PARLIAMENTARY DEBATE
Vaccination Strategy - 12 January 2022 (Commons/Commons Chamber)

(Urgent Question): To ask the Minister to provide an update on the Government’s vaccination strategy.

I am grateful to my hon. Friend for her question. We have built three lines of defence to give us the best chance of living with covid-19 and avoiding strict measures: vaccination, testing and treatments. Vaccination is the most important of those three, especially in light of the new omicron variant. Recent data from the UK Health Security Agency shows that unvaccinated people are between three and eight times more likely to be hospitalised with covid-19, so every jab counts in keeping people out of hospital and saving lives.



Since omicron began making its way around the world, our strategy has been to massively expand vaccination. We set the highly ambitious target of ensuring that everyone eligible for a booster would be offered one by the end of December, and we met that target. Some 80% of eligible adults in England have now had the booster, including 87% of people over 50. That means that, per capita, we are the most boosted large nation on the planet. In addition, more than 1.4 million young people aged 12 to 15 have already had their first dose since the vaccine was rolled out to that age group in September, with thousands still getting jabbed every day. As of 10 January, eligible children aged 12 to 15 are being offered a second dose in their school. The vaccination effort is a vital part of ensuring the safe return of pupils to the classroom after Christmas, and the continuity of in-person education, which we know is so important for their development.

Throughout our vaccine programme, we listened to the advice of the Joint Committee on Vaccination and Immunisation, whose clinical expertise is second to none. As we have done so, our vaccination strategy has been highly successful, allowing us to live with fewer restrictions than many other places around the world and keeping our children in education settings, where they belong. Once again, I underline my thanks to everyone who has made our national vaccination programme possible, including the JCVI, the NHS, our vaccines taskforce, the vaccinators and all volunteers across the country. I am sure that the whole House will join me in thanking them for everything that they have achieved.

I thank the Minister for her statement. The UK’s vaccine roll-out has indeed been enormously effective, but in September the JCVI expressed concerns about a child vaccination programme because of uncertainty regarding the magnitude of potential harms. Following advice from the chief medical officer, the Government pushed ahead with the mass vaccination of healthy children on the basis that, although the benefits to children’s health were marginal, it may reduce transmission and keep kids in school. Around 50% of 12 to 15-year-olds have now been jabbed, so what assessment has been made of the effectiveness of the vaccination programme in keeping children in face-to-face education?

Now that the omicron variant is dominant and more evidence is available, the benefits and risks of vaccinating children may have changed. What assessment has been made of the risk of hospitalisation of healthy children due to omicron compared with delta? Evidence is emerging that vaccination has minimal impact on omicron transmission, so what reassessment have the Government made of the potential future impact of child vaccinations on reducing transmission in schools? Given a recent Centres for Disease Control and Prevention study showing that the risks of myocarditis in young people following vaccination may be greater than previously thought, and compounded by multiple doses, will the Government urgently review the potential harms of vaccinating children?

This weekend, the NHS put out a press release encouraging more children to get jabbed, including the line:

“Young people can get their life-saving protection”.

It also said:

“Vaccines will protect young people from Omicron”.

Where is the evidence for those claims, and does the Minister believe that that communication meets the commitment not to put pressure on children? Lastly, given the evidence on transmission, will the Government push ahead with the compulsory vaccination of NHS staff, and will they insist on a booster dose for all staff every few months? If not, where is the evidence that compulsory vaccination of staff will increase patient safety in the long term?

My hon. Friend is quite right to raise some of her concerns. We need to start from scratch, remembering that it is the Medicines and Healthcare products Regulatory Agency, which is the highly thought of regulator, that has deemed the vaccine to be safe for this age group. As a result, the JCVI provided its recommendations, and our chief medical officers across all four nations added to that. The vaccine has already been given to millions of 12 to 15-year-olds in a number of countries, including 8 million in the United States. Data from those countries shows that the vaccine has a good safety record. I am completely confident that the JCVI would not make those recommendations if there were any doubt at all. That is why all eligible 12 to 15-year-olds are able to book their second jab. It is the best way to protect young people and make sure that they are kept in education. We all know that face-to-face education is one of the most valuable things for young people, and we will do whatever we can to keep them in that position.

