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Covid-19 Vaccine

Volume 683: debated on Tuesday 10 November 2020

I beg to move,

That this House has considered covid-19 vaccine.

Is locking down the nation the only way of combatting covid-19? Whatever suggestions emerge from this debate, we must continue to protect the vulnerable and at-risk individuals. I was briefed by three leading vaccine manufacturers to discuss their work in the fight against this disease. Following those calls, I wanted to have this debate to see what can be done to accelerate the licensing and deployment of vaccines, and the immediate extension of vaccine and therapeutic trials, and how we can ensure that people can take up these vaccines when they are approved.

According to the Department of Health and Social Care website, the Government’s preferred route to enable deployment of the vaccine remains through the usual licensing routes available. It goes on to say that temporary licensing can occur only in “exceptional circumstances.” The recent report of the Tony Blair Institute for Global Change has been helpful in bringing further attention to this issue. It highlights four ways to avoid further lockdowns, of which two are of interest: expanding the trial of therapeutic drugs and shortening the process for approving vaccines. The report is helpful, although it has its limits, and I believe that we can go further and do better, first, by seeking volunteers to extend trials on a larger scale and to those who are most at risk.

We do not really know what scientists and the pharmaceutical industry can accomplish, and there are ethical and responsibility issues that we need to address, but at the moment the risk/reward ratio is out of kilter and we need to do far more to address the possibilities. There are 258 candidate vaccines worldwide, around 50 of which are in clinical testing and 11 in the final regulatory approvals process. Between the three candidates that I mentioned, the Government have forward purchased a total of 190 million doses. The most publicised of these are the joint enterprises between, first, AstraZeneca and Oxford University, widely seen as the most advanced in the world, and secondly, Pfizer and BioNTech, also much publicised after their promising announcement yesterday. The third is Valneva. All three companies emphasise the support and help that the Government have given them. Let us not make another massive communications error by failing to remind the people that these decisions by the Government have helped provide stability and confidence, which have accelerated the whole testing process.

None of the vaccines is the same and all three are unique in their approach. AstraZeneca and Oxford are pursuing an active vaccine. That type of vaccine uses a weaker and smaller amount of the virus to create immunity in the body. Examples of active vaccines are those for MMR––measles, mumps and rubella––and yellow fever. The former provides immunity for the rest of an individual’s life, but it is not known whether that would be the case with covid-19. Valneva is pursuing an inactive vaccine, using a killed version of the germ that causes the disease. Such vaccines are less able than active vaccines to provide immunity for life; typical examples are the flu jab and the rabies injection. Pfizer and BioNTech are pioneering an mRNA vaccine. This is a relatively new type of vaccine that uses a short segment of genetic material to make a harmless version of a target protein or immunogen. This activates an immune response and generates antibodies that fight off the virus.

The development of vaccines is typically a long and drawn-out process, but in response to the pandemic, the Government have helped to speed it up. There are usually three phases. The first involves producing a small amount of vaccine for use in a controlled study with a small number of healthy adults. Tests are performed on participants, half of whom are given the vaccine, the other half a placebo. This ascertains whether the vaccine generates the expected immune response and if it is safe. This stage usually takes only one or two years, yet all that has been passed by all three vaccine candidates already. Scientists at this time will work to provide the data, and a deal will be made with manufacturers to produce whatever amount is required.

Phase 2 sees the data from phase 1 scrutinised to determine whether those who received the vaccine had any adverse reactions. Again, this phase can take up to two years, yet it has already been completed by all three candidates. A larger group of people—several hundred—will then be given the vaccine to broaden the data set. Until that phase is over, scientists and patients will not know who has received the vaccine and who has had the placebo. That prevents the data being deliberately altered and manipulated. At the same time, work will continue to define the manufacturing methods and ensure consistency in the process.

Phase 3, the final phase, will include tens of thousands of study participants who represent a similar demographic to the population, including important factors such as age and ethnicity. As is the case with other phases, the scientists, the patients and those collecting the samples or checking the results do not know who has received the vaccine and who has received the placebo. Getting to phase 3 demonstrates a confidence in the safety, efficiency and efficacy of the vaccine candidate.

During this accelerated process, independent regulators have continued to monitor the trials, as they would with any other vaccine. Safety and accountability have not been compromised or relaxed in any way. As I call for a further acceleration of this process, I do not wish to see those standards dropped. Instead, we need better and faster collaboration between Governments and regulators internationally, because at the end of phase 3 the regulator will investigate the data and decide whether the vaccine candidate is effective enough for mass production.

