Hansard

Fourteen routine vaccines are given to people throughout their lives, from two months old to over 70—and the meningitis B vaccine is coming along. Despite periodic concerns about safety, immunisation, whether it is routine or additional, for travel, is one of medicine’s greatest success stories.

Recent additions, such as the shingles and rotavirus vaccines, are quickly finding their place. Rotavirus kills more than 600,000 children worldwide each year. In the UK, our wealth allows us to vaccinate more to prevent admissions than to prevent death, but in sub-Saharan Africa, rotavirus can be fatal when it is combined with bad water and poor sanitation.

All new vaccines, such as the human papillomavirus vaccine, have their critics. New vaccines should be carefully monitored as they enter the mass market.

Smallpox has been eradicated internationally. That is the effect of the first-ever vaccine, which was introduced by Jenner in 1796. Polio has been reduced to a few areas, but health workers who deliver the vaccine in north Pakistan have been murdered, through ignorance and prejudice. We should use this debate to send a message from our Parliament to support and encourage courageous health workers who risk their lives on a daily basis.

Measles cases have been reduced by 74 per cent worldwide. The global vaccine action plan, or GVAP, to which 200 countries have signed up, is a road map for extending the delivery of a basic package of vaccines.

It is estimated that 1.5 million children die each year—one every 20 seconds—from vaccine-preventable diseases. The challenge is to extend vaccines to the poorest countries. Big pharmaceutical companies are beginning to address the issue, through novel funding approaches and research into vaccines for diseases that are prevalent internationally. For example, a vaccine is in development for malaria, which is thought to cause between 1 million and 3 million deaths annually. Incidence of the disease had been reducing, and it is to be hoped that a vaccine will curb its re-emergence.

The biggest vaccine story in the United Kingdom and the western developed world at the end of the previous century and the beginning of this one was the MMR vaccine, to which the minister referred. The consequences should not be lost on politicians who supported the Wakefield fraud. It would have been bad enough if that had been the first time that a single scientist had created a storm around a vaccine, but it was not. In the 1980s, Dr Macfarlane raised concerns about the whooping cough vaccine, and the resultant drop in uptake, which was encouraged by the media, caused a re-emergence of whooping cough and young children were damaged. No proof of a problem with the pertussis vaccine was ever established and the campaign petered out.

The autism link story, which was created out of bad, unethical research, cruelly misled parents into abandoning the MMR. Opposition politicians supported the single vaccine, despite expert opinion and evidence from Japan that single vaccines were not effective. I was personally vilified in this chamber and in the press over my firm support for the triple vaccine, and some politicians berated the Labour Government for following the advice of all the royal colleges.

The result of the scandal was shown in last year’s outbreaks of measles in France and Wales. The Scottish response to the outbreak in Wales, which came on top of a significant outbreak in France and led to a call from the European Union for a significant programme of catch-up, was complacent and slow. There was no national urgency and no national campaign to update people who had missed out on the MMR vaccination. Although letters were sent to parents of children to whom the vaccine had not been administered, without a national campaign we are still at risk. There was no campaign directed at colleges and universities, where there has been an increase in the incidence of mumps as a result of the MMR scandal.

There are to be two new vaccines: the meningitis B vaccine, which is to be made available following last week’s announcement by the Joint Committee on Vaccination and Immunisation; and the HPV vaccine, in its new nine-valent form, which might be made available to boys. Patrick Harvie talked about that.

The influenza vaccine will be administered intranasally to young children. Along with the shingles and rotavirus vaccines, the influenza vaccine should be monitored to see what happens when it is put into the mass market.

Flu immunisation is very important. We made good preparation for the pandemic, and I made my own contribution to that with my report in 2001. I recommended at the time that we should stockpile Tamiflu, but I have to say to the minister that there has subsequently been much debate about how effective Tamiflu is, partly because of the failure by Roche to publish all the research timeously.

There is a big increase in the immunisation budget next year, which I assume is partly due to the new immunisations that are coming in. In reviewing the swine flu pandemic, which was fortunately not very serious, I hope that we will consider again the pandemic programme for the future and make some decisions about whether we should restock with Tamiflu.

The evidence of pressures, which we mention in our amendment, is important. It is based on the NHS Scotland staff survey, which revealed that only a third of nurses and midwives said that they could meet all the conflicting demands on their time at work and only a quarter think that there is enough staff for them to do their job properly

I have been told that midwives have refused to administer vaccines recommended for pregnant women. Such opportunistic vaccine is important, so midwives should be required to administer whooping cough vaccine in pregnancy and MMR before women leave hospital in particular. Are such practices even being monitored?

New vaccines are being introduced, with new pressures on staff. Health visitors play an important role in supporting parents—if not administering the vaccine—through an increasingly complex child vaccine programme, but the number of health visitors is determined by individual health boards. Our recent freedom of information inquiry showed that to be inadequate.

The combination of new vaccines and the demands of family-nurse partnerships and having a named person for every child means that when the Government publishes its workforce plans in June, it will have to display a degree of leadership on health visitors. Scotland has done very well with our immunisation programme.

I move amendment S4M-09446.1, to insert at end:

“; welcomes the recent additions of rotavirus and shingles vaccines and the announcement of adding meningitis B vaccine, but recognises the pressures that administering these additional vaccines and the need for the catch-up programme for the MMR vaccine place on staff”.