We must recognise that myocarditis occurs as a result of covid infection as well. We need to get the balance right to ensure that we are doing whatever we can to protect the majority of young people and make sure that they are kept in education in a timely manner. I think it is right that we continue to follow the scientific evidence and the clinical advice, as we have done throughout this pandemic.

I thank the hon. Member for Penistone and Stocksbridge (Miriam Cates) for securing this urgent question; you, Mr Speaker, for granting it; and the Minister for her statement.

Our incredible NHS has moved heaven and earth during the vaccine roll-out and has achieved an extraordinary amount in the face of profound challenges. As the Minister makes clear, it is only through vaccination that we can begin to contemplate building a world beyond covid. I would therefore be grateful if she explained what assessment she has made of the current vaccine take-up rates, which have dropped to the lowest level since mid-October, and what plans she has to ramp them up again.

Will the Minister also clarify what action the Government will take to drive up vaccination rates among 12 to 17-year-olds, following media reports of children having to wait until February and travel 50 miles to get an appointment for their first covid-19 vaccination? Will she advise the House on what steps she is taking to persuade those who have yet to have the vaccine to do so as soon as possible, and what action her Department is taking to tackle the raft of misinformation about the vaccine that continues to circulate on social media and beyond, doing real damage to public health messages? I would also be grateful if she gave an assessment of the impact on vaccination rates of the introduction of NHS covid passes.

Over the course of the pandemic, immunocompromised, immunosuppressed and clinically extremely vulnerable people have been badly let down. They are crying out for further clarity, and recent reports highlight that more than 300,000 housebound people are yet to receive their booster. Will the Minister take this opportunity to provide the vital clarity that people need and set out the Government’s booster vaccination strategy for housebound, clinically vulnerable and clinically extremely vulnerable people?

Lastly, will the Minister outline what further steps are being taken to vaccinate the world? As the development of omicron shows, delay with regard to global vaccination has stark public health consequences here at home. With reports of the UK discarding hundreds of thousands of vaccines over the past few months, can she reassure the House that assisting with vaccinating the world remains a priority for her Department and this Government?

I thank the hon. Gentleman for his measured approach. We have seen throughout the pandemic that everybody working together gets us where we need to be, which is making sure that people are safe.

The hon. Gentleman asked a few questions about the current vaccine programme and the uptake rate. I am delighted that about 80% of people over 18 have now been boosted, which is a fantastic achievement. Over 90% of the population aged 12 or over have had their first dose and 83% have taken up the offer of a second. I reiterate that the offer of a first and second dose is always there. If people have not yet come forward for their first dose, it is not too late: they can go to a walk-in centre or make an appointment through the national booking service or their GP to get that all-important vaccine.

With regard to 12 to 17-year-olds, the school-age immunisation service has started to roll out again this week. People can also take the out-of-school offer through the national booking service or the walk-in sites. The hon. Gentleman mentioned a case where somebody had to travel 50 miles. We did look into that situation, and it was not quite right. We have been in touch with that member of the public, and the situation has been resolved.

Housebound patients are the responsibility of the primary care network or the clinical commissioning group, depending on the local scenario. Every housebound patient has been offered their booster vaccine now, but if the time was not quite right, or any Member has taken up such a case with their CCG and not had a solution, I would be happy to take the case up on their behalf.

The hon. Gentleman talked about the ambition not just to vaccinate the UK but to make sure that people globally are protected. I am delighted to announce that, as of the end of last year, we donated 30 million doses, partly through COVAX and partly through bilateral agreements, which is a great achievement, and we have a commitment in place for 100 million doses by the end of June this year.

This country has one of the best vaccination programmes in the world and the very best in Europe. We should remember that the foundations were put in place when, at the height of the first wave, the then Health Secretary bought 400 million doses of vaccine that we did not even know would work. That has meant that we are now emerging sooner and more broadly than nearly anywhere else. But that success was also because a lot of GPs in the NHS were diverted away from their normal work into the vaccination programme, and that has come with costs in terms of the other treatments they are not able to deliver. When will we see a workforce plan that takes account of the new responsibilities for vaccination that the NHS will have? When will the budget for Health Education England be agreed, because two and a half months before the next financial year we still do not know what it is? Will the workforce plan have independent forecasts so that we can make sure we are training enough doctors and nurses for the future?

