Respiratory Syncytial Virus: Immunisation Programme

Lord Evans of Rainow Excerpts

Thursday 19th October 2023 Lords Chamber

[Baroness Ritchie of Downpatrick]

To ask His Majesty’s Government what assessment they have made of the budget implications of implementing the recent statement of the Joint Committee on Vaccination and Immunisation recommending a respiratory syncytial virus immunisation programme to protect (1) infants, and (2) older adults.

[Lord Evans of Rainow (Con)]

My Lords, officials across the Department of Health and Social Care, the UK Health Security Agency and National Health Service England are developing policy options based on the joint committee advice regarding an expanded immunisation programme to protect infants and older adults. As the expanded programme has yet to go to tender, the department is unable to confirm any budget implications at this moment.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I thank the Minister for his Answer. The JCVI stated in its previous minutes that there is a long lead-in time for procuring vaccines and getting a programme set up, so there needs to be sufficient time in place between a policy decision being finalised and a programme being ruled out. In view of that, will it be possible with the current infrastructure, or are new additions required? Can the Minister give us a little more detail about discussions on funding measures, and what funding measures have been identified in the budget to execute implementation of the RSV vaccination programme? Will that vaccine be available for the 2024 winter season for infants and older adults?

[Lord Evans of Rainow (Con)]

My Lords, I pay tribute to the noble Baroness for her doughty campaigning on this subject. The UK system is responsive and agile in setting up new immunisation programmes, as demonstrated in the response to Covid-19. The Government are progressing rapidly with operational and other relevant planning to develop policy options for infant and adult RSV programmes. It is not appropriate to commit to a definite timeline at present; however, planning is continuing at pace. Remaining challenges include the availability and price of potential immunisation products, along with their licensing. The department is engaging with HM Treasury to seek support for a potential programme, and it is working with UKHSA and NHS England to identify and mitigate against any potential barriers to implementation.

The moment I have any news to answer the noble Baroness’s question about 2024, she will certainly be one of the first to know about it.

[Baroness Butler-Sloss (CB)]

Does the Minister know that this vaccine is widely given in the United States? Indeed, it is about to be given this month, and I tried to get it when I was there last month. Why is the UK not looking at how the Americans are giving it, and taking their advice?

[Lord Evans of Rainow (Con)]

I am grateful to the noble and learned Baroness. Yes, I am very much aware of what goes on in the United States, but I also look at what is going on in European countries such as France and Germany. The NHS is ground-breaking in European terms, and I am confident that by 2024 we may have some good news. I am aware of what goes on in America, but that is not always appropriate for the United Kingdom.

[Baroness Manzoor (Con)]

Can my noble friend tell me how the Government are assessing new vaccines and giving confidence to the public on this issue? How are they tackling vaccine hesitancy and misinformation?

[Lord Evans of Rainow (Con)]

My noble friend makes a very good point, and the noble Lord, Lord Hallam, often refers to this issue. The latest figures confirm that 95% of parents have confidence in the efficiency of the vaccine and immunisation programme. The Government are committed to tackling vaccine misinformation, which includes ongoing monitoring by the UKHSA of vaccine uptake and attitudes to vaccines.

I refer to my original point—it is very important that we get this right. If we act prematurely and get it wrong, misinformation and conspiracy theories grow from not doing it properly in the first place.

[Lord Allan of Hallam (LD)]

My Lords, I shall not disappoint the Minister by failing to follow up on this question of vaccine hesitancy, which certainly came to the fore during the Covid pandemic. Like many other noble Lords, I have been to get my flu and Covid booster, and it was interesting that the person giving the vaccination said that they were seeing quite a low uptake. I am interested in understanding whether the Government will carry out a serious study into the extent and causes of vaccine hesitancy during this year’s flu and Covid booster programmes so we can learn from that for future programmes, such as the one for RSV.