Several factors affect the effectiveness of a vaccine. For example, the higher the number of patients in the trial who test positive and require medical assistance, the more data manufacturers and regulators have to use. This is referred to as “an event” and it allows scientists and regulators to determine and prove the efficiency or efficacy of the vaccine—in other words, how likely it is to be effective. The more events that occur within the placebo patients, the more it helps scientists come to their final conclusions on how well the vaccine is working. In statistical figures, one hopes to achieve a p-value or confidence quantifier lower than 0.5. That would mean there is a lower than 5% chance that the figures in the test are wrong, giving the scientists 95% assuredness that the test results are reliable and the vaccine is effective. I hope that in a matter of weeks it will be announced that the phase 3 trials have been completed, and then the regulators will study the data before pronouncing whether the vaccine is fit for the public.

The problem is that different regulators around the world have different demands and requirements. This is plainly an area where we can assist the manufacturers, by ensuring that the process is accepted as safe globally and that the different demands, which delay the final outcome, can be agreed by the experts and the approvals process can become smoother.

The pandemic reminds us that we are all people with the same biological make-up, and to defeat the virus we need to unite rather than specialise. Of course, the sooner we can vaccinate those most at risk—the elderly, care workers and frontline staff—the sooner we can begin to rebuild the country and the economy. When the common flu or influenza arrived, it was very likely to result in death. Nowadays, we give those most vulnerable in our society a flu jab to ensure that they remain safe, and we can beat covid-19 in the same way. By reaching phase 3, these vaccines are deemed to be safe.

The question of how effective the vaccine is remains unanswered, but that should not deter us from getting on with vaccinating more people. For example, yesterday’s announcement by Pfizer was a promising step forward on this front. Normally, scientists strive for 70% to 80% efficiency, meaning the vaccine is 70% to 80% effective in reducing the likelihood of contracting the virus. Therefore, even if it was lower, say 40%, we should still look at beginning the roll-out, because 40% could be the difference between life and death for thousands of people. That is why the existing Human Medicines Regulations 2012 contain a provision, regulation 174, that enables the temporary authorisation of the supply of an unlicensed medicine in response to a public health emergency.

With over 200 vaccines in development worldwide and 50 clinical trials, 11 of which are in final phase 3 trials, the Government could look at incorporating as many of those candidates as possible into further trials. We could also have more of the public participating in trials, and not only healthy people but volunteers—they must be volunteers—who are vulnerable and at risk. The Pfizer and BioNTech candidate is already incredibly close to completion, with footage of its full-flowing production line shown in the media only a couple of weeks ago, and yesterday we had the announcement that the safety monitors had found no problems and that it was 90% effective. Now we have to wait for the final data, but the Government could apply the same parameters for therapeutics and their wider use.

Therapeutics are medicines that help people who already have the disease, treatments that are improving to help reduce the fatalities from covid-19, and we have learned a lot about them since March. They are typically used when someone has a disease for which they have been hospitalised. They can both relieve pain and fight back against the virus, reducing its effect on patients. For disease treatment, therapeutics are generally in the form of a drug, and there is substantial evidence to suggest that the use of therapeutics when administered can alter and halt the spread of the virus. Vaccines help prevent people from catching the virus, but therapeutics work for those who already have it. The fear of overwhelming the NHS with covid cases prompted our Prime Minister to lock us down again, but therapeutics can prevent the NHS from being overwhelmed and keep people off ventilators.

Therapeutics come in a variety of forms, and the type being trialled for covid-19 is antibody treatment, of which there are three types: single monoclonals; cocktails of monoclonals, which most covid-19 trials are using; and polyclonals, such as plasma. Only four have so far been approved worldwide, and the only one currently approved in the UK is dexamethasone. Eli Lilly, an American company, is proving to be close with two separate antibody treatments, LY-CoV016 and LY-CoV555, the latter of which is being tested in America as a preventative therapy for residents in care homes.

Another therapeutic is Regeneron, which President Trump famously claimed cured him of his own bout of covid-19, and AstraZeneca is in phase 3 trials for its candidate, AZD7442. The UK Government have agreed to an unspecified amount of the AZ candidate. Pfizer also has advanced therapeutic trials under way, being developed in Sandwich in Kent, and 50 of these trials are going on worldwide. I think the Government could reach out to manufacturers currently in trials and look to extend the trial in this country as soon as possible. Therapeutics could significantly reduce the number of deaths, and these trials could be extended to those who are on ventilators or on oxygen, working not only with regulators but with medical bodies to agree on the ethical stance of compassionate use.

Therapeutics have another huge advantage: their cost. A treatment course of dexamethasone can cost as little as £5. Those courses are largely available and work well with the rapid testing trials that are going on in Liverpool, bridging the gap until the vaccine is approved. I have written to the Prime Minister and the Health Secretary, urging them to extent trials of vaccines for those people who are at risk. During my call with AstraZeneca, I asked, “What more could we do to test safe medicines for people who fear for their lives, who at the moment can do nothing but hope?” I expected to be told that nothing more could be done, but instead AstraZeneca’s team suggested that we ask them for suggestions on what they think they could do. I have faithfully passed on that request, because I think that, for all of us, this stems from the need to save lives.