I thank my right hon. Friend for his question. He has made it his ambition, as has the Department, to ensure that we have the right workforce in place. He raises a really good point about the vaccines and how we continue to administer them—not just the covid vaccine but the flu and other vaccines that we have throughout our lifetimes. We have learned an awful lot from rolling out the covid vaccine programme, and like my right hon. Friend I commend the vaccine taskforce for having the foresight to look beyond what some other countries did, to make sure we had the vaccines in place when we needed them.

We do need to look again at how we maximise what has been such good will. In terms of the vaccinators who have come forward, some were not trained as vaccinators before. As I travel around some of the vaccine sites, I meet people from all backgrounds who have taken up the challenge to come forward and become vaccinators. The other day, I actually met a builder who is now a vaccinator, and he is loving every minute of it. I also thank the volunteers who have come forward and made sure that this programme has been so effective. It is about bringing together what we have learned in this programme over the last year to make sure that we can roll out other programmes in an effective manner.

Once again Scotland has set an example for the UK, and I want to take this opportunity to thank all those NHS and frontline key workers involved in the excellent vaccination roll-out programme. We lead the way on first and second doses administered, and we rank second worldwide for the most successful booster roll-out programme, with over 80% of our adult population given their third vaccine. The rest of the UK also has one of the highest vaccination records in the world, along with most of Europe. Is it not well past time to begin a serious campaign of vaccine sharing and the vaccination of those who have so far been left behind in our global community?

Secondly, when the booster roll-out does wind down, will the UK Government commit to shifting the momentum from domestic vaccination to vaccination sharing with the poorest countries? While we welcome the 30 million doses that have been donated, they are a mere drop in the ocean in terms of what is actually required. Lastly, will this Tory Government finally show a shred of compassion for the plight of those around the world?

The hon. Gentleman makes a good point about ensuring that rural communities have access to vaccines, and that is exactly what we have done through our programme. We have made sure that walk-in centres have been stood up, as well as other ways for people to access vaccines such as vaccine buses, so that community pharmacists can deliver in rural settings and among hard-to-reach groups. Whether in rural or urban areas, it is important that we use every possible route—for example, working through community groups, local leadership and faith groups—to put everything in place to ensure that everyone has access to the life-saving vaccines.

I reiterate what I said to the hon. Member for Denton and Reddish (Andrew Gwynne), that to date we have donated 30 million doses to COVAX and bilaterally. We will continue to fulfil our commitment to donate 100 million jabs globally by the end of June this year.

I was not expecting to be called, Mr Speaker. I congratulate my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates) on securing this important urgent question. Reflecting on what the Chair of the Health and Social Care Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), said about workforce planning, I know that in my constituency, Wealden, and across East Sussex, there is huge concern about accessing healthcare and treatment. Will the Minister explain what risk assessment has been done of how, if unvaccinated staff—as many as 88,000—leave the NHS, treatment will be made available and how my constituents will be able to access day-to-day healthcare and treatment?

I think my hon. Friend is referring to vaccination as a condition of employment. I should like to inform the House that already over 93% of the NHS workforce have had their first jab, which is incredible. It is the will of the House, expressed before Christmas, that we implement this policy. Peer-to-peer conversations are going on to make sure that people have the right information they need to take up the offer of a jab, which not only protects them but protects their patients, who are some of the most vulnerable people in society.

I pay tribute to the hard-working staff at St Thomas’ Hospital in my constituency, who have helped many Members of this House to receive their booster jab, and to the many volunteers throughout Vauxhall. The Minister outlined that 90% of people have had their first dose and over 80% their second. With the emergence of omicron, we have seen that unless everyone is vaccinated, we are not safe. We are not safe until everyone is safe, but around the world there are still places where people are not receiving vaccines. Will she outline what work the Government are doing to make sure that there are enough vaccines globally to ensure equitable access for everyone?

I also pay tribute to the staff at St Thomas’ Hospital. I visited the vaccination centre there and was really impressed by the way it is set up, with the paediatric side as well, and by all the volunteers who were there making sure that everyone felt comfortable about going forward. Some of the people there had thought for quite some time about taking the plunge and getting their first dose, so I thank the staff for their work.

