Covid-19: Planning for a vaccine Part 1: preparations for potential Covid-19 vaccines.
Covid-19: Planning for a vaccine Part 1: preparations for potential Covid-19 vaccines.
11 January 2021
Full Oral evidence transcripts
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Q16 Sir Geoffrey Clifton-Brown: Happy new year to all our witnesses. Sir Simon, may I ask you one or two macro questions? First, the Prime Minister in his broadcast introducing the lockdown said that if all went well, the first four priority groups would be vaccinated by the middle of February. Is that still on course?
Sir Simon Stevens: Yes, it is on course and the aim is to have been able to offer everybody in those first four groups an appointment by 15 February.
Q17 Sir Geoffrey Clifton-Brown: May I clear up the total number of people you expect to vaccinate? The report has different views on this. At one point, it says your Department wants to vaccinate everybody, at another point it says we need to vaccinate 70% of the population and at another point it says that we need to vaccinate 25 million people. How many people do you intend to vaccinate or offer the vaccination to? Sir
Simon Stevens: Within the first four priority groups in England there are an estimated 12.2 million people. We aim to offer all 12.2 million people a vaccination before 15 February. How many of them choose to take up the offer will obviously reveal itself with each successive day and week. The central expectation is that around three quarters of people may do so, but we believe it could be higher, given that in this year’s flu jab season we have seen around 80% of people aged 65 and over choosing to accept the flu jab, up by about 10 percentage points on last year. The point is that there is enough vaccine, provided that supply carries on coming onstream as we expect it to, so that if all 12.2 million people say yes, we can jab all 12.2 million people. If, on the other hand, some do not—as, of course, in the real world is likely—then that is vaccine that we can use for other people. Then, just to clarify the 25 million number that you referred to, which is mentioned in the NAO Report, that is not now the number that we expect to be vaccinated during calendar year 2021; it is the estimated number of people who are in the full JCVI risk pyramid categories 1 through 9. In other words, it is everybody aged 50 and above as well as the clinically extremely vulnerable. We aim to be able to offer that group by late spring, assuming that vaccine supply carries on, and then all the rest of the country, the other 17.7 million adults in England, during the balance of the year. Does that clarify it?
Q18 Sir Geoffrey Clifton-Brown: It does, thank you very much. The rate of vaccination—again, you will have intelligence on this—will no doubt depend on the supply of vaccines. The Prime Minister originally said that he wanted a vaccine rate of 2 million a week. He now says that he hopes we will have 13 million vaccinated by mid-February. That is stepping up a bit from the 2 million a week. Taking the previous answer, how long do you realistically think the first category 9 lot will take, and how long do you realistically think that the vaccination programme will take through ’21 to get all of those that really want the vaccination vaccinated? Chair: We have covered some of this already, but Sir Simon can give us a quick recap. Sir Simon Stevens: It is a very good question. As I have said, we have got two sprints and a marathon. We have got a sprint now to 15 February for the first 12.2 million people—
Chair: We have covered that point. I think Sir Geoffrey had problems connecting before.
Sir Geoffrey Clifton-Brown: I am sorry, Chair. If you have covered it, don’t worry.
Q19 Chair: What about the other points?
Sir Simon Stevens: The Health Secretary said by the autumn. Matt Hancock has said that by the autumn we hope to be able to offer the vaccine to everybody in the country who wants one.
Sir Geoffrey Clifton-Brown: That is very helpful. Thank you.
Q124 Sir Geoffrey Clifton-Brown: We have had a long session on this very important subject. Just a few questions to wrap up. First, to Dr Lawson, it appears in behavioural terms that the younger groups are not adhering to the guidance as much as the older groups. It looks as though the take-up of the vaccine is going to be quite high in the older groups, but we know that those under 65 were only 45% of in the flu vaccine take-up. Are you worried that the take-up will decline as we get down the priority groups, and what action are you going to take to prevent that?