Of course, I understand that people are concerned about the new vaccines. However, despite the social media opportunities, less time should be spent on the anti-vaxxers and more on those who want to protect their parents and grandparents. Given the guidance from the Joint Committee on Vaccination and Immunisation, the current advice is that vaccines will be administered not to children but to adults, starting with the most elderly and working down to the over-50s.

Detractors and anti-vaxxers believe that vaccines can be unsafe, and it is true that vaccines can run the risk of causing side effects in some people, just like driving a car or riding a bike can pose risks—nothing in life comes without a degree of risk. Those people want to wait for the one-in-a-million or even the one-in-10-million event to occur before we deploy. Those arguing against rushing the vaccine cite examples such as the H1N1 swine flu vaccine. Those shots reportedly caused Guillain-Barre syndrome paralysis in 6.2 people per 10 million who received the vaccine. If we cast our minds back to that pandemic, 284,000 people died of swine flu globally. Undoubtedly, the vaccine did more to halt the spread of the virus as opposed to the damage it caused. Indeed, as outlined in a 2010 article in Neurology Reviews, GBS was associated with the seasonal flu shot at a rate of 10.6 cases per 10 million doses. That did not stop more than 14 million people from receiving a flu vaccine last year alone without incident.

There must be a balance in this argument between covid-19 and the risk to the 194 people who were killed by it in the UK yesterday—eight people every hour. This virus has killed over 49,000 people in this country alone. There is untold damage to people’s wellbeing, mental health, livelihoods and the economy. Unemployment is rising and small businesses are closing. Social isolation inflicts vast damage, particularly on the old and the poor, but if someone is vaccinated, the likelihood of their dying from this disease is significantly reduced. Vaccination could also prevent people from passing the disease on, often unknowingly, to those they love, such as parents or grandparents. The Government and the World Health Organisation should address not just how we vaccinate, and the therapeutic trials and approvals; in addition, lessons need to be learned and procedures changed.

The suffering and death of so many people can be reduced, with collaboration and a reduction in bureaucracy. There must be a balance, weighing up the positives against the risks. The World Economic Forum gauges that coronavirus has cost at least $8 trillion globally, and possibly as much as $16 trillion, and the cost is only increasing. There is a way out and I hope that the Government in this country and Governments abroad, the manufacturers, scientists, medical professionals and regulators will all work together to strive for a final resolution and a better way of addressing the threat of viruses in the future.

I congratulate the hon. Member for North Herefordshire (Bill Wiggin) on setting the scene so well. I am very supportive of his comments and recognise the need to get a covid vaccine in place.

The Health Secretary announced on TV this morning that, as was rumoured last night, a vaccine has been found, but at the same time he was cautious in his assessment, stating that we should welcome what is happening but remain ever mindful of the need for medical trials, which the hon. Gentleman also referred to. We watched that unfold and then later in the day we had an opportunity in the main Chamber to ask the Health Secretary questions—I think 60 right hon. and hon. Members did just that.

I welcome the fact that there might be 10 million doses of the vaccine available by the end of this year. I am particularly happy because it is a bit of good news at long last. I am always a “glass half full” person, but in the last six months it has been very difficult to try to be positive about where we are going, because the uncertainty was unreal. So today we have some good news. I know that we are not there yet, but we are moving in the right direction.

I am very pleased that Pfizer has achieved this breakthrough. However, I have some concerns at this stage that the vaccine will only be for adults—I will comment on children in a few minutes. The fact that AstraZeneca is also involved, as are many other companies around the world, shows the need to work together. I think that the Health Secretary said, in reply to one of the questions put to him today, that we need to work on an international basis, and he is right. The hon. Member for North Herefordshire also referred to that. It is really important that we realise that we are all in this together, the world over, so it is important that we get ourselves organised.

I am a diabetic—a type 2 diabetic. It is one of those chronic diseases that means I have to get the flu vaccine every year. I was fortunate enough to get the flu vaccine way back in September, I think, when I had occasion to be in the doctor’s surgery. I am not there very often, but I was down getting a check-up and they said, “Take your flu vaccine now.” I am glad that I did, because the fact of the matter is that they have run short of flu vaccines in my constituency, and in many other parts of the United Kingdom.

