Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment he has made of (a) changes in the number of cases of, and deaths from pneumococcal disease (b) the number of pneumococcal conjugate vaccine (PCV) vaccinations given each year and (c) the cost of delivering that programme of vaccinations on an annual basis since the introduction of PCV in 2006.

The total number of cases of invasive pneumococcal disease (IPD) and case fatality ratios (CFR) since 2006 are shown in table 1.

Table 1. Total cases of IPD and case fatality ratios (CFR).

¹Total cases of laboratory confirmed IPD, England and Wales (excluding cases only confirmed by DNA detection and bronchiolar alveolar lavage (BAL) samples).

²Proportion of cases of IPD that were found to have died within seven days of IPD onset (excluding BAL) ascertained by tracing GP registration records. Data on CFR prior to 2009 are not available.

The current PCV offered to infants helps protect against 13 of the 95 known pneumococcal serotypes. The incidence of IPD caused by these serotypes has fallen by 90% in children younger than five years since the introduction in 2005 of PCV in the childhood immunisation programme. The vast majority of IPD cases in this age group are now due to non-vaccine pneumococcal serotypes. In addition, although the vaccine is only given to infants and young children, IPD due to the vaccine serotypes has declined in older children and adults through herd protection. Consequently, there has been a 36% decrease in the number of IPD cases across all age groups between 2005/06 (6,250 IPD cases) and 2013/14 (4,032 IPD cases) in England and Wales (Table 1) because of the infant immunisation programme.

Pneumococcal conjugate vaccination (PCV) was introduced in September 2006, with a catch-up campaign for children up to two years of age. The number PCV vaccinations given each year are shown in table 2.

Table 2. The number of children at 12 months of age vaccinated with primary PCV, and the number of children at 24 years of age who have completed the PCV schedule, by year, in England.

The complete course comprises three doses of PCV vaccine: these are given at two months and four months (the primary doses), and a booster dose at 12-13 months.

In 2014/15 the NHS incurred approximately £9 million delivering completed courses of PCV and Haemophilus influenzae type b / meningococcal C (Hib/MenC) vaccination. Costs in 2013/14 would have been similar. NHS England does not have details of delivery costs prior to 2013/14. This figure does not include the cost of the vaccine, which is procured centrally by PHE, and is commercially confidential.