Immunisation: Children

Lord Markham Excerpts

Wednesday 8th May 2024 Lords Chamber

[The Lord Bishop of St Albans]

To ask His Majesty’s Government what plans they have to address the decline in uptake of childhood immunisations.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

NHS England’s 2023 vaccination strategy set a range of ambitions, including to improve uptake of children’s vaccines across the board. On mumps, measles and rubella in particular, between January and March the NHS and partners administered around four times as many MMR vaccinations to those aged five to 25 as last year and focused on engaging groups with historically lower vaccination rates. We intend to build on these experiences to further improve uptake.

[The Lord Bishop of St Albans]

I thank the Minister for his reply and pay tribute to the NHS for its sterling work in this area. I have a couple of points. First, I wonder what consideration His Majesty’s Government have given to working with leaders of harder-to-reach groups, some of the smaller groups and some of the faith groups, where messaging can be more powerful when it is done by a local leader. Secondly, there is a worrying increase in the level of whooping cough. Indeed, I believe there has been a childhood death recently. Can the Minister update us on what is being done about this worrying development?

[Lord Markham (Con)]

I thank the right reverend Prelate. First, I completely agree that using faith leaders is often a very good way to reach hard-to-reach communities, particularly as it is often ethnic-minority communities that have lower rates of vaccine uptake. Whooping cough has been a concern; we had about 850 cases in January 2024 compared with about 550 for the whole of 2023. We are deploying a number of strategies that have been proven to work in areas such as MMR: using outreach groups, having leaflets in 15 languages and having recall programmes. In the case of whooping cough, if we can get pregnant mothers vaccinated, that is 97% effective.

[Lord Allan of Hallam (LD)]

My Lords, I know the Minister agrees that it would help if parents had online access to their children’s vaccination records and, with his customary efficiency, he kindly wrote to me following a previous exchange on the digital red book to say that parental access to baby records is being piloted in 70 general practices. Can I ask the Minister to give us a ballpark date for when it might be rolled out to the other 6,000-odd GP practices in the United Kingdom? Will it be shortly, soon or in due course?

[Lord Markham (Con)]

Or “none of the above”. The noble Lord is quite correct. Of course, data is vital in this whole area, and getting that sharing of data and understanding with people is vital. I will come back on the precise date, but I hope it will be soon.

[Baroness Finlay of Llandaff (CB)]

My Lords, there have been more than 1,000 cases of measles in the last six months. What action are the Government taking to make sure that mothers are given options, which maximise convenience, of places to go and times when they could take their children for vaccination, rather than tying them to appointments that may clash with the working day when they cannot get childcare for other children?

[Lord Markham (Con)]

That is an important point. We must try to make sure that vaccination clinics are widespread. We have used pop-up clinics successfully in many locations, particularly around London, and that has helped get 25,000 more jabs into unvaccinated people’s arms in the last few months.

[Baroness Manzoor (Con)]

My Lords, I welcome the action that the Government are taking to ensure that MMR vaccinations are going up in underrepresented groups. Can my noble friend the Minister say what action the Government are taking for people seeking asylum? What kind of service are they being offered, and what access do they have to vaccination?

[Lord Markham (Con)]

I thank my noble friend for the question. Actually, it is not just asylum seekers; it is often migrant groups full stop. Their communities or the countries they have come from often do not have the same level of vaccination programmes. It is part of the check we try to give people as they come into the country, and something we ask GPs to look out for, so that we can get them in a catch-up programme. A lot of the work we are doing on outreach is also particularly focused on those communities.

[Lord Watts (Lab)]

My Lords, is it not the case that we need to make the case for public health, and that our public health policy is determined by parents getting their children vaccinated? Do we not need to make the case that they put their own and other people’s children in danger unless they comply with vaccination?

[Lord Markham (Con)]

Yes, absolutely. Unfortunately, we are all aware of the Wakefield effect on the MMR vaccine. That knock of confidence was completely unjustified and irresponsible, but we know the impact it had. Clearly, a lot of the anti-vax sentiment around Covid has not helped either. We need to overcome all these messages.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, on the Wakefield effect, as the Minister called it, he will remember that the impact it had on a lot of people was very profound. In particular, some of that was associated with incidence of autism, which again was completely unjustified. Can he tell the House whether any work has been done, in the interests of public information, on what happened to the children who were not vaccinated at that time, and what the outcomes were for them? As a deterrent, it might be useful for people to know what the worst that can happen is if you do not get your children vaccinated.

[Lord Markham (Con)]

The noble Baroness is quite right. I had two young sons at around that time, and it was a concern. Of course, we did go ahead, but it was a consideration. It is an excellent question. I have not seen the study of those various cohort groups but I will go back, because it is something we need to bring out.

[Baroness Merron (Lab)]

My Lords, it is concerning that measles cases continue to rise, with a particular spike in London, where certain areas have low vaccination rates. With the advent of microarray patch technology, can the Minister confirm that this is being looked at? Does he agree that the chance to dispense with using needles and special storage, and the opportunity to use less of professionals’ time, could present an opportunity to drive up vaccination rates?

[Lord Markham (Con)]

It has to make sense to take more measures that are easy for people, including maybe less skilled people, to operate. Funnily enough, I was talking just today to the head of Moderna about how it is packing syringes, or has planned to for vaccinations going forward, rather than vials, to take that step out of the process. The easier we can make it, the better.

[Lord Kamall (Con)]

My Lords, the right reverend Prelate rightly spoke about the role of faith communities in reaching those hard-to-reach communities. I know that my noble friend the Minister has answered these questions previously, but I wonder what lessons the department has learned from previous vaccination campaigns—Covid, MMR, et cetera—to make sure that the initiatives it is using to reach those hard-to-reach communities are more effective.

[Lord Markham (Con)]

It really is about having the whole toolkit. Clearly, it is about making sure that we are using communications in 15 different languages. It is about the outreach groups and, particularly, the catch-up programmes. We have been doing one for 17 to 25 year-olds for polio and MMR. It is about all those strategies and the pop-up clinics, so that it is very easy to catch people in places that are convenient for them.

[Baroness Hollins (CB)]

Does the Minister agree that the anti-vax sentiment is a powerful deterrent with some of the misinformation on social media? Is there anything more that can be done to try to counter that misinformation?

--- Later in debate ---

[Lord Markham (Con)]

We are trying to get the facts out there. I appreciate the efforts of all noble Lords in doing that. I welcome any ideas on what more action we could be taking. The UK measures at the highest level internationally in terms of parents who believe that vaccines should be used. The level is 97%. That is high, but the trouble is that 3% in concentrated areas can still be quite dangerous.

[Lord Geddes (Con)]

My Lords, further to my noble friend’s question about asylum seekers and immigrants and the Minister’s answer, how are GPs going to check whether such children have been immunised? They will not be carrying any paper proof, and they will certainly not have an app on their phones.

[Lord Markham (Con)]

It is often a case of asking them and seeing what they recall. There are a lot of vaccinations, such as the six-in-one ones. Often, they might not have had any vaccinations. My noble friend is correct that it is not easy to find out that information, but in many cases, where we can, it is good to apply the precautionary principle and offer vaccinations anyway.