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Covid-19: Vaccination

Volume 809: debated on Wednesday 20 January 2021


Asked by

To ask Her Majesty’s Government what plans they have in place to ensure that no one has to wait more than three months for a second dose of a COVID-19 vaccination.

My Lords, we are absolutely committed to making sure that everyone gets two doses, so if they have received their Pfizer first dose, they will get a Pfizer second dose within 12 weeks of the first one. Similarly, if they have had their AstraZeneca first dose, they will get their AstraZeneca second dose within 12 weeks. The four UK CMOs and the JCVI agree that prioritising the first vaccine dose will protect the greatest number of at-risk people overall in the shortest period of time.

My Lords, naturally I thank my noble friend for that Answer. I have just returned from the very efficiently run county showground vaccination centre outside Lincoln, where I have had my first dose and have been given a date for my second. My noble friend has certainly reassured me on the Government’s determination both to give the same vaccine and at the right time. However, is he aware of the findings in Israel, where there has been an extremely impressive rollout of vaccination, which have cast considerable doubt on the wisdom of delaying the second dose? This has caused a great deal of concern, not least in your Lordships’ House, voiced by the noble Baronesses, Lady Boothroyd and Lady Bakewell, among others. Can he please give us some reassurance that there is no danger of diminishing the efficacy of the vaccine by delaying the second dose?

I am extremely pleased to hear the update from my noble friend, and I thank all those in Lincoln who were contributing to his effective vaccination and his second appointment, which is very reassuring. I reassure him that, on the Israeli numbers, Sir Patrick Vallance, the Chief Scientific Adviser, has been very clear—he was on the media round this morning. The Israelis looked at a very specific time period—14 days—and a very specific age group. This is very different to the analysis done by the JCVI and the MHRA, which looked at all age groups over a much broader period. The efficacy of immunity from days 10 to 21 is thought to be 89%. That is a very considerable and impactful effect, and I have spoken to the noble Baroness, Lady Boothroyd, to reassure her on that matter.

My Lords, the rollout of the first vaccine has gone fairly smoothly, although there have been glitches or bumps, particularly in terms of regional disparities. What lessons have been learned, and what was the reason for choosing 12 weeks—was it administrative, medical or supply?

My Lords, there have been glitches; I do not know whether there are lessons learned. However, I can share with the noble Lord that the practicalities of getting the Pfizer vaccine in particular—which, as he knows, requires deep-cold storage—into every part of the country are quite challenging, and we are trying to reach not only the big mass centres but community pharmacies and GP surgeries. The delivery of the vaccine to thousands and thousands of locations will always be a little uneven, and there have been occasions where we have deemed it the correct procedure to have people stood up for their vaccination even though we were not 100% sure of the delivery of the vaccination. That does create concern but I think has been the right approach to take.

My Lords, my question follows that of the noble Lord, Lord Anderson of Swansea. For many in isolation, the appointment for their first jab is all that has kept them going, and the certainty of timing of the second has changed since the introduction of the vaccine regime. Can the Minister tell us whether that is to do with the region—there seem to be problems in the south-west—or is it demand, logistics or science?

My Lords, if I understood the noble Baroness’s question correctly, I reassure her that absolutely everyone’s details are registered in the national immunisation database, so everyone will receive an invitation for their second dose, as I mentioned earlier. However, the reason for having this longer period before the second dose is completely pragmatic. Every 250 doses saves a life, so it is absolutely essential that we get the maximum number of first doses out as quickly as possible. The MHRA, the JCVI and others have looked at the safety and efficacy of this approach, and they have found reassuring evidence that this will work extremely well. I take great joy in the fact that we have found a way to get the highest number of doses to the greatest number of people as quickly as we possibly can.

My Lords, mindful of the impact of Covid-19 on front-line health staff during this pandemic, and given the report in the Times today of reduced supplies of the Pfizer/BioNTech vaccine during January and February, can the Minister say what plans there are to ensure that these front-facing health staff in hospitals and care homes are prioritised as a matter of urgency to protect them from the pandemic? As someone in his late 70s who is waiting for the vaccine, I am happy to forgo mine until such time as the health staff I mentioned are protected.