[Lord Evans of Rainow (Con)]

The noble Lord makes a very good point. He is an expert on this matter, and I can assure him and the whole House that NHS England has been proactive in this matter. He is ahead of the game: I have yet to have my vaccines done, but the local GP practices in my neck of the woods, I notice, are doing it digitally, online and via text. They are very good at that.

NHS England is preparing earlier than ever before for what is expected to be another challenging winter. More than 7.7 million people have already received their flu jabs since the start of the autumn campaign on 11 September, so we are making good progress. But that is not to say that some areas could not do better.

[Baroness Wheeler (Lab)]

My Lords, the JCVI endorses the RSV vaccination programme for 75 year-olds and ages above, but its 11 September statement underlines that the cost-effectiveness of vaccinating over 65s should also be kept under review, particularly as evidence of the protection offered to over 75s emerges. Does the Minister have any further information on how this review has been taken forward, and on timescales for possible conclusions and recommendations? Obviously, extending the vaccination to over 65s would be a major advance.

--- Later in debate ---

[Lord Evans of Rainow (Con)]

The noble Baroness makes some very good points. It just so happens that I asked that very question. Unfortunately, I cannot provide a specific timeframe, but it is clear that vaccinating members of the population aged over 75 is cost effective, and I therefore hope that we will be able to announce something in the new year. However, unfortunately I cannot give the noble Baroness a specific date.

[Baroness Bennett of Manor Castle (GP)]

My Lords, in looking into RSV vaccinations, I found on the internet a press release dated 14 October stating that in the UK there are now 12,000 pharmacies in which, for the payment of £180 to £200, over 60s can access an RSV vaccination. RSV for vulnerable older adults can be deadly. Does the Minister think that life or death should depend on whether people have £200?

[Lord Evans of Rainow (Con)]

I am not aware of what the noble Baroness is saying, but I refer back to my earlier answer. This has to be done in an appropriate manner. All due diligence has to be followed, which is why the vaccine is not available for this winter, but we are hopeful that it will be available for winter 2024.

[Baroness Armstrong of Hill Top (Lab)]

My Lords, the Covid pandemic demonstrated clearly that there were differential impacts on different ethnic communities. We know now that black and ethnic-minority communities in this country suffered much more and that there are particular long-term conditions that ethnic-minority community people suffer more acutely from than the white population do. One issue is that insufficient numbers of black and ethnic-minority people are involved in the trialling and testing of vaccines, so the vaccines are frequently not effective in certain of those populations. What are the Government going to do about this?

[Lord Evans of Rainow (Con)]

I am grateful to the noble Baroness. She makes a very good point, and I will feed that specific question back to the department. One thing that we were aware of was that certain communities were not as keen as others to take up the immunisation programme, and a lot of work has been done on that.

[Lord Watts (Lab)]

My Lords, are the Government sure they have got their timing right? It seems to me that the boosters have been given about a month behind, in the sense that both Covid and flu are raging before the Covid vaccination boosters are available.

[Lord Evans of Rainow (Con)]

I refer to the answer I gave just a moment ago: 7.7 million people have received their flu jabs since the start of the campaign on 11 September. I assure the noble Lord that NHS England has planned well ahead of this winter season, and I believe that we are making progress. But there may be cases where it could and should be done better.

[Lord Kamall (Con)]

My Lords, following up the question from the noble Baroness, Lady Armstrong, the first issue is making vaccines available, the second is letting people know that they are available, and the third is making sure that groups that have traditionally been vaccine hesitant are reached. What have we learned from previous programmes to make sure that we can reach those groups, particularly those from ethnic minorities and others, who are slow in coming forward for their vaccines?

[Lord Evans of Rainow (Con)]

My noble friend makes a good point. Lessons have been learned that certain communities are more hesitant. There is a case-by-case basis for communicating with community leaders for those communities, and on social media. Not everybody follows social media, so we have to look at other ways to communicate—through letters and texts, and of course including social media but also by word of mouth, ensuring that those hard-to-reach communities take up the immunisation programme.