Dr Caroline Johnson

It is a pleasure to serve under your chairmanship this afternoon, Mrs Barker. I congratulate the hon. Member for Uxbridge and South Ruislip (Danny Beales) on securing this important debate. Why do we vaccinate? As we have heard today, we vaccinate because it prevents illness, it reduces the severity of illnesses that do occur, and it reduces complications. I should declare an interest as a consultant paediatrician in the NHS, as a parent of three children between 11 and 19 and as someone who was a volunteer vaccinator for many months at the local vaccine centre during the covid-19 pandemic. Vaccines were first identified, or discovered, by Edward Jenner in 1796. He discovered the smallpox vaccine, which eliminated smallpox completely between 1958 and 1977. We have seen that happen with so many diseases. I have a list, but it is so long that I am not sure I have time to read it all out: diphtheria, tetanus, polio, haemophilus influenzae, pertussis, rotavirus, hepatitis B, tuberculosis, flu, respiratory syncytial virus, shingles, human papillomavirus, various strains of meningitis, rubella, mumps, coronavirus—I could go on. There are so many different things to which we now have vaccines that we did not have previously and that have reduced the incidence of death and serious illness in so many people. It is almost impossible to quantify how many lives have been saved. I want to focus on measles, which several hon. Members have mentioned. My great-uncle Leonard died of measles at the age of 15 months. Pre-vaccine, it was a common condition that killed many people. Thankfully, now it is not—and why? Because of vaccines. Vaccination rates have fallen, however, and we have lost our measles-free status. We need to make sure, as far as possible, that everyone gets the vaccine. The concept of herd immunity means that if some children cannot be vaccinated because of a personal health condition, they will be protected to an extent by the fact of a large proportion of the population having been vaccinated, and by the reduction of that disease within the community in some conditions. If vaccination rates fall, there is a risk to those people, as well as to those who have just decided not to have the vaccine. I would be interested to know how the Minister will focus on measles in particular. When we were in office, the Conservatives modernised the routine vaccination programme. In 2015, the UK became the first country to offer the Bexsero vaccine against meningitis B, which was given to babies aged eight to 16 weeks, followed by a booster around their first birthday. In 2017, we also switched to the hexavalent six-in-one routine vaccine programme so that babies could be protected against hepatitis B for the first time. Conservative Ministers expanded the HPV vaccination to boys, bringing the UK in line with other developed countries and preventing approximately 30,000 cases of cancer in males. The vaccine taskforce secured seven vaccines for the UK during the coronavirus pandemic, invested over £400 million in scaling up domestic manufacturing and mobilised more than 100,000 volunteers with sites right across the country. We also backed the Oxford-AstraZeneca vaccine with public funding and agreed a 10-year partnership with Moderna to invest in mRNA research and development. The previous Government supported vaccination in a number of ways; I look forward to hearing from the Minister what her Government will do to support it. I also want to talk about meningitis B, which is a horrible, rapid disease that affects patients very quickly. It is one of the diseases that is quite frightening to see as a paediatrician because of the speed at which a child goes from being well to being critically ill. We have all heard about putting the glass across the rash to see whether it disappears, but I have watched that rash appear on children with lightning speed. The disease kills, and it leaves many children with severe, lifelong disabilities. In 2015, the UK was first in the world to bring in a vaccine against meningitis for small children, but last year we saw meningitis B infections in groups of older children and young adults in Kent, Dorset and Reading. There were 21 cases in Kent and two deaths. The Government quickly brought in a local vaccine programme to treat people who might have been at risk, but there was also a stampede for private provision; Boots, Superdrug and other commercial ventures ran out of the vaccine within a few hours. The Government have decided to bring in a system under which people born between 1 September 2007 and 31 August 2008, and those who are starting university or further education colleges for the first time this year, will be able to get the vaccine. However, the JCVI has suggested that children who have been vaccinated with one dose should be given a booster at age 15. That means those who were born after 1 May 2015, so the Minister has a little while to manage that, but the JCVI has also recommended two doses for adolescents who did not get the first dose. The Government do not seem to have taken up that recommendation yet. Will they do so? When? A meningitis vaccine has also been brought in for men who have sex with men