The hon. Lady makes a good point when she says that we are not safe until everyone is safe. I reiterate our commitment to COVAX, not just through donating vaccines but financially as well. Just over a year ago, the first AstraZeneca vaccine jab in the world was given to a gentleman in Nottinghamshire. As a result of our collaboration with Oxford University and AstraZeneca, those jabs continue to be delivered at cost throughout the world. That is a really good outcome of the Government’s investment.

Given its success, I believe we should now place our faith in the vaccination strategy and not in further controls. When I voted against plan B before Christmas, I said that more and more regulation creates more and more hypocrisy. Despite what is going on in Russia and the cost of living, we spent most of Prime Minister’s questions debating the fact that the Prime Minister wandered out of his house, where he lives and works, and had a drink with colleagues. The truth is that the Government should learn a lesson from this. We must sweep away every last vestige of telling people how to live their lives. We have had enough of it. The British people have had enough of it. These controls are actually making things worse—for example, forcing staff to isolate and putting our NHS at risk—so please, let us free the people.

I reassure my right hon. Friend that we will not have the restrictions in place for a day longer than necessary. He is aware that the current plan B restrictions will be reviewed on 26 January.

Many hon. Members have constituents whose long-awaited treatments and operations are being cancelled because hospitals are full of the unvaccinated. We in England have one of the most indulgent approaches to the unvaccinated. Why does the Minister not follow the example of New Zealand, Australia and the rest of Europe and do much more to incentivise people to get vaccinated?

I reassure the right hon. Gentleman that we are doing what we can to ensure that people get vaccinated. Some of the stats speak for themselves: people are eight times more likely to be hospitalised if they are unvaccinated and more than 60% of those in ICU are unvaccinated. We are not a nation that forces people to do things unnecessarily. The behavioural insights team across Government has been looking at different ways to get those who have not come forward yet to get their jab and at the pros and cons of different ways of doing that. At the moment, I think we have the right approach, which is explaining why it is important for them to come forward to get a jab.

The question of my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates) was about whether there was a reassessment of the strategy on the basis of what we know now about omicron that we did not when the strategy was set out. Will the Minister answer that, particularly in respect of the policy of sacking NHS staff who are not vaccinated, given that we know that the rationale has disappeared because it does not stop people from catching it or from infecting others?

My right hon. Friend makes a very good point, but I go back to the MHRA, which is globally recognised as one of the best regulators and has advised that,

“the benefits of vaccination still outweigh any risk in most individuals.”

With regards to myocarditis, to which I think he was referring as well, it is greater in those children who have been infected with covid than in those who have been jabbed. I must stress, however, that instances of both those circumstances are extremely rare. The JCVI continually reviews all the data.

It is clear that the Government need a new strategy for driving up vaccinations among the unvaccinated. Around the country, there are practical examples of things that are working that they could roll out nationally. Will the Minister commit to looking at ideas such as vaccine tracing; the offer of an on-the-spot vaccination when somebody comes into contact with any part of the NHS; and the offer of free cabs for those who are struggling to get to a vaccination centre because of the cost or caring arrangements? Those things are working already, yet they are not being rolled out nationally.

I reassure the hon. Lady that many different measures are being put in place across the whole country depending on what works in different specific areas. For example, there are pop-up clinics in mosques and temples; there have been all-female clinics that help different communities; and there have been clinics in restaurants in certain parts of Bradford. There is a wide range of measures because, as she rightly indicated, there is not one solution for everybody. The fact that more than 90% of people have already had their first dose is a huge success, but the last few are the hardest to reach. That is why we are putting in place different measures to ensure that we do the right thing for individuals in different places and look at what will work for individuals across different communities.

When what is at stake is the balance of health risk for children right across Wycombe and every constituency in the whole country, is my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates) not absolutely right to ask my hon. Friend the Minister to task the JCVI and the medical officers with a reassessment of new evidence? My hon. Friend just said at the Dispatch Box that evidence is kept under continuous review—and she nods—so why can she not please say at the Dispatch Box that she will ask the experts to revisit the new evidence, just to check that the balance of health risk for children is still appropriate and that she is satisfied with the responsibility, which she bears, for the decision that has been taken?

