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Vaccine Rollout

Volume 809: debated on Monday 25 January 2021

Commons Urgent Question

The following Answer to an Urgent Question was given in the House of Commons on Thursday 21 January.

“We are in the midst of one of the toughest periods of this pandemic. Yesterday saw 1,820 deaths, which is the highest toll since the crisis began. As we endure these dark days and the restrictions that we must all follow to save lives, we know that we have a way out, which is our vaccination programme. Thanks to the hard work of so many people, we now have an immense infrastructure in place, which day by day is protecting the most vulnerable and giving hope to us all.

I am glad to report to the House that we have now given more than 5 million doses of the vaccine across the UK to 4.6 million people. We are making good progress towards our goal of offering everyone in priority groups 1 to 4 their first dose by 15 February. That is a huge feat, and one in which we can all take pride. We are vaccinating at a greater daily rate than anywhere in Europe—twice the rate of France, Spain or Germany.

The first 5 million doses are only the beginning. We are opening more sites all the time in cathedrals, food courts, stadiums, conference centres, GP surgeries and many, many other places. Today, a cinema in Aylesbury, a mosque in Birmingham and a cricket club in Manchester have all come on board as part of 65 pharmacy-led sites across England that are joining our vaccination programme this week. That ongoing expansion will help us protect even more of the most vulnerable even quicker. From today, we will also publish more localised, granular data, broken down by NHS sustainability and transformation partnership area, as well as by region, so that the public have the best possible information about all this work.

This virus is a lethal threat to us all. As we respond through this huge endeavour, let us all take comfort in the fact that we are giving 200 vaccinations every minute. In the meantime, everyone must follow the rules to protect the NHS and save lives. We can do that safe in the knowledge that the tide will turn and that, with science, we will prevail.”

My Lords, there was a very worrying story in the media this weekend, which I hope the Minister will use this opportunity to clarify. We learned that the MHRA and NHS Digital have issued official instructions on how to use NIVS, saying that where staff do not have an NHS number, the vaccine should not be given. One email sent to a hospital explicitly states that overseas nurses without NHS numbers, even on the front line, should not be vaccinated. And what about security staff, porters, student nurses coming from outside the country to work for us and staff such as cleaners? Through contracts, lots of people from BAME backgrounds and recent immigrants working in the NHS are not registered with GPs, do not use the NHS, and do not have an NHS number. How can it possibly make sense, from a public health point of view, not to vaccinate everyone on the front line?

My Lords, I am extremely grateful for that question, because it will help me to clear up a misconception in this area. Having an NHS number is very important. We cannot know who has had the vaccine and who has not if we do not know what their NHS number is. That is extremely important for their own treatment; it is also best practice. As any clinical practitioner will tell us, it is imperative to know the identity of the person being treated. It is also very important for pharmacovigilance and for the research that will come on the back of the vaccine. If we were to vaccinate a large proportion of the population without knowing who they were, we could not do the research necessary. There will be some people who do not have an NHS number, and we have put in place protocols to ensure either that they can get an NHS number or that a workaround can be found. Those we are pursuing with haste. I emphasise to noble Lords that this is an opportunity to ensure that everyone in this country, whether a visitor or a resident, has an NHS number by the end of this programme.

My Lords, here in Sheffield, approximately 45,000 people have been vaccinated, owing to the excellent work of our local GP hubs, but because of lack of vaccine supply, 10 out of 15 of those will be closed and will not be able to get the jab into vulnerable people’s arms again until the middle of next week. Yet the new Sheffield mass vaccination centre has opened today and has vaccine. Local GPs have asked me to ask the Minister why the distant megacentre has been given priority for vaccine supply over the local and effective GP hubs.

It is not a question of one place taking precedence over another. I take a moment to applaud and pay tribute to GPs in Sheffield, and to all those who have proceeded at pace and got through their allocation as quickly as they could. That is absolutely the right priority and the right approach, and it is how we are going to get through the population very quickly. However, some people will get through their list more quickly than others, and it would be a mistake then to start asking them to move down the list when there are still those with very high priority who need to be vaccinated. Although I understand that it may be frustrating for a GP to stand idle, those are the practicalities of what we are doing. The mass vaccination centres are essential to deal with the very large numbers of people that we plan to vaccinate over the next few months. That is why the Sheffield vaccination centre is such good news.

My Lords, I support the Government’s utilitarian public health approach to the spacing of vaccine doses, but does the Minister accept that the argument is dependent on an understanding of the full implications of different dosage regimes, and that a lack of specific data on this particular point in relation to the Pfizer vaccine is fuelling concerns? Will the Government now undertake research on this specific point as part of a vaccine rollout programme, to underpin robust and well-supported policy implementation, both here and in many other countries that could benefit from this data?

