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Covid-19: Vaccines

Volume 809: debated on Monday 1 February 2021

Private Notice Question

Asked by

To ask Her Majesty’s Government what plans they have to ensure that the second dose of the Pfizer/BioNTech COVID-19 vaccine is delivered to patients within 12 weeks of receiving the first dose.

My Lords, the second dose completes the course and is vital for long-term protection. That is why all patients will be offered a second dose between 77 and 84 days after receiving their first. We have already vaccinated almost 9 million people, with the ambition to reach the 15 million people in the most vulnerable groups 1 to 4 by the middle of February.

I thank the noble Lord for his partial reassurance; however, the question is actually whether there will be a supply available in the timeframe. Given that any unvaccinated area provides a potential pool for new strains of Covid to develop and re-infect the world, extending immunisation to the whole world is not

“only a matter of altruistic engagement,”

but “of enlightened self-interest,” to quote Tony Blair. Does the noble Lord agree that countries must come together to reject vaccine nationalism in favour of co-operation? At what point in terms of vaccination of priority groups will the UK be able to make vaccinations available to other countries that are in need?

I completely agree with both the noble Baroness and the former Prime Minister Tony Blair on this matter. Not only must we vaccinate our own country, but we are not safe until the whole world is vaccinated. That is a basic public health and epidemiological observation. It is why we are very committed to international efforts—to CEPI, Gavi, COVAX and ACT. They are all working hard to get fair distribution of vaccines. We have also put £571 million into the funds at COVAX to support vaccines for the developing world. However, we have to start at home and it is not possible to make a commitment on the schedule for when we will be in a position to think about exporting vaccines until that is completed. When it is completed, I will update the House accordingly.

My Lords, we welcome the efficiency with which the UK is providing vaccines, but vaccines affect only part of the problem. As my noble friend Lady Thornton and the Minister said, this is indeed a global issue. Prompt diagnosis and early treatment with antivirals will become vital. Time is limited. Can the Minister inform the House what measures the Government are taking to stimulate investment and make urgent research into effective antiviral drugs specifically designed against SARS-CoV-2, which are likely to be easier to distribute in many countries?

The noble Lord is entirely right: the vaccines are a hugely important development, but so is investment in all therapeutic drugs. We are extremely blessed to have had a contribution towards dexamethasone, tocilizumab and other therapeutic drugs which have greatly improved outcomes for patients in hospitals. He is right that antivirals also present an opportunity. The reason we have supported research into antivirals through the urgent regime in our clinical trials is to ensure that there is sufficient commitment in hospitals and primary care on antivirals. We are tasking the Therapeutics Taskforce with a specific mandate to look at antivirals and whether we should give greater resources to this avenue of therapeutic development.

My Lords, having the second dose of the Pfizer/BioNTech vaccines in the right quantities in the right place at the right time is vital. Will the Minister guarantee that people will be able to get their second dose of it at the local GP hub where they had their first dose administered without being directed to a mass vaccination centre to receive it?

In response to the noble Baroness, I said that we were confident that we had the supplies of the vaccines to do the second dose. It is not our policy that anyone has the second dose of anything other than the vaccine they had the first dose of. We will work with people to give them the most convenient place to have the vaccine, but I cannot offer the guarantee that the noble Lord seeks.

My Lords, while it is important to extend vaccination programmes at home and abroad, the recent reports of emerging mutations of the virus—the South African, Brazilian and the recent Californian mutations—risk significantly increasing transmissibility and serious illness, particularly in younger people. It is extremely worrying, and it may lead to the virus getting around the vaccine-related immunity. We need to be ahead of the curve if we are to avoid serious illness and deaths in the young. What plans do the Government have to mitigate against this?

The noble Lord is entirely right; the threat of a vaccine-escaping mutation is very present on our minds. I pay tribute to the word of Sir Patrick Vallance, Clive Dix and all those who are working on this issue in the expert advisory group on vaccines. The noble Lord mentioned the threat of transmissibility among the young. We have already made the commitment of offering a vaccine to all ages. He is entirely right that we may reach a point where it is particularly important to ensure that young people have the vaccine so that they are not responsible for transmitting the disease to those who are more vulnerable.

My Lords, I congratulate the Government on their very impressive vaccine rollout. Bringing in retired doctors, nurses and non-healthcare professionals to be part of the national vaccination effort will be vital to being able to continue to deliver all doses of the vaccine at scale—and, of course, it will help to relieve the pressure on our hard-working NHS workers. Can my noble friend the Minister update the House on the progress of these applications?

My Lords, we have tens of thousands—38,000, I think—currently employed by the NHS delivering the vaccine: a remarkable army of people. We have had further offers from hundreds of thousands of people—300,000, I believe—to support the vaccination effort. Those offers are being processed by voluntary groups; I pay particular tribute to the St John Ambulance, which runs an extremely good training programme and has enabled tens of thousands of people to join the vaccination effort. We continue to engage with those offering to help to ensure that they get the training and opportunities to help wherever they can.

How can the Government ensure that the second dose of the Pfizer BioNTech vaccine is delivered to patients within 12 weeks? I do not think the Minister answered that part of my noble friend Lady Thornton’s Question. What steps are the Government taking to ensure that this is done, and are there any circumstances in which vaccines would be mixed at the second dose?