My hon. Friend is quite right that we do bear responsibility. I do not take these decisions lightly at all and neither does my right hon. Friend the Secretary of State. That is why the JCVI and the CMO continually review not just the UK data but the national data for every age range, every vaccine and every eventuality. The CMO will have heard my hon. Friend’s request and I am sure he will be completely focused on making sure that the JCVI continues to monitor the situation in the specific way my hon. Friend asks for.

I thank the hon. Gentleman for raising this important part of our strategy to make sure we can react quickly in respect of those with certain conditions. Giving them ready access to the antivirals is the third part of our strategy to combat coronavirus. GPs and hospital consultants should link up to make sure that the right conditions are considered. I advise the hon. Gentleman’s constituent initially to contact her GP to make sure that she fits the category. If she has received the letter but no PCR test, she should contact 119—Test and Trace—

Or she should go online to find out whether there has been a mismatch in the data. If she has received the letter saying that she should receive the PCR so that she can do one if she has symptoms, we just need to make sure that she gets one delivered to her home.

It is great news that the Minister reports that 93% of NHS staff have received the vaccine—that is fantastic—and I commend every effort made to encourage NHS staff and all those involved in the delivery of care to receive the vaccine, but what will the Government do if, in a few weeks, a critically high number of people in the NHS have still not had the vaccine? Will they all face being sacked or moved in April? How would that protect the NHS?

As my hon. Friend said, to date over 93% of NHS staff have had their first jab. I want to put out a plea. We already have vaccination as a condition of deployment in the care sector and we did not see the cliff edge that so many people predicted. In terms of my own personal circumstances, my father was in a care home for over seven years and his carers became his family. We always do the best for our family and want to make sure that they are protected in the same way that we are protected, and that carries through to NHS staff as well, and to those in other Care Quality Commission-regulated organisations. It is about patient safety: at the end of the day, we are looking to make sure that every patient is kept safe.

I must say that I am amazed at the Minister’s complacency about the potential loss of staff as a result of the vaccine mandate. The care sector has lost 54,000 people who refused to take the vaccine, with the result that hospital beds are blocked, care packages are not being given and care homes are under pressure. The social care sector is an indication that we cannot force people to take the vaccine, and the Minister’s own assessment is that up to 88,000 staff could resist taking it. In the past week, 40,000 people in the NHS have been off work because they had to isolate, and we have seen the chaos that has caused. How does she intend to deal with the chaos of 88,000 staff not being available because of the vaccine mandate?

I do not recognise the data given by the right hon. Gentleman. We have already invested £465 million in a recruitment and retention programme for care home staff. It is important to recognise that caring is a worthwhile career. The carers I have met are really dedicated and get a lot from it. I come back to the fact that it is important to keep the most vulnerable in our society safe, whether they are care home residents or patients who are acutely ill in hospital.

My sources in the NHS tell me that last week they received either from the Department or from NHS England instructions effectively on how to go about firing people from the NHS in April if they have not been vaccinated. That caused them considerable concern. The Government’s own analysis, prepared by the Minister’s own Department, is not of the position now; it is of the expectation of where we will be in April. Analysis from her own Department, signed off by her, thinks that 73,000 NHS staff and 38,000 domiciliary care workers will leave.

I want people to be vaccinated, but we know that the protection against infection wanes quite quickly from 10 weeks onwards, which means that we are not protecting others. I want people to be vaccinated, but I—and public health professionals—think that the best way is to persuade them, not threaten them with the sack. If people have not had their first jab by 3 February they will be unable to be fully vaccinated by April, so may I urge her, even at this stage, to come back to the House and reflect on whether threatening people with the sack if they do not get vaccinated is the right policy?

I completely agree with my right hon. Friend that persuasion is the right way to go. That is why the uptake went up tremendously among care home staff and since we implemented the policy for the NHS the uptake among NHS staff has increased tremendously as well, which is really encouraging. We want it to be a positive choice, and we want people to understand that they are protecting not just themselves and their families but the patients they care for, ensuring that they are safe. Those one-on-one conversations are ongoing to ensure that people understand that, from the perspective of patient safety, this is the right choice to make.

