Asked by: Jessica Toale (Labour - Bournemouth West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when the Joint Committee on Vaccination and Immunisation last reviewed the cost-effectiveness model for providing the Meningitis B vaccine to teenagers; and whether his Department plans to commission an updated model.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
In 2013, the Joint Committee on Vaccination and Immunisation (JCVI) advised that the cost-effectiveness of an adolescent Meningitis B (MenB) vaccination programme would be dependent on the impact of the vaccine on protection against meningococcal carriage, which was uncertain at the time. Since this advice was published, the JCVI has continued to review the MenB vaccination programme. Recent evidence, discussed by the JCVI meningococcal sub-committee in March 2025, indicated that MenB vaccination in adolescents has little to no effect on meningococcal carriage.
The sub-committee noted that when available, they would like to review a model evaluating the impact of MenB vaccine when given in a teenage programme in a two-dose schedule, including impact on meningococcal disease and gonorrhoea.
Asked by: Jessica Toale (Labour - Bournemouth West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department has made an assessment of the potential merits of extending routine NHS vaccination against Meningitis B to teenagers and first-year university students.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Policy regarding vaccination programmes is based on advice from the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI keeps all vaccination programmes under review, and the meningococcal sub-committee have met a number of times over the past year to discuss the meningococcal vaccination programme. The minutes of all JCVI meetings are available at the following link:
In 2013, the JCVI advised that the cost-effectiveness of an adolescent Meningitis B (MenB) vaccination programme would be dependent on the impact of the vaccine on protection against meningococcal carriage, which was uncertain at the time. Recent evidence considered by the meningococcal sub-committee indicates that MenB vaccines do not protect against carriage of meningococcus serogroup B in adolescents.
The sub-committee noted that when available, they would like to review a model evaluating the impact of the MenB vaccine when given in a teenage programme in a two-dose schedule, including the impact on meningococcal disease and gonorrhoea.
Adolescents remain eligible for the MenACWY vaccine until their 25th birthday.
Asked by: Jessica Toale (Labour - Bournemouth West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment his Department has made of trends in the level of Meningitis B cases among teenagers and university students; and what steps he is taking to help reduce that level.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The UK Health Security Agency continually monitors the incidence and profile of invasive meningococcal disease (IMD) in England across all age groups to provide information to the Joint Committee on Vaccination and Immunisation to help inform policy decisions.
The United Kingdom has a world-leading meningococcal vaccine programme, and we were the first country to introduce a national Meningitis C (MenC) vaccine programme in 1999 and an infant programme targeting Meningitis B (MenB) disease in 2015, the year in which the teenage MenACWY vaccination was also introduced.
Cases of IMD in England have fallen from over 2,500 in 1998/99, before the first routine meningococcal vaccination against MenC, was introduced, to 378 cases in 2024/225. The MenACWY vaccine also stops carriage and transmission. With this high population-level control of MenACWY disease, MenB disease accounted for 313 of the 378, or 83% of, cases in 2024/25.
MenB remains rare but is now the leading cause of meningococcal disease in all age groups in England, including teenagers and young adults. Further information for the 2024 to 2025 epidemiological year, running from July 2024 to June 2025, is available at the following link:
Asked by: Jessica Toale (Labour - Bournemouth West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential implications for his policies of (a) the CDC guidance in the US and (b) other international models for management of Diethylstilbestrol exposure.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department has not undertaken any specific assessment of the potential implications for its policies of guidance by the Centers for Disease Control and Prevention of the United States or other international models for the management of exposure to diethylstilbestrol.
The Department works closely with various expert United Kingdom bodies, recognised and widely respected internationally for their excellence, and bases policies on evidence provided by national authorities such as the National Institute for Health and Care Excellence.