My question to the Health Secretary this afternoon was about the shortage of flu vaccines, and the importance of ensuring that the covid-19 vaccine, once trials are completed, is available to those who need it, so that we do not find ourselves in the same situation as many of my constituents—of a certain age, vulnerable, and who have come to me for assistance because they cannot get the vaccine. We also want to ensure that the flu vaccine that many are waiting for is available.

School teachers and care professionals—nurses, doctors and frontline workers—must be considered priorities for the vaccine once we know it is safe. If the vaccine is offered, I intend to take it, but some of my constituents have contacted me to say that they do not wish to do so. The Minister has previously said that there will be no compulsion, but my health is not just about me: it is about you, Mr Dowd, about the shadow Minister, about hon. Members and about every one of my constituents. My duty is to everyone else.

I am conscious of the time and I will not take much longer, but I want to make a plea for something that will be possible only with the support of the pharmaceutical companies and those who understand the science. I, like you, Mr Dowd, and other Members, regularly see children at my constituency surgeries with chronic asthma and other respiratory complaints. Their parents send them to school daily in fear. The young girl who drafts my speeches and does my research has a four-year-old with chronic asthma. She had to self-isolate at home from March until the beginning of August. Members might ask whether that is possible, but it is what the doctor told her to do with her child. I hope that the trials will come up with a covid-19 vaccine that children can access to.

I support the Education Minister and my own Education Minister back home in saying that children need to be at school, but they need to be safe at school. Only yesterday my grandchild was sent home because some of the pupils and teachers in the form above her showed covid-19 symptoms. They are all self-isolating for two weeks, but the fact is that we just do not know where we are with the virus. Ever mindful of the shortage with the flu vaccine, I hope we will ensure that the covid vaccine is available.

In this morning’s debate, which was also attended by the Minister, there was mention of the black, Asian and minority ethnic community and people with obesity, who are more liable, according to the stats, to have a covid-19 diagnosis. Again, when it comes to prioritising, I hope that we may include that issue.

I want to make a plea for ethnic groups across the world, as I did in the Chamber last Thursday in a debate about vaccines across the world opened by the hon. Member for North East Fife (Wendy Chamberlain). I have a personal interest in religious minorities and different ethnic groups, and I want them to have the opportunity to have the vaccine. The hon. Member for North Herefordshire mentioned that issue, and he was right. When it comes to handing out vaccines or covid-19 help and assistance, the people at the end of the queue every time are the Christians and small minority groups in countries across the world. The Health Secretary also mentioned that in passing today in the Chamber—I am referring to him quite often, and that is because I am taking note of the points that he made in the Chamber. I want to make sure that the vaccine is available not only for us, here, but for every person in the world. That comes back to the point about needing to deal with the matter internationally, and I hope that that is where we will be going.

It is a pleasure to serve under your chairmanship, Mr Dowd.

Yesterday the news was announced that Pfizer had a potential vaccine that was quite advanced. I do not know how it affected other hon. Members in the Chamber, but my heart skipped a beat. It was brilliant news, and it is not surprising that the attitude in the rest of the country has been exactly the same. It is also not surprising that the stock exchange has effectively gone wild in some areas. People are utterly depressed by the lockdown they are living in, and the news gave them hope that there is a real light at the end of the tunnel, towards which they could drive. Unlike the lights in most tunnels, it is not an oncoming train, but a real opportunity to get out of the situation we are in.

However, it was quite right of the Prime Minister to pull back a bit on that in his broadcast last night. A number of things need to be looked at and studied before we can really rejoice in what Pfizer has done. Most scientists, for example, anticipate that a vaccine will not be 100% effective. As my hon. Friend the Member for North Herefordshire (Bill Wiggin) said, it is only—I use the term lightly—90% effective. However, no vaccine will be 100% effective. We need to ensure that any approved vaccines are as effective as possible, so that they can have the greatest impact on the pandemic.

We have also heard that there is a robust pipeline of potential vaccines in development and that some have already advanced to phase 3. However, we cannot be certain when a vaccine will become available. That is why we cannot rely on a future vaccine to fight the pandemic. We must use all the tools we already have at our disposal, such as testing, contact tracing, physical distancing and masks. I also recommend co-trimoxazole, a drug that is being trialled in Bangladesh and India and that has also been trialled to a certain extent in the UK, which stops the inflammation of the lungs that comes with this terrible virus.

It is too early to know whether covid-19 vaccines will provide long-term protection. Additional research is needed to answer that question. However, the thing that encourages me from the data on people who recover from covid-19—I believe my hon. Friend has recovered from it—is that they develop an immune response that provides at least some protection against reinfection, although we do not know how strong that protection is and how long it lasts. However, that data gives me encouragement that a vaccine can duplicate and pick up on that—if it was not there, I would be very worried that a vaccine was not going to work.

