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Health: Adult Pneumococcal Vaccination

Volume 767: debated on Tuesday 8 December 2015

Question

Asked by

To ask Her Majesty’s Government what plans they have to improve the efficacy of the adult pneumococcal vaccination programme and to ensure optimal coverage of target populations in the United Kingdom.

My Lords, vaccination of children, adults and risk groups with pneumococcal and influenza vaccines has led to a significant reduction in pneumococcal disease in the UK. The Joint Committee on Vaccination and Immunisation published an interim statement on adult pneumococcal vaccination on 18 November. The JCVI statement is subject to stakeholder consultation before being finalised. The interim statement advises continuation of the existing adult pneumococcal vaccination programmes. The Government will respond fully once the advice is finalised.

I thank the Minister for that reply. As he knows, this disease puts an enormous pressure on the NHS and on patients. The recent report that he mentioned from the ONS showed that pneumonia was the underlying cause in almost a fifth—19%—of the 43,900 excess deaths in England and Wales just last winter. The recent review by the Joint Committee mentioned by the Minister recommended no changes to the adult pneumococcal vaccination programme at this time, which is a bit surprising. The committee is currently consulting, as the Minister mentioned, and it acknowledged that there are weaknesses with the levels of protection offered to at-risk adults. Will the Minister look into this issue and work to make sure that the pneumococcal vaccination programme provides optimal protection for vulnerable adults?

My Lords, the report by the JCVI was very clear in its recommendation that the existing vaccination, PPV, was the most appropriate for those aged over 65 and that PCV 13, which is the vaccination used for young children, because it provides herd protection—that is, young people who are treated with it can no longer carry the disease—offered the best long-term protection for the elderly as well.

My Lords, this year community pharmacists have been given the opportunity to provide NHS vaccinations. Can the Minister say something about how successful that has been? Does he think that there is much greater potential for community pharmacists to do more work for the NHS in this and other areas?

My Lords, there is a huge and growing role for community pharmacy in delivering services that have traditionally been supplied by the NHS. If we were to discuss this in five years’ time, I am sure that we would see a far greater role played by community pharmacy. I am not sure that I can give the noble Lord a specific answer on vaccinations. I can just say that the flu vaccination rate so far this year to date is 66%. Last year, by the end of the winter, it was 72%, so we are roughly on target to do the same as last year.

My Lords, the service standards say that local authority directors of public health have a key role to play in ensuring good coverage of vulnerable groups in their area. Given that fact, what assessment has the Minister’s department made of their ability to carry out that role, given the recent large cuts in public health budgets?

My Lords, the principal role for pneumococcal vaccination—the subject of the Question—lies with GPs. Take-up of the PPV for those aged over 65 is 70%; for those aged over 75, it is 80%. For young children, the rate is more than 95%.

My Lords, one of the great advantages of the pneumococcal vaccination programme is that it is widely believed that a single injection gives lifelong protection—or at least substantially lifelong protection—against pneumococcal pneumonia and pneumococcal meningitis. Is the Minister satisfied that that is still sufficient?

My Lords, the noble Lord knows far more about this than I do. I can tell him that the PCV 13 vaccination for young children provides long-term protection and, as importantly, prevents the disease spreading. The PPV—the polysaccharide vaccination provided to older people—does not have the longevity of PCV 13, but it provides wider protection against 23 of the serotypes, rather than 13. It does not provide the length of protection that PCV 13 does, but it still provides some protection.