Vitamin D: Covid-19

Jo Churchill Excerpts

Thursday 14th January 2021 Commons Chamber

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

I am extremely grateful to my right hon. Friend the Member for Haltemprice and Howden (Mr Davis) for having secured this debate, as well as to the hon. Member for Strangford (Jim Shannon); it would not be an Adjournment debate if he did not play his part.

As we have always said, the Government consistently review the latest data and information on covid-19 as it emerges. This, of course, includes the progress there has been in treatments for those suffering with the virus, as well as preventive measures. I would like to express my thanks to health and care workers and to the scientific community, whose dedication and hard work has made this possible, and I am sure right hon. and hon. Members from across the House will join me in doing so. Over the past months, there have been reports about vitamin D potentially reducing the risk of coronavirus, and I am aware of colleagues’ interest in the relationship between vitamin D and covid-19. I welcome the opportunity to discuss it today because, as my right hon. Friend says, nothing should be taken off the table, and we should be constantly vigilant when it comes to new science and information.

Several nutrients are involved in the normal functioning of the immune system; however, there is currently insufficient evidence that taking vitamin D will mitigate the effects of covid-19. In collaboration with Public Health England and the scientific advisory community on nutrition, NICE has published a rapid guideline on vitamin D in relation to covid-19, which my right hon. Friend mentioned. That data was reviewed by an expert panel and included the best available scientific advice published so far, including both randomised control trials and observational trials. That expert panel supported current Government advice, and the recommendation for everyone to take a 10 microgram vitamin D supplement throughout autumn and winter. However, it concluded that there is not currently enough evidence to support taking vitamin D in order to help, or treat, covid-19. There are still significant gaps in the current evidence, and studies to date have not reached the high level of data quality required to revise the guidance.

I heard what my right hon. Friend said about not wasting time, but as he mentioned, the Spanish study to which he alluded only included 76 participants. The smaller the sample group, the more challenging it can be to draw conclusions about the effect. We are also dealing with very poorly people, with multiple different factors affecting how they are responding and what they are responding to, so it is important to ensure that we can rely on that data. Indeed, there was a good double-blind trial before Christmas that showed no effect. However, there is a large-scale trial currently at Queen Mary University of London. I hope that it will give us some good clarity when it reports later in the year.

The current evidence base is mixed, and dominated by studies that are not always of great quality, with substantial concerns about bias and confounding. At the moment, they are unable to demonstrate that causal relationship between vitamin D and covid-19, because many risk factors for severe covid-19 outcomes are the same as for low vitamin D status. Due to the lack of reliable evidence, the NICE guideline recommends that more research is conducted. Government guidance continues to stress the use of high-quality randomised controlled trials in future studies. There are 70 trials under way in the UK and internationally, including some very high-quality ones that will answer key questions from NICE, Public Health England and the Scientific Advisory Committee on Nutrition, and they are monitoring this new evidence. My right hon. Friend asked for my assurance that we are doing that, and I can give him that.

The long-standing Government advice is that, between October and early March, everyone should take a supplement containing 10 micrograms, or 400 international units, of vitamin D a day. Vitamin D helps to regulate the amount of calcium and phosphate in the body, and protects bone and muscle health. In April and autumn 2020, PHE reiterated its advice. It also ran a marketing campaign throughout December 2020. This had a specific focus on the communities mentioned by my right hon. Friend, in particular the BAME community, for whom vitamin D supplementation is very important. PHE advice to continue taking vitamin D supplements is important for those who are shielding, care home residents and prisoners, as well as for those who choose to cover most of their skin when outdoors. As he said, BAME individuals have a greater risk of not having high enough levels of vitamin D, and are advised to take a supplement all year round.

We are actively supporting the uptake of PHE’s recommendations to ensure that those who need vitamin D supplementation receive it. The Government are providing a free four-month supply of 10 microgram vitamin D supplements to all adults on the clinically extremely vulnerable list, going far beyond care home residents who have opted in, residents in residential and nursing care homes in England, and the prison population; Her Majesty’s Prison and Probation Service have made supplements available across England and Wales. Through this commitment, this winter we have offered 2.7 million eligible people in England free vitamin D supplements, and to further drive uptake we have extended the registration period to 21 February so that even more people can benefit.

The Government have prioritised groups who were asked to stay indoors more than usual in the spring and summer due to national restrictions. In addition, recipients of the Healthy Start scheme are also offered access to vitamin supplements by the Government, and of course GPs and pharmacists may be approached for general advice on taking vitamin D. However, we do not expect this measure to place any additional burden on either group, as they are under some pressure during the current pandemic. Guidance can be found online and we encourage individuals to buy 10 microgram vitamin D supplements, which are easily available from supermarkets, chemists, and health food shops.

We must keep looking at the evidence, and as research into the impact of vitamin D on covid-19 continues, we will continue to monitor it as it is published in real time. We have committed to keep this under review. PHE, the Scientific Advisory Committee on Nutrition and NICE will update advice if and when necessary. Of course, I welcome any further studies into this emerging area.

I know my right hon. Friend wants us to move at pace. He embarks on everything he does with enthusiasm and vigour. However, I am sure he will agree that we are nudging along and some progress has been made. Future decisions should and must be based on robust evidence.

Question put and agreed to.