A number of people have mentioned the need to do things on an international basis, and that is a great concern of mine. I happened to meet and have discussions with Dr David Nabarro, who is the special envoy on covid for the World Health Organisation. The Council of Europe—this is one of the great things that comes out of the Council of Europe made a discussion available to members of the social affairs committee. We had a virtual session with Dr Nabarro, who is an engaging, absolutely brilliant man who answers questions forthrightly—he will never make a good politician, but what I got out of the session was absolutely brilliant. To think that, in 2017, we put him forward to be the director general of the World Health Organisation, a proposal that was lost in the politics of the WHO. What a shame. What a difference that man would have made to the World Health Organisation.

The World Health Organisation has a number of programmes. It has a value framework for the allocation and prioritisation of covid-19 vaccinations. It has a road map for prioritising population groups for vaccines foe covid-19. The fair allocation framework aims to ensure that successful vaccines and treatments are shared equitably across all countries. The framework advises that once a covid-19 vaccine is shown to be safe and effective and is authorised for use—there is an argument, which I fully accept, that we could do more to make sure that different regulatory authorities are brought into line on this—all countries should receive doses in proportion to their population size to immunise the highest priority groups. That is just the first phase, after which the vaccine will roll out. If the World Health Organisation can continue in its role—I hope the United States backs off from deserting it and allows it to continue—it will be one of the things that helps to get the vaccine to all countries.

I am sorry for intervening, but I am concerned that those who are in good health but who happen to have a fairly deep pocket financially may think they can access this vaccine. It is really important that the people who access the vaccine for covid-19 are those who need it right now and who perhaps do not have the finance to buy it, as others might. Does the hon. Gentleman agree?

The hon. Gentleman makes a good point. The World Health Organisation’s group of experts has already provided recommendations to countries about which populations should be prioritised. They include frontline health and care workers at high risk of infection, older adults and those at high risk throughout the population—people who are suffering from conditions such as heart disease and diabetes. As the second phase rolls forward and more doses are produced, the vaccine should go to groups at less risk of being infected or suffering badly.

I will finish there. This is an exciting opportunity, which we should not let go of. We should keep on top of this. Let us all hope that maybe in a few months’ time we can all be here celebrating the distribution of at least one—and perhaps more than one—vaccine that will help us out of this situation.

I thank the hon. Member for North Herefordshire (Bill Wiggin) for securing this important and highly relevant debate. It is understandable that we may share a feeling of cautious optimism with the news that the candidate vaccines are showing not only promise but a high degree of efficacy based on the phase 1 and 2 data. I pay tribute to the scientists who have led this encouraging development, and I wish them every success as they move to take the vaccine through the necessary steps to ensure that it is clinically safe and as we begin to prepare for widespread deployment.

Those steps and others, such as continuing to manage the current outbreak through test, trace and isolate methods and protecting our frontline staff with the necessary personal protective equipment, are absolutely vital if we are to rebuild each nation’s economy and return to as normal a way of life as possible. While I may have some sympathy with those who desire less rigorous controls on our freedoms, the economy and clinical trials, the consequences of relaxing too soon are clear to see given the second wave we are living through and a second nationwide lockdown in England. While some have argued that that is a risk worth taking to protect the economy, the consequences will ultimately be further damage to that which they argue they are trying to protect.

That is, similarly, the situation regarding drug licensing, and I want to pick up on some of the points the hon. Member for North Herefordshire referred to. The desire to suspend usual licensing rules would have consequences. They have been developed for important reasons, and those consequences matter. Just as with the caution over announcing a lockdown, I would urge caution over taking any liberties with the phasing of clinical trials. That phasing really matters. It is exactly what is required, particularly if we want to give a clear, confident message to the population that any vaccine has been tested to ensure it is safe.

I would pick up on one example. This vaccine uses an angiotensin-converting enzyme II molecule as its entry receptor, and in situ and in vitro it has been demonstrated to have had a paradoxical effect, so it is not well understood. It has a key role to play in blood pressure and other cardiac regulation, so it is important that we pay attention to the short-term and particularly the late effects of any such treatment.

I also urge caution over the temptation to rush forward, in that we have serious issues to consider ahead of the deployment of any vaccine in a meaningful way across the nations of the UK.

I hoped I had been clearer that I was not calling for a curtailment of any of the safety steps. However, with eight people dying every hour, delay has consequences too. What is not acceptable is that the standards for safety in the UK may be slightly different from the standards around the rest of the world. I was asking for a coming together so that we can have that agreed consensus on safety.

I thank the hon. Member for that helpful clarification. I certainly hope that there would be a concordance of agreement to ensure not only that similar standards are followed, but that research can be worked on across all countries that have the capacity to do so.