With rates of infection high among teenagers, many are simply unable to get double vaccinated yet as they were infected in the period when they would have been eligible and had to wait 12 weeks to get the jab. Unfortunately for families hoping to travel in half term, they cannot access a covid recovery certificate through the NHS app or through 119, despite contracting covid being the reason that they are not double vaccinated. Families are facing the prospect of cancelling their travel plans for half term, which will have an impact not only on our constituents but on the travel industry. I know that the Department is considering a solution, but will the Minister give some clarity that that will be achieved before half term, to give people the confidence to make travel plans?

The hon. Lady makes a very good point, and it is not the first time the issue has been raised with me. We had that situation in the run-up to Christmas, and we are obviously now in the run-up to half term and Easter as well. I assure her that measures are being considered to see how to resolve the situation.

I thank my hon. Friend for her efforts to save us from vaccine-only passports, leaving the option for testing on the table, given what we know about the impact of vaccination on transmission and that fact that with compulsory vaccination the Government’s central assumption is the loss of more than 100,000 healthcare workers. She has set out that patient safety is paramount to her. Does she therefore share my concern that we risk lulling healthcare workers and patients into a false sense of security? Is it not the case that daily healthcare worker testing is a much safer option to rely on for the protection of patients?

My hon. Friend makes a good point about daily testing, which is being carried out with certain cohorts of the workforce. The UKHSA continues to monitor the best way to ensure that the workforce, whether in the NHS or other parts of industry, protect one another as they go about their work tasks.

Having turned 60 yesterday—[Interruption.] It is very difficult to believe, isn’t it, Mr Speaker, but you are not saying I am misleading the House, obviously. Having turned 60 yesterday, I feel I ought to ask a question about the elderly. Quite a lot of people in the elderly group who have had their booster vaccines will have had them in September and October of last year. I had mine at the beginning of November. What will our policy be from now, because, as the right hon. Member for Forest of Dean (Mr Harper) pointed out, the immunity that comes from the booster runs out somewhat after 10 weeks?

I wish the hon. Gentleman a happy birthday for yesterday. He does not look a year older than 59—just one day older. He makes a good point. The JCVI, which provides advice for Ministers, has considered that question. Towards the end of last week, it felt that a fourth dose or a second booster was not appropriate at this time and that it was important to focus on first boosters and people coming forward for their first and second doses. But I reiterate that the JCVI continues to keep the question under constant review and, should the situation change, it will provide that advice.

I am going to hand over to my colleague in the Chair, but before I do so, to help the Minister I remind Members that we still have some nurses who can give injections at a pop-up in the House of Commons.

I declare my interest as a consultant paediatrician working in the NHS and as a volunteer vaccinator. I am very proud to be part of the vaccination programme that has undoubtedly saved so very many lives.

I want to focus on children. I have worked in hospital over the past month and have been looking after children who have had positive tests. That is not unexpected because the virus is high in the population and of course we test everybody. However, I have not been looking after children who were admitted because of covid. In September, we heard that the decision on whether to offer children vaccines was finely balanced. Indeed, the JCVI referred that decision to the chief medical officers, who finally decided, on the basis of educational disruption, to offer children vaccines. Given that omicron is less harmful than the variants we were considering at the time, has the Minister asked the JCVI and the CMOs to consider whether these vaccines are still, on balance, better for children than not—except, perhaps, in the context of travel?

I thank my hon. Friend for her role in vaccinating probably thousands of people by now. Everybody has played their part, using their skills and their time to roll out the vaccination programme in such an amazing way. I assure my hon. Friend, who obviously has an awful lot of expertise and knowledge, that JCVI continually looks at the data. We hear announcements from the JCVI and think they are just about what it has considered on that particular day, but I assure the House that it continually looks at the data to make sure that we move forward in the right manner.

As vaccination uptake increases, conspiracy theory-inspired groups have hardened their language and threats against those involved in vaccination delivery have also increased. Some groups—I will not name them, because what they do is so despicable—are attempting to disrupt vaccinations, and even to attack testing facilities. The threat posed by conspiracy theorist anti-vaxxer groups is real and cannot be ignored. What assessment has the Minister’s Department made of how to counter those groups and safeguard the vaccine roll-out?