because, interestingly, it also has a 42% protective rate for gonococcal conditions. There was a record high of 85,000 cases in 2023. The vaccine has helped with those cases, but it would be beneficial to know when the Government will ensure that all our young children have the protection that they need against this frightening disease. Other things are slipping, too. The flu vaccination is highly effective at reducing seasonal hospital admissions. The WHO recognises that it is the most effective way to prevent infection and severe outcomes from flu, but coverage among the elderly and at-risk groups has declined in England. I would be interested to hear why the Minister thinks that is, what her research shows and what she is going to do about it. Respiratory syncytial virus affects not just children, but the elderly. The vaccine is incredibly effective in the elderly; last year, the JCVI recommended its extension to the over-80s. At the time, I asked Ministers whether the vaccine, having been recommended by the JCVI in the early summer, would be ready for last winter. My understanding, from what was said, was that they were going to work at pace. They reassured me that it would happen, but it did not. I believe that the vaccine will be available to older people this winter, but what is the Minister doing to make sure that they are aware of that so that they take it up? It will help to reduce admissions to hospital over the winter and reduce the pressure on A&Es and ambulance services, and it will mean that people are less unwell, which is obviously a good thing. Many hon. Members have talked about vaccine hesitancy. Polling by Ipsos found that more than two thirds of adults believed that it was “difficult for the public to spot misleading health information.” It also found that those in the most deprived areas were more likely to be affected. According to a UK Health Security Agency survey, last year 47% of parents who reported seeing concerning information about vaccines said that they had seen it on social media. As hon. Members have said, those sorts of message, such as the suggestion that cancer in the royal family was caused by vaccines, were platformed by a political party at a conference. It is important that we give responsible information about vaccines that we know to be true. We do not pretend that there are no risks. There is always a small risk to anything: we take a risk when we get up in the morning and come to work, and we take a risk every time we cross the road. Every aspect of our life contains risk, but we need to be honest with people and explain that the risks of vaccines are tiny and the risks of the disease are potentially much greater. That will mean that people can make informed decisions. When patients who have not been vaccinated come to clinic—we check with all children whether they have been vaccinated when they come for their first clinical appointment—they have very often refused once and not been asked again. The reason why has not been discussed. No one has asked them why they are worried about the vaccine; it has just been accepted at face value. Very often, when we talk to parents about it, they will then have their children vaccinated. We need to make sure that when unvaccinated children do present to medical services, we take the opportunity to try to get them vaccinated. I welcome the addition to the relationships, sex and health education curriculum of facts about vaccination and immunisation, but what is happening to provide public information to parents and other adults? It is said that vaccine uptake among ethnic minority groups is markedly lower. Does the Minister understand why? What is she doing to improve it? The Prime Minister has previously attested that Healthwatch is a key factor in engaging marginalised communities, but this Labour Government have placed it on the chopping block in the Health Bill, which is due back in the House next week. How does the Minister foresee that role being taken up by the patient experience body with which the Government intend to replace it? From April next year, integrated care boards instead of NHS England will be responsible for vaccinations. I understand that that is part of the Minister’s strategic commissioning vision, but will that additional responsibility be met with additional resources? How will the Government ensure that it does not cause further slippage in vaccinations? Finally, I want to mention the life sciences industry, which is struggling under this Government’s tax burden. Now that the Department for Science, Innovation and Technology has been abolished, what will the Minister do to ensure that the industry is given the support that it needs? Occasionally during my career, a parent of a critically ill child has looked me in the eye, often as the child is being put in an ambulance to an intensive care unit, and said, “If I’d given my child the vaccine, they wouldn’t be this ill, would they, Doctor?” There is trauma and grief for those parents, and a regret that is completely unnecessary and can be prevented. It is in the hands of the Minister and of this Government to do what they can to prevent it. I look forward to hearing what the Minister plans to do.