I will make some progress. In our collective hope that there is indeed light at the end of the tunnel, the darkness of our shared journey through this pandemic must not be allowed to obscure our important public duty to act in good faith and with financial probity. That responsibility is not only of value in and of itself; we must do that out of respect for the many who did not make it through and who succumbed to covid-19, and in memory of those key workers who did so for the most selfless of reasons.

I want to refer to comments made by the hon. Member for Strangford (Jim Shannon). I agree with him that this has been a long, dark six months; it has been incredibly difficult. There is a need to feel optimistic, but it almost feels too good to be true. We hope that we will see this through, but again, I urge patience so that we can move forward collectively.

We must not emerge from this dark period with an “at any cost” attitude. We must ensure that the burden was shared equally and we acted together. In the spirit of co-operation alluded to by the hon. Member for Henley (John Howell), during Prime Minister’s questions on 18 March I asked a question about scientific support and I concluded:

“Does he agree that the prize on this occasion must be the victory and not patents and profits?”

In response the Prime Minister stated:

“I endorse completely the sentiment that the hon. Gentleman has just expressed about the need to do this collectively.”

And he concluded that

“everybody is working together on the very issues that the hon. Gentleman raised.”—[Official Report, 18 March 2020; Vol. 673, c. 1001.]

With regard to the spirit of togetherness, it is deeply concerning that we repeatedly hear of cronyism at the heart of this Government, particularly in relation to their less than rigorous approach to appointments and procurement. This morning on the BBC’s “Today” programme, the Secretary of State was challenged about the costs surrounding the vaccine taskforce’s work and its processes. Rightly or wrongly, the appointment of Kate Bingham has proven controversial, and there are no doubt questions to be asked about the absence of any clear recruitment process. However, when she appeared before the Health and Social Care Committee last week, I was very impressed by her performance. She has a very real command of the work that she has been leading, and the relevance and depth of her skillset were clearly in tune with the demands of such a position. However, that does not negate the Government’s or, indeed, any appointee’s responsibility to act ethically and in good faith and, most importantly, to transparently account for their actions.

Concerns about passing on company names that the Government favoured in the pursuit of a vaccine is not a matter for me to pass any judgment on, but they do need to be scrutinised fully. The most recent concerns, set out in The Guardian this morning, are also significant. In simple terms, how can a job be considered unpaid when the postholder holds a position of influence or control in the process of awarding a £49 million investment in a company that they remain a managing partner of? That Ms Bingham is married to a Treasury Minister should have set off the ethical alarm bells well in advance of the matter appearing in the media.

I am just about to finish, Mr Dowd; sorry.

Whether the sign-off of the £49 million award came from Nick Elliott or, as the Secretary of State claimed this morning, some civil servant, this matters. These allegations of cronyism, if investigated and found to be true, are sure to make the expenses scandal, the cash-for-honours scandal or the cash-for-influence scandal seem like child’s play. This is a day for cautious optimism indeed, but not at any price.

It is a pleasure to serve under your chairship for the first time, Mr Dowd. I am grateful to the hon. Member for North Herefordshire (Bill Wiggin) for initiating today’s debate on this topic. Timing is everything in politics, and his is clearly spot-on. Similarly, a rare political skill is the ability to make the complex comprehendible, and he really did that in his setting out of the debate. I do not know who is watching, but I did plug this debate when I was on Sky News at lunchtime, so I hope a few people are, because that was the best explanation that I have heard, and certainly the best one that can be distilled into about 15 minutes, of just how rigorous the process is. I hope people will take from that explanation the reassurance that although we are keen for the vaccine to succeed, there is a rigorous process. It has not been retrofitted to fit the vaccination’s journey, so we should have some confidence in that.

To reflect on the two Back-Bench contributions, when the hon. Member for Strangford (Jim Shannon) referred to it being bit of good news, = he was speaking for all of us. He mentioned the groups that will be prioritised, and I think there will be a high level of consensus on that. Hopefully, it is something that we will settle on very quickly. I was cheered by the hon. Member for Henley (John Howell), who talked about the Council of Europe and the World Health Organisation, because those are exactly the sorts of fora that we need to engage with to get an equitable distribution around the world. It is hard for all of us; this is why political consensus is so important. It is hard for us to tell our constituents why we feel there needs to be a global distribution when people are so desperate to get their lives back to normal, but we know there is both a moral and a pragmatic obligation to do that. The organisations that the hon. Gentleman talked about are exactly the places for those conversations.

On the politics of this, it is really important that we do not mess around or be mischievous with the idea of the vaccine. There is a big public conversation about this. Any look of doubt from us would be magnified significantly. As community leaders, we have a responsibility to say that we trust the process. The outcome is whatever the outcome is, but the process itself is a proper one that we trust. That is certainly what hon. Members will see from the Opposition.