Misinformation costs lives. It is totally inappropriate, and there is no place for it in our society. As the hon. Lady rightly highlights, testing centres have also been attacked, which I am sure is under police investigation. I reassure her that we have a unit that considers such issues all the time, and numerous online presences are taken down on a regular basis. As she will imagine, various police investigations are under way.

When the facts change, we are entitled to change our minds, and since we passed the regulated activity regulations in December we have had further evidence to suggest that the transmissibility of covid declines after 10 or 12 weeks, as has been mentioned. In light of that, has the Minister gone back to challenge the JCVI on its advice about whether we should compulsorily vaccinate health workers, particularly given that it now appears that the risk they pose to patients declines after a very short period, and especially given that we have the alternative of regular lateral flow testing, which will tell, more or less in real time, whether healthcare professionals pose a threat to their patients?

It is important to go back to some of the stats I set out earlier. Those who are unvaccinated are eight times more likely to be hospitalised, and more than 60% of people in intensive care units are unvaccinated. If we can stop people getting the virus in the first place, it will not be transmitted and people will not catch the disease and be hospitalised. It is important to note that it was the will of the House to introduce that policy in December. As I have said repeatedly, the JCVI keeps all the data under constant review, which obviously has an impact on Government policy.

I wish to follow the question raised by the right hon. Member for South West Wiltshire (Dr Murrison), because the reality is that the facts have changed, and depleting efficacy, as well as transmissibility, is presenting a challenge for the Government and their longer term management of covid. Rather than forcing NHS staff to have their first vaccine by 3 February, which will present a massive risk to the NHS—the Government’s own assessment is that between 64,000 and 115,000 NHS and healthcare staff will be sacked—will the Government go back and review the issue, and ask the JCVI what the best strategy is for managing the pandemic from this point forward?

We have our plans in place. We have our vaccination programme, our testing, and our antivirals. Part of the purpose of the vaccination programme is to ensure that some of the most vulnerable in our society are protected. As I said earlier, having the vaccine as a condition of employment is about patient safety and ensuring that people who are in hospital or care homes are protected from this deadly virus.

I have been a big advocate of the vaccination programme, and I got my jabs as soon as I could. Will my hon. Friend address a key issue of concern? The time gap between the different vaccines has been adjusted at various times and, as the hon. Member for Rhondda (Chris Bryant) mentioned, those who are extremely clinically vulnerable had their booster a long time ago and its effectiveness is waning. We know that Israel is already administering a fourth dose to the extremely clinically vulnerable. Will the Minister take that point to the JCVI, so that it can look specifically at the extremely clinically vulnerable and see whether they need a fourth dose?

Those who are clinically extremely vulnerable or immunosuppressed have already been offered a booster, so they have already received four doses. As I said earlier, at the end of last week the JCVI determined that at this stage it was not appropriate for others to have a booster or a fourth dose.

The Titanic Exhibition Centre, which is the largest vaccination centre in Northern Ireland, is to close on Sunday 16 January. Has the Minister made an assessment, in her Department, of the impact that the closure of mass vaccination centres will have on the booster process throughout the United Kingdom of Great Britain and Northern Ireland?

As I understand it, the location of vaccination sites in the devolved nations is the responsibility of those nations. I can only speak for England in that regard, so the hon. Gentleman may wish to take the matter up with the Minister of Health in Northern Ireland.

May I take this opportunity to put on record my thanks to my daughter, and to all her colleagues across the NHS who have worked on the frontline throughout the pandemic, caring for those who have sadly needed hospital treatment?

I have been very supportive of the Government’s approach to the pandemic and their actions, but I tend to agree that as the facts change, we should change our approach. What we have learnt about omicron is that the rationale behind mandatory vaccination has now shifted from protecting others to protecting oneself. Should we not revisit that, given the figures that the Minister has been quoting about the vaccination status of those in hospital and in intensive care units?

When we protect ourselves by having a vaccination, we protect others. My hon. Friend mentioned omicron, but we have seen other variants before, and we will no doubt see more in the future.