I am enormously grateful for my noble friend’s important gesture and pay tribute to his generosity of spirit. However, it is absolutely essential that he gets his vaccine as soon as he can, because he is at the top of the list. Morbidity is determined by age, not proximity. Healthcare staff are of course of deep concern to all of us, but those who are in PPE and in protected conditions have no greater chance of getting the disease than members of the general public. It is essential that we put those who have the highest risk of morbidity—the oldest—at the front of the queue, which is why we have the prioritisation list that we have.

My Lords, I thank the hard-working Minister and his Government for listening to the most clinically vulnerable groups and for reprioritising vaccination for all care workers, ensuring their greater safety. However, I am concerned that people under 65 with learning disabilities who live in care homes are in group 6 rather than in group 1, when ONS data clearly shows that they have been disproportionately affected throughout the pandemic. It is illogical that they now have to wait longer than other people with learning disabilities—older ones—in residential care. What plans do the Government have to ensure consistency and fairness in vaccination allocation to all people in residential care, especially in this category of people?

My Lords, the noble Baroness puts her point very well. There is a huge amount of sympathy and concern for those who have underlying conditions, and she is right that ONS data on those with underlying conditions demonstrates a higher hospitalisation and mortality rate. That is why we have put all individuals between 16 and 64 with underlying health conditions that put them at a higher risk of serious disease and mortality higher up the prioritisation list than others. However, it is age more than anything else that is the greatest determinant of morbidity, and that is why the list looks the way it does.

My Lords, I would like to ask the Minister about those who are housebound and bedbound. If their domiciliary workers, care workers and unpaid carers are vaccinated in centres and with their GPs, what arrangements are in place for home visits to vaccinate this particular cohort of people, who cannot leave their home because of their disability or their particular conditions? It has been rumoured that there is no intention to vaccinate this cohort at present, which I find remarkable. So I would like the noble Lord to assure the House that arrangements are being made for this particular cohort.

My Lords, I reassure the noble Baroness that it is absolutely not our intention to leave those who are housebound out of the scheme—not at all. In fact, they are an important priority. They are logistically a big challenge. We are in a numbers game. We are trying to get the greatest number vaccinated as quickly as possible. However, we are working extremely closely with community pharmacists and GPs to try to figure out the way in which we can get the vaccine to people who cannot make their own way to a vaccination centre. Those plans are in advanced progress. I do not have details of them to hand, but I would be glad to write to the noble Baroness with those details.

My Lords, can the Minister say how concerned the Government are that diminishing efficacy in partially immunised people among a population with high prevalence of the disease, as we have in the UK, will foster ideal conditions for the virus to mutate into vaccine-resistant forms?

My Lords, I do not quite agree with the premise of the question, which is the concept of being partially vaccinated. When you get your first vaccination shot, you are vaccinated, your body has been primed, B cells make the antibodies and you learn how to fight the disease. That is categoric. Where the noble Baroness absolutely has a point is that it is an uncomfortable truth that when we lean in to the virus, it will seek to escape and mutate, and that is the moment of absolute highest risk for the country. That is why we are trying to move as quickly as we humanly and possibly can: there is a moment in time, an opportunity to get the vaccine out to as many people as possible to avoid the mutation throwing up variants that escape our vaccine.

We heard a few voices last spring and summer suggesting that the National Health Service was not good enough and that a privatised service would have been better in dealing with the pandemic. They are remarkably silent now. Will the Minister join me in the celebrations across this country at the moment of the brilliance of the National Health Service and the fact that people being vaccinated are going in with a smile on their face, being welcomed by people—volunteers and staff—with a smile on their face, all saying how brilliant our National Health Service is?

My Lords, I am enormously grateful for the testimony of the noble Lord, but I would probably put it slightly differently. Listen, we are in Act I, and I do not think it is quite the right moment to take curtain calls and bows just yet. The NHS has stepped up to this challenge absolutely magnificently, but there is still a huge amount to do and to get through. In addition to the praise that the noble Lord rightly gave the NHS, I also pay tribute to other parts of government, and particularly to the Army, local authorities and the private sector, which contributed the vaccine in the first place, all of which have worked together in a great spirit of collaboration. It is only through that spirit of collaboration that we have been able to deliver what we have.