My Lords, the amount of research that we have on the Pfizer vaccine and all other vaccines is huge. Most, though not all of it, is published. I assure the noble Baroness that we have all the data needed to make the decision that we have. She is right that we are doing the pharmacovigilance that is necessary to understanding the efficacy of the vaccine and any possible side effects. That research will be shared with international partners in the way that she suggests.

My Lords, the Prime Minister revealed on Friday the great news that 10% of all adults have now received their first dose of the Covid vaccine, with two-thirds of elderly residents of care homes now meeting that first milestone. This wonderful effort now needs to be matched by a strategy to ensure that it is not only the elderly who are protected but the young, with a commitment to reopening our schools as soon as possible. Social mobility gains that have given a lift to disadvantaged children over the past decade are at risk of being wiped out by Covid lockdowns. The gap between disadvantaged pupils and their peers has already increased by almost half, with 12% of 11 to 18 year olds not having access to the internet at home. Given that the rollout of the vaccine to the most vulnerable is set to reduce deaths by 88% by mid-February, what steps are Her Majesty’s Government taking to increase NHS capacity to ensure that schools can open as soon as possible?

My Lords, it is indeed very good news. I pay tribute to the work of my noble friend and of the Legatum Institute in championing the need to address social inequality. She rightly draws attention to the horrific impact that this pandemic and the associated lockdowns are having on social mobility. It is a massive priority for us. The problem that we are wrestling with is not just hospitalisation but the transmission associated with schools, but I assure her that this is a number one priority for us.

I wish to make two points and I draw attention to my interests as listed in the register. First, I am very concerned about prisons. There are reports that about 71 prisoners have died, and the number of prison staff who have tested positive continues to rise alarmingly. There is great flux within a prison, with staff coming and going, and those being released from prison and those coming into prison. Will the Government consider prioritising the vaccinating of prisoners and those who work in prisons? Secondly, I add my voice to those calling for teachers and early years staff to be prioritised. Schools are open and our dedicated teachers and early years staff must be able to continue their work safely and not be off sick, if we are to do the right thing by our children.

The right reverend Prelate is entirely right to highlight prisons, and I share her deep concern in this area. I pay tribute to the Prison Service for keeping Covid out of prisons for nearly a year. It has done an amazing job, and we should all be very pleased with the incredible protocols that have been put in place to save our prisons. However, she is entirely right that we have a problem on our hands. It is a major priority for the Prison Service, which is bringing in testing protocols and, if necessary, will look at other measures to ensure that prisoners and those who work in prisons are safe.

I want to follow up on the answer that the Minister gave to my noble friend Lady Thornton. I was quite shocked by his reply, because I am quite sure that most people working in the National Health Service who do not have a number are probably the lowest paid, from black and ethnic-minority communities, or temporary staff—the very people who are just as much on the front line as doctors and nurses. I do not think that being assured that there will be a protocol, or a workaround, is adequate. Can the Minister say what protocol there will be, what priority it will have, and how soon all of this will be communicated to the people who are affected?

My Lords, I assure the noble Baroness that it is communicated on the front line immediately. I did not have a valid NHS number until a week ago: it took me a couple of days to get one, but it was provided extremely promptly. I am hopeful that anyone who is lacking an NHS number can get one extremely quickly when they apply.

My Lords, I am grateful to the Minister for all his hard work on this subject. As he says, the vaccination rollout rightly aims to prioritise the people who are most vulnerable to Covid, but this mainly focuses on age. On the BBC news yesterday, we heard directly from several people with learning disabilities about their well-founded worries concerning the Public Health England data, which shows that they are six times more likely to die from Covid. Given this, and the fact that only 40% of people with learning disabilities reach the age of 65, does the Minister agree that relying on a strategy of vaccinating them at the same age as other people magnifies their existing health inequalities and discriminates by failing to recognise their increased risk?

My Lords, the JCVI looked at this very question in great detail. It is very conscious of discrimination, but its focus is on morbidity. Its judgment, which I entirely back, is that age, more than anything else, is the driver of morbidity. That is why the prioritisation is structured in the way that it is. Those who are CEV are also prioritised. Many of those who are most vulnerable and who also have learning difficulties will qualify under the CEV threshold. However, I have passed her arithmetic to the vaccine taskforce. She makes a very good point that those with learning difficulties and autism have a different life profile and die at an earlier age. I have asked the system to ensure that this arithmetic has been considered in the prioritisation list. I will be glad to reply to her when I have the answer.

Sitting suspended.