Before Christmas, the JCVI issued the welcome guidance that five to 11-year-olds who are either clinically vulnerable or living with someone who is immunosuppressed should be vaccinated against coronavirus, but since then we have heard very little. Can the Minister tell me when the roll-out to five to 11-year-olds will start, whether it will take place in schools or in vaccination centres, and how those who are immunocompromised will be identified—this is very important to those who are living with someone in that position—given that their GP records will not show their condition? I declare a personal interest.

The fact that the hon. Lady has asked that question demonstrates that this is quite a complex matter. NHS England is looking into it, to work out the best way to roll out the vaccine to that particularly vulnerable group of five to 11-year-olds.

I often pay tribute in this place to the leadership on vaccines of Dame Kate Bingham. Speaking about the cancellation of the Valneva contract in Livingston, Dame Kate described the decision as “short-sighted”, “problematic” and “inexplicable”. She also said that it

“set aside the need to build resilience”

and “capability” through the

“flexible state-of-the-art”

technology that Valneva offered. Moreover, it would help us to tackle vaccine hesitancy and our international responsibilities, owing to the lack of cold chain problems. Will the Government listen to the sage advice of Dame Kate, and reinstate the Valneva contract as a matter of urgency?

I, too, pay tribute to the work of Kate Bingham. Without her leadership, we would be in a worse position in regard to vaccines.

The hon. Gentleman has raised the issue of Valneva in the past, and, as I have said in the past, I cannot comment on commercial decisions.

I join the Minister in thanking all those who rushed out the booster programme in December, but some of our constituents have been confused by the two booking systems, the one for the GP centres and the national booking system. Will she commit herself to trying to establish a single booking system by the time we get round to the autumn boosters, or whatever we are going to have, so that we can see full capacity in all the sites that patients can use in one location?

My hon. Friend makes a very good point. I think what we have achieved in the last year is incredible, and we know that we can improve things such as booking services, which is one of the areas I am sure we will be looking at. My hon. Friend makes the point that sometimes people were not aware that slots were available through their GP and thought they had to go through the national booking service. These are lessons to be learned. We have achieved an awful lot in just over a year, and I am sure we will be looking into that as a matter of urgency.

I congratulate the United Kingdom Government on one of the most successful and leading covid-19 vaccination programmes anywhere in the world. As we go forward, can I seek assurances that those who are immunocompromised and immunosuppressed, such as blood cancer patients, will have a real focus from the Department of Health?

I would like to reassure my hon. Friend that that will be the case. I have met a number of the charities concerned in this area, and I will continue to have meetings with those who represent the patients to hear their views.

The House was asked before Christmas to vote for the mandatory vaccination of health workers on the basis of the argument that it would stop transmission. We now know that this is almost certainly not the case. I think we are almost at the end of this session, and it would be tremendous to hear a commitment from the Minister that she will formally request the JCVI to review the evidence behind this policy. The only argument she is giving for it is that it will help protect health workers, but that has to be a decision that they take for themselves. Rather than sacking compulsorily what may be over 100,000 health and social care workers, surely before the deadline is upon us we should reconsider this policy.

It is quite clear that the vaccine does reduce transmission. It is a matter of protecting the individual, but in these settings there are also some very vulnerable people who can ill afford to get more seriously ill. It is only right that we look at every aspect of this. It is not just about the omicron variant; it is about other variants in the future.

We have already heard from my right hon. Friend the Member for South West Wiltshire (Dr Murrison) and others the expression attributed to John Maynard Keynes, but actually by Paul Samuelson:

“When the facts change, I change my mind. What do you do?”

Decisions about recommending vaccinations for 12 to 15-year-olds were regarded as very finely balanced in any case with delta as the predominant variant. Now we have omicron, that so-called fine balance, with all the complications of children’s benefit versus societal benefit and the small but real risk of myocarditis, has clearly altered. Will my hon. Friend ensure that she reflects on that very wise quotation in this instance?

I refer back to the fact that the MHRA confirmed that the Pfizer vaccine is safe and effective in 12 to 17-year-olds, and that followed the rigorous review of the safety, quality and effectiveness of the vaccines in this age group. Obviously, the JCVI then made that recommendation, and the CMO has backed it up. It was based on those experts that this decision was made.