Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Written Answer by Baroness Merron on 29 January (HL13801), whether they plan to collect data on respiratory syncytial virus related hospital admissions of infants under one year old in weekly surveillance reports; if not, for what reason this data is being omitted.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Numbers of respiratory syncytial virus (RSV) admissions in infants are reported by a sentinel network of approximately 15 to 20 National Health Service trusts in England to the Severe Acute Respiratory Infections-Watch Surveillance at the UK Health Security Agency. Participation in this surveillance is completely voluntary for NHS trusts. Therefore, the number of participating trusts can vary from week to week, and comparisons based on simple counts may be misleading.
To provide appropriate context for reported weekly data, weekly admission rates are calculated to monitor trends over time. This uses trust catchment populations published by the Office for Health Improvement and Disparities, which are estimated for under five-year-olds, but which have not been estimated specifically for the under one year old age group, or infants.
Therefore, published rates are based on the available denominator data for the under five-year-olds, and these are publicly available in the national surveillance weekly reports and corresponding datafile at the GOV.UK website.
Further surveillance data and a programme impact assessment will be included in the annual surveillance report on RSV, due to be published in summer 2026. Please refer to the 2024/25 annual surveillance report for a summary of the previous winter season, which is available at the GOV.UK website.
Surveillance reports use hospital admission data and the Office for National Statistics’ mid-year estimates to model catchment populations for hospital trusts. Modelled catchment populations use hospital data, aggregated over three years and resident populations in five-year age bands.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government, further to the Joint Committee on Vaccination and Immunisation’s (JCVI’s) advice in November 2024 to expand eligibility for the shingles vaccination programme to include people aged 80 and over, what assessment they have made of the impact of delays in implementation on those with comorbidities who are at highest risk of severe shingles disease; what steps they are taking to prioritise protection for these high-risk individuals; and whether they will commit to implementing the JCVI advice before this winter.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Currently, adults become eligible for their shingles vaccination when they turn 65 or 70 years of age, and they remain eligible until their 79th birthday. Adults who are severely immunosuppressed, and therefore most at risk of serious illness and complications from shingles, are eligible from 18 years old and do not have an upper age limit.
The shingles vaccination programme has been in place since 2013, and therefore there will be a significant portion of adults currently aged 80 years old and over who were offered, and received, Zostavax, the previous shingles vaccine. All those who were born after 1 September 1933 would have been offered a vaccine in the programme.
In November 2024, the Joint Committee on Vaccination and Immunisation provided advice to the Government on eligibility for the shingles vaccination programme. This included advice that the Government should consider expanding the shingles vaccination offer to include older adult cohorts aged 80 years old and over. The Government is carefully considering this advice as it sets the policy on who should be offered shingles vaccinations in the future.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to strengthen the evidence base for assessing the wider economic and societal impacts of vaccination; and what assessment they have made of the potential benefits for evidence generation of explicitly incorporating such impacts into health technology assessment frameworks.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.
Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.
If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the quantified economic and societal benefits omitted from vaccine appraisals under the existing health technology assessment framework, including impacts on economic inactivity, workforce participation, productivity and long-term growth.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.
Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.
If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the economic and societal costs of maintaining a health technology assessment framework for vaccines that does not explicitly account for wider impacts beyond the health system, including potential losses to productivity.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.
Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.
If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the potential benefits of incorporating wider societal impacts into health technology assessments on the assessment of value for money and long term return on investment for vaccination programmes.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The Government recognises the value in improving our understanding of the impact that vaccines have on wider society. Demonstrating the impact that childhood vaccines can have on the number of days of education that children may miss, for example, could encourage greater uptake of childhood vaccination. We have recently been able to say that childhood chickenpox costs the United Kingdom’s economy £24 million every year in lost income and productivity, and the chickenpox vaccination programme launched last month is expected to reduce that loss.
Vaccine appraisals play a particular role within the process of understanding that value, using the best robust evidence available across all vaccination programmes to focus investment of the health budget on programmes that deliver the greatest health benefit to the greatest number of people. Focusing our appraisal process on health benefits and costs, which have better evidence than socio-economic impacts, follows the process used by the National Institute for Health and Care Excellence.
If this process were to change, and wider socio-economic benefits were to be formally included, this could have unintended consequences. For example, it could have the effect of prioritising investment in vaccines for working populations over those who are not or will not be economically active. Additionally, the available data on socio-economic benefits is robust for only a small number of vaccines. Factoring this data into appraisals for only a small number of vaccines would create a bias for these programmes with better quality data. Conversely, if this data on wider benefits were to be factored into appraisals for all vaccination programmes, the use of lower quality data risks increasing uncertainty in appraisals and reduces our ability to ensure responsible and effective spending of public funds.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what evidence, analysis or expert advice Ministers relied on in concluding that broadening the scope of health technology assessments for vaccines to include wider economic and societal impacts is unnecessary; and whether this conclusion was informed by any assessment of the capability and remit of the National Institute of Health and Clinical Excellence and the Joint Committee on Vaccination and Immunisation in areas beyond pure health system cost-effectiveness, such as macro-economics, public finance, and social and welfare analysis.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
We are proud to have one of the most comprehensive vaccination programmes in the world. Our approach to evaluating vaccination programmes, underpinned by recommendations and advice from the Joint Committee on Vaccination and Immunisation (JCVI), is