Yesterday’s news on the progress and the efficacy of the vaccine will have cheered all of us. I know that the Government are on record with regard to doses from that particular provider, but when we add in the AstraZeneca-University of Oxford one and the Moderna one, might the Minister be able to tell us how many pre-orders have been put in place for the vaccinations? That would help us to gauge the scale. I know the Government have laid the pitch for the roll-out through the changes to the human medicines regulations, and significant changes were made, including giving the Medicines and Healthcare Products Regulatory Agency the powers to grant temporary authorisation pending the granting of a licence.

I was grateful for the time that the Minister gave me with her and the deputy chief medical officer to talk about those changes, but when will there be a parliamentary opportunity to do so? We need to demonstrate that we have scrutinised this properly because the public want to know that we are talking about these things to the fullest extent. That would also allow us to address the point about immunity from civil liberty that the manufacturers and healthcare professionals are seeking, which is not surprising, but there are important and significant qualifiers around that not extending to sufficiently serious breaches. Will the Minister explain what a sufficiently serious breach would look like, or when we might have an occasion to talk about that further?

On vaccine hesitancy, it seems there are distinct phases. We have the anti-vax movement, which is about the substance of vaccinations to an extent, but it also about a broad range of other things. As our constituency mailbags will reflect, there is also a group of people who are hesitant, which is entirely understandable. They want to know that any vaccination, whichever one it is, is a safe one, but it is telling that last year the WHO had vaccine hesitancy in its top 10 threats to global health—up there with a future pandemic. That is something that we need to be aware of. We know that such speculation and the stuff that moves online at an incredible pace can really damage the process. For example, in Denmark in 2013 there were false claims from a documentary about the HPV vaccine, which led to a decline in uptake among some of the cohorts from levels of around 90%. Similarly, between 2014 and 2017 in Ireland, vocal attacks on the HPV vaccine from the anti-vaccine lobby led to a drop in take-up from 70% to 50%. These things matter. One thing that best counters them is proactive, positive health promotion campaigns. I am keen to hear whether the Government plan to talk about these things to educate the population ahead of time, but, again, it something that we all need to buy into, share and push out on a cross-party basis.

An area where I think there might be a little more room for divergence is delivery. We do not know what the future holds for the vaccine or when things will pop up, but it is reasonable to say that we expect one, and we know the scale of our population, so we have no reason not to have significant plans. When the Health Secretary was pushed on it this afternoon, he said that there were plans, but he was less forthcoming on what they were. I am keen for more detail. Whether it was PPE at the early stage of the pandemic or test and trace, frankly, throughout it, such big-scale planning and logistical exercises have not gone flawlessly. Qualifications could be made when they were being done for the first time, but we cannot repeat those mistakes now that we are, I hope, learning from what has happened.

Again, the Health Secretary has talked quite a bit today in the media and the Chamber about the importance of general practice. As I understand it, the BMA’s GP committee, NHS Improvement and NHS England have agreed an enhanced service for general practice to lead this process. That is good. People will want to see this delivered through the NHS rather than a private company, whether because they believe in its efficiency, as I certainly do, or whether in general they think that will reflect best in the population. That is a wise thing to do.

I understand that it is optional for practices to sign up, so may I get more detail from the Minister on that? If take-up is not good enough, will an alteration be considered? I also want to understand what assessment has been made about GPs’ capacity and workload. As I understand it, the programme requires participants to deliver at least 975 vaccinations over a seven-day period from each designated site—that will require 12-hour days seven days a week, including bank holidays. GPs are already busy, so I am keen to know about what assessments have been made about prioritisation.

I do not have enough time to talk about this properly, but I turn finally to the point made clearly by the hon. Members for Henley and for North Herefordshire: we have to come to an equitable settlement globally, too, and to play a leading role in global organisations as we do so.

Thank you, Mr Dowd. I will try to be concise. We have covered an awful lot of ground, and to give my hon. Friend the Member for North Herefordshire (Bill Wiggin) his two minutes—

Right—bless you!

It is a pleasure to serve under your chairmanship, Mr Dowd. I congratulate my hon. Friend the Member for North Herefordshire on securing this debate—and on such a timely day, as the hon. Member for Nottingham North (Alex Norris) said. It is almost as if my hon. Friend had planned it. I agree wholeheartedly with his comment that we must continue to protect the vulnerable as a priority. I also agree with much of what he said about making sure that we are moving at pace, while never sacrificing safety or efficacy, to drive forward and make sure, in therapeutics and particularly in vaccines, that we are delivering as fast as we can.

Many of those doing the work are involved not only in vaccine development but in vaccine manufacture. That means that they are ready to deploy once regulatory approval has been received. But the process has to be properly and ethically done, and people have to be secure in the knowledge that the vaccine is safe.