Dr Lawson: I should say, first of all, that there is a cross-Government communications team, which includes those from the Vaccine Taskforce and the Cabinet Office, for example, led by the DHSC, that is looking at all the issues of communication around the vaccine. I am happy to give a view, but it may be that we want to ask the question more broadly as well. The polling that was referenced earlier has shown that the UK has one of the highest, if not the highest, openness to vaccines of any country in the western world, with 82% of people saying in a survey last week that they would either consider or strongly rush towards getting a vaccine, so we start in an incredibly powerful position. As you say, that is highest in the older age groups but one of the ways to increase vaccine confidence and vaccine uptake is for people to see their grandparents, their teachers, their uncles and aunts, et cetera, getting the vaccine and for that to start making a change in how we are all able to live. We think the best strategy is to do this and do it really well and safely, and make sure that the whole atmosphere around the programme is one of an effective mass vaccination programme that really changes how the country is able to operate. That that is what we are focused on. The JCVI published some helpful guidance about what it takes to run a successful mass vaccination programme, which includes that operational delivery angle, as well as very straightforward cohorting and openness to take the vaccine. Those are the guidelines that we are following collectively across the programme.
Q125 Sir Geoffrey Clifton-Brown: Thank you very much. My next question is to Nick Elliott. This RNA technology for vaccines is entirely novel. Is it only suitable for SARS-type viruses, or could it be replicated to deal with a wide range of different viruses?
Nick Elliott: I might pass that one on to Kate, but my understanding is that it could be used for a wide range of different viruses. It provides us with lots of flexibility for the future. It is a quite exciting new development in the response to these type of challenges. Kate, do you want to say anything further?
Kate Bingham: What it is, basically, is a piece of genetic material that allows the cells—to translate those into proteins that basically make a bit of viral protein, which is then recognised by the immune system and generates that immune response. It doesn’t matter what it is. You can deliver any form of genetic material in this format. It is suitable for viruses, but it is also suitable for cancer. It is suitable for anything where you want to stimulate an immune response against a specific protein.
Q126 Sir Geoffrey Clifton-Brown: In “Political Thinking with Nick Robinson” last week, you talked about the UK needing to scale up a bulk antibody manufacture. How is your work on the Taskforce leading to that possibility?
Kate Bingham: We started a market engagement process when I was still there. I do not know where that has got to now, but what was set out was a discussion with industry to say, “What are the options for the Government to work with industry to create that bulk antibody supply?” It is not just for prophylactic treatment for immunosuppressed people; it could also be used for therapeutics. Biotherapeutics, or basically biologicals, as drugs are becoming an increasingly important part of treatment in medicine today. I do not know if Nick or Sarah can update you on where we got to, but the market engagement started in November.
Q127 Sir Geoffrey Clifton-Brown: Perhaps they can when either you or they answer this question. Is this the real bonus that we might get from this whole unfortunate Covid-19 episode, through setting up this whole new industry?
Kate Bingham: For sure, and that is why it is so exciting. We are the only western country to show that we can take academic science and turn it into a commercially industrial, consistent and approved vaccine. To go from academic to launch in less than a year is phenomenal. We have the underlying science and we have all the different bits, so that we can make the vaccines, whether they are viral mRNA protein or whole virus, plus then antibodies. We have state-funded groups, such as the Centre for Process Innovation up in Darlington, which have those additional capabilities to support the supply chain. Combine that with the capabilities we have in the UK through the NIHR, where we have national clinical trial networks. Again, the fact that every single person has an NHS number and we are able to bring people into trials in the way that we have sets us apart from the other countries. Finally, on genomics, the UK has sequenced more of the strains of Covid19 than all the other countries put together. Lots of what we the UK have been able to pull together comes from existing Government-funded institutional activity. It is just very exciting. The idea that we can come out of this stronger than we went in is absolutely something that we should be shooting for. We need to ensure that next time a pandemic comes along, we treat this like just another flu jab, because we have all the bits in place, everyone is talking to each other and it works well. That will set us up incredibly well. The one bit I have not mentioned is the MHRA and the fact that they have shown their nimbleness and co-operative working with the different vaccine companies, as well as pharmacovigilance, which is about assessing the safety and efficacy of the vaccines once they have been deployed. That is fundamental to public trust in vaccines. It really matters that we do this properly and that in future we manage the analysis of how the vaccine has performed, because that will affect what future vaccines we want to give, as well as understanding what the best regimes are, how we do it and how we can best protect the population. That will be relevant for every country around the world. Again, very few countries anywhere have the same capability as we do in the UK.
Sir Geoffrey Clifton-Brown: Ms Bingham, I am going to leave it there. I have done hundreds, probably thousands, of these PAC inquiries, and may I say a big congratulations to you and the whole of BEIS and the NHS for putting the UK in the world lead in this field and finding a probable solution to this dreadful period that we have been through with the Covid virus. Many congratulations and thanks to all of you.