Asked by: Jessica Toale (Labour - Bournemouth West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what guidance is available to clinicians for patients with a family history of diethylstilbestrol exposure.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government encourages all women, including those exposed to diethylstilbestrol (DES) in utero, to attend regular cervical screenings which test for human papillomavirus, the cause of most cervical cancers. Women who believe or know that they were exposed to DES in utero may also need regular colposcopy which falls outside the routine screening programme. We recommend that they should speak to their general practitioner about this as local arrangements should be made for the follow up of women who display evidence of DES exposure. Further information regarding individuals exposed to DES is contained within the cervical screening guidance for the National Health Service, at the following link:
My Rt Hon. Friend, the Secretary of State for Health and Social Care, has asked NHS England to work with local cancer alliances to ensure that providers are aware of this existing screening and follow up guidance for individuals exposed to DES, and that those who could benefit from additional screening have access to this.
The National Institute for Health and Care Excellence (NICE) is the national body that develops authoritative, evidence-based guidance for the NHS on best practice in the care and treatment of patients with defined conditions. NICE has not issued any guidance on the diagnosis and management of patients potentially exposed to DES and it currently has no plans to do so. Decisions on the development of new topics for NICE guidance are taken by the NICE prioritisation board, chaired by its Chief Medical Officer, in line with its published prioritisation framework.
Asked by: Jessica Toale (Labour - Bournemouth West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to issue updated clinical guidance on diethylstilbestrol (DES) exposure to (a) general practitioners, (b) gynaecologists and (c) oncologists.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government encourages all women, including those exposed to diethylstilbestrol (DES) in utero, to attend regular cervical screenings which test for human papillomavirus, the cause of most cervical cancers. Women who believe or know that they were exposed to DES in utero may also need regular colposcopy which falls outside the routine screening programme. We recommend that they should speak to their general practitioner about this as local arrangements should be made for the follow up of women who display evidence of DES exposure. Further information regarding individuals exposed to DES is contained within the cervical screening guidance for the National Health Service, at the following link:
My Rt Hon. Friend, the Secretary of State for Health and Social Care, has asked NHS England to work with local cancer alliances to ensure that providers are aware of this existing screening and follow up guidance for individuals exposed to DES, and that those who could benefit from additional screening have access to this.
The National Institute for Health and Care Excellence (NICE) is the national body that develops authoritative, evidence-based guidance for the NHS on best practice in the care and treatment of patients with defined conditions. NICE has not issued any guidance on the diagnosis and management of patients potentially exposed to DES and it currently has no plans to do so. Decisions on the development of new topics for NICE guidance are taken by the NICE prioritisation board, chaired by its Chief Medical Officer, in line with its published prioritisation framework.
Asked by: Jessica Toale (Labour - Bournemouth West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to update NHS clinical reference materials or NICE guidelines to include information on the diagnosis, management, and screening of patients potentially exposed to Diethylstilbestrol.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is the national body that develops authoritative, evidence-based guidance for the NHS on best practice in the care and treatment of patients with defined conditions. NICE has not issued any guidance on the diagnosis and management of patients potentially exposed to diethylstilbestrol (DES) and it currently has no plans to do so. Decisions on the development of new topics for NICE guidance are taken by the NICE prioritisation board, chaired by its Chief Medical Officer, in line with its published prioritisation framework.
The current advice from the UK Health Security Agency, formerly Public Health England, is that routine cervical screening is appropriate for those who believed they were exposed to DES in utero. Further information on the UK Health Security Agency’s advice is available at the following link:
Participation in the National Breast Screening Programme is also recommended. Pregnant women who know that they were exposed in utero to DES should inform their obstetrician and be aware of the increased risks of ectopic pregnancy and preterm labour.
Asked by: Jessica Toale (Labour - Bournemouth West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential third-generation health impacts of Diethylstilbestrol exposure; and whether specific research has been commissioned to examine those impacts on fertility, pregnancy outcomes, and cancer risk.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government encourages all women, including those exposed to diethylstilbestrol (DES) in utero, to attend regular cervical screenings which test for human papillomavirus, the cause of most cervical cancers. Women who believe or know that they were exposed to DES in utero may also need regular colposcopy which falls outside the routine screening programme. We recommend that they should speak to their general practitioner about this as local arrangements should be made for the follow up of women who have the stigmata of DES exposure. Further information regarding individuals exposed to DES is contained within the cervical screening guidance for the National Health Service, at the following link:
My Rt Hon. Friend, the Secretary of State for Health and Social Care has asked NHS England to work with local cancer alliances to ensure that providers are aware of this existing screening and follow up guidance for individuals exposed to DES.
