great deal of work is going on in this area, but of course there is always a need to do more.

I turn to the issue of raising awareness among parents, because that is where we can do more. I announce to the House today that I have asked Public Health England to develop a national awareness campaign that will focus on the dangerous infections that parents worry about the most, including meningitis, septicaemia and sepsis. The campaign will focus on the symptoms that parents need to look out for. To get that right, we will work with the appropriate experts and charities, and of course more details will be available in due course. I will look to keep the relevant Committees up to date with that, but it is my intention that this information should be rolled out before the peak of cases in the winter.