When you go to have your vaccine, as several noble Lords have done, you are given a card like the one I am holding, on the back of which the date of your second dose is printed. That is how we ensure that people know where and when to go for their second dose. We are working extremely hard to ensure that there are supplies of the second dose, and I am confident that we have the arrangements in place. It is not our policy to give anyone a second dose of an alternative vaccine to their first dose.

My Lords, how can the Minister overcome the reported suspicion of the Covid vaccines among ethnic minorities and, of course, the anti-vaxxers, no doubt fuelled by President Macron’s unfounded attack on the effectiveness of the AstraZeneca vaccine?

My Lords, the noble Baroness is entirely right to be concerned, but I can report from the front line that concerns about the impact of anti-vaxxers have not materialised in a huge impact on confidence. I pay enormous tribute to all those in civic society and religious groups in all parts of Britain who have done a tremendous job of ensuring that groups and communities who might once have been suspicious of a vaccine supplied by the British Government have instead turned up in droves. I am extremely confident that the message has got across: this is a safe vaccine, everyone who qualifies should take it, and you should trust the Government and the NHS to supply it.

My Lords, I join my noble friend Lady Sugg in congratulating the Government on their outstanding work in rolling out this vaccine programme. As I am a bear of very little brain, can I ask my noble friend to explain: if we are to maintain the current level of first vaccinations and at the same time start giving second doses to those who have had their first, will we not have to double our capacity to give vaccinations over the next month or six weeks? Are the Government confident that they can achieve that?

My noble friend is entirely right: from March, we will have considerably more work both to deploy the second dosage and to supply it. We have those plans absolutely in place: the supply of the vaccine has been put in place to ensure that we have a sufficient number of doses, and the workforce and locations are in place to ensure that we can deliver them.

My Lords, among Northern Ireland Health Minister Robin Swann’s many achievements since the start of the pandemic, he has overseen the establishment of seven regional centres across the Province where the Pfizer Covid-19 vaccine is now administered. I understand that a further significant consignment of the AstraZeneca vaccine is due in Northern Ireland this week for distribution to general practitioners. Can the Minister assure me that the Province’s stocks of the Pfizer vaccine are also being replenished to allow the regional centres to continue their excellent work at the fastest possible pace, including the delivery of a second dose?

I join the noble Lord in paying tribute to the good work of the Northern Ireland Health Minister, Robin Swann, whom I commend for his collaborative approach during this entire pandemic. I reassure the noble Lord that we are allocating doses on the business-as-usual, Barnett formula split, with 2.85% going to Northern Ireland. I pay tribute to the NHS there, where 214,601 people have had their first dose. A further 24,323 have had their second dose, and I reassure the noble Lord that we will maintain that velocity of delivery in the weeks to come.

My Lords, when I received the Pfizer vaccine, I was given a leaflet that stated

“you should receive a second dose of the same vaccine … 21 days later to complete the vaccination series. Protection against COVID-19 disease may not be … effective until at least 7 days after the second dose.”

Now that 21 days has been extended to 77 to 84 days, what is the efficacy of the vaccine after a gap of six weeks and three months?

My Lords, I congratulate the noble Lord on having his vaccine so early, and I share his concern on this matter because those who had their first dose early received a leaflet of exactly the kind he described, and, since then, the CMO’s advice has changed. I reassure him that, using data for those cases observed between days 15 and 21, efficacy against symptomatic Covid-19 for the Pfizer vaccine was estimated at 89%. Those kinds of statistics reassured the CMO to change the date to three months, and I reassure the noble Lord that he is in safe hands.

My Lords, I am perfectly happy with waiting for the three months, but I am concerned about people over the age of 80 who are living in their own homes, rather than retirement homes, who I understand are not yet receiving the vaccine. I can understand that it would be difficult to go to individual homes, but can my noble friend tell me what the position is?

I reassure my noble friend that we have put in place a systematic arrangement to visit care homes and those living at home with domiciliary care in order to bring the vaccine to their homes. That system includes GPs, community pharmacists and, where necessary, mobile vaccination units. It is proving to be extremely effective. The big numbers will be delivered by the mass vaccination centres, but we will not overlook those who cannot move from their home.

My Lords, what information does the Minister have about individuals who may have tested positive for Covid-19 after their first vaccination, either because they are a carrier but healthy or because the first vaccination—which statistically is not 100% successful—did not work?

My Lords, the noble and gallant Lord touches on a number of connected issues. The first vaccination does take a little bit of time; depending on which vaccination is administered, it takes between one and three weeks before it is truly in the system and protects the patient most effectively. It is, of course, possible to subsequently catch the disease without showing symptoms. One of the most emphatic results of having a vaccination is not necessarily that you do not catch the disease but that it saves you from serious disease and hospitalisation. That is where the vaccines are making a massive difference. We are expecting a dramatic fall in the number of hospitalisations and deaths as a result, but it is possible that people will still carry the disease. That is why the advice to all people, including noble Lords, is that just because you have had the vaccine, it does not mean that you can travel around the community as you did previously.

Sitting suspended.