Furthermore, where appropriate, my Rt Hon. Friend, the Secretary of State for Health and Social Care is considering how the Department may be able to share awareness of this issue with colleagues from across the Government who are responsible for related areas of chemical and environmental health policy, with a view to minimising future public health risks.
There are no plans by the Department to undertake an assessment of the potential impact of DES exposure on the long-term or intergenerational health of people in the United Kingdom.
The Department invests over £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR). While no research has been commissioned into the health outcomes of people exposed to DES in utero, the NIHR would welcome high quality funding applications in this area. Further information on the scope of research funding calls is available on the NIHR website.
Asked by: Jessica Toale (Labour - Bournemouth West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to raise awareness among healthcare professionals of the long-term health risks associated with in utero exposure to diethylstilbestrol.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government encourages all women, including those exposed to diethylstilbestrol (DES) in utero, to attend regular cervical screenings which test for human papillomavirus, the cause of most cervical cancers. Women who believe or know that they were exposed to DES in utero may also need regular colposcopy which falls outside the routine screening programme. We recommend that they should speak to their general practitioner about this as local arrangements should be made for the follow up of women who have the stigmata of DES exposure. Further information regarding individuals exposed to DES is contained within the cervical screening guidance for the National Health Service, at the following link:
My Rt Hon. Friend, the Secretary of State for Health and Social Care has asked NHS England to work with local cancer alliances to ensure that providers are aware of this existing screening and follow up guidance for individuals exposed to DES.
Furthermore, where appropriate, my Rt Hon. Friend, the Secretary of State for Health and Social Care is considering how the Department may be able to share awareness of this issue with colleagues from across the Government who are responsible for related areas of chemical and environmental health policy, with a view to minimising future public health risks.
There are no plans by the Department to undertake an assessment of the potential impact of DES exposure on the long-term or intergenerational health of people in the United Kingdom.
The Department invests over £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR). While no research has been commissioned into the health outcomes of people exposed to DES in utero, the NIHR would welcome high quality funding applications in this area. Further information on the scope of research funding calls is available on the NIHR website.
Asked by: Jessica Toale (Labour - Bournemouth West)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of diethylstilbestrol exposure on the (a) long-term and (b) intergenerational health of people in the UK.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government encourages all women, including those exposed to diethylstilbestrol (DES) in utero, to attend regular cervical screenings which test for human papillomavirus, the cause of most cervical cancers. Women who believe or know that they were exposed to DES in utero may also need regular colposcopy which falls outside the routine screening programme. We recommend that they should speak to their general practitioner about this as local arrangements should be made for the follow up of women who have the stigmata of DES exposure. Further information regarding individuals exposed to DES is contained within the cervical screening guidance for the National Health Service, at the following link:
My Rt Hon. Friend, the Secretary of State for Health and Social Care has asked NHS England to work with local cancer alliances to ensure that providers are aware of this existing screening and follow up guidance for individuals exposed to DES.
Furthermore, where appropriate, my Rt Hon. Friend, the Secretary of State for Health and Social Care is considering how the Department may be able to share awareness of this issue with colleagues from across the Government who are responsible for related areas of chemical and environmental health policy, with a view to minimising future public health risks.
There are no plans by the Department to undertake an assessment of the potential impact of DES exposure on the long-term or intergenerational health of people in the United Kingdom.
The Department invests over £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR). While no research has been commissioned into the health outcomes of people exposed to DES in utero, the NIHR would welcome high quality funding applications in this area. Further information on the scope of research funding calls is available on the NIHR website.