As everybody has mentioned, yesterday’s news excited us. However, as my hon. Friend the Member for Henley (John Howell) mentioned, there is not a golden bullet. We need to carry on with the non-pharmaceutical interventions and with driving down the R number, as we are doing. But we have had good news, and we can all afford a little moderated optimism to give ourselves a little bit of cheer. It is promising progress that takes us one step closer to finding a vaccine and, as has been much mentioned in this debate, to helping protect millions of people across the world as well as in the UK.

We need to make the vaccine clinically safe. We know that it will not by itself bring the pandemic to an end, but an assured vaccine would be a huge step forward towards resuming a normal way of life. After clean water, vaccination is the single most effective public health intervention. As my hon. Friend the Member for North Herefordshire said, the benefits are enormous. Working with the Department for Digital, Culture, Media and Sport and social media platforms, we are making sure that the message of vaccination hesitancy is worked on. We are doing that across Government and, more broadly, across companies. This is a national effort, and we have to work together to make sure that we give the right message that gives people confidence.

There is enormous collaboration across science, medicine, industry and government, here and internationally, to find a safe vaccine. Our aim of rapidly developing a mass-produced vaccine means that we are striving to do something that has never been done before. Progress is being made at an extraordinary pace.

My hon. Friend the Member for North Herefordshire took me back to my degrees by mentioning p-numbers and statistical significance, and as he said, although access to the vaccine should be given as quickly as possible, we must ensure that it is safe. I congratulate the vaccine taskforce, which has been mentioned, on its hard work leading the UK’s effort to find and manufacture a vaccine. It has successfully secured early access to 350 million doses through agreements with six separate vaccine developers.

My hon. Friend spoke of several of the vaccines, but not all of them. We have four different types: the Oxford-AstraZeneca vaccine, which is in phase 3 trials; the BioNTech-Pfizer mNRA vaccine, about which we had the excellent phase 3 trials news yesterday; and inactivated whole virus vaccines and protein adjuvant vaccines, which are all in phase 1, 2 or pre-clinical trials. The vaccine taskforce makes a call on those most likely to be effective, because we need a rational approach. The vaccine candidates are all in different stages, and extraordinary progress is being made with the phase 3 clinical trials underway in the UK, the USA, India, Brazil and South Africa. I reassure all hon. Members that the Government are prioritising developing, acquiring and deploying vaccines as soon as they are safely available.

The NHS covid-19 vaccine research registry has been developed in partnership with NHS Digital to help facilitate the rapid recruitment of large numbers of people into further trials over the coming months, so that an effective vaccine for coronavirus could potentially be found. It is important that we spread the net and encourage as many people of both genders and from as many different backgrounds as possible to take part, because we know that there is often a degree of over-representation in clinical trials in certain areas. I know that my hon. Friend is particularly interested in ensuring that we do not dismiss any potential vaccines, but he also said that he is very interested in seeing things sped up, so that bench to patient is much quicker. I could not agree more.

Experts from the NHS, academia and the private sector have worked closely with us to explore and establish human challenge trials in the UK, backed by more than £33 million-worth of investment. The studies offer a chance to accelerate the development of promising covid-19 vaccines in a safe and controlled environment. They are being considered by regulators and ethics committees and, if approved, would start in January with results expected by May 2021. Almost £20 million more is being made available to scale up capabilities to process blood samples from clinical trials.

We have invested significantly through UK Research and Innovation to provide unique capability for process, development and scale up. Once an effective vaccine is ready, we must be able to manufacture it at an unmatched and hitherto unseen speed. We will then move on to deployment. I am running out of time, but I am sure that the usual routes will give us a chance to talk about that deployment and other pertinent issues at another date.

The global co-operation was mentioned by several hon. Members. Globally accessible vaccines, treatments and tests are needed for all of us. No single country holds the key; it is a worldwide pandemic, and we are stronger when working together. The UK has taken a strong role in global leadership and in collaborating with other countries. Our commitment to international collaboration is clear, and we were proud to work through multilaterals—such as the G7 and G20, and with the WHO and other international partners, including industry —to agree collaborative approaches to supporting vaccine development, manufacturing scale-up and future distribution to meet domestic and international needs, including for the world’s poorest countries, which touches on points that were made earlier.

I thank scientists and clinicians around the world for their remarkable efforts in working at pace to develop covid-19 vaccines. I thank my hon. Friend for securing this debate. The vaccine will not be a silver bullet—we have to keep trying—but it will be one of the several tools that help our fight against the virus and allow us to have a more normal way of life.

Question put and agreed to.

Resolved,

That this House has considered covid-19 vaccine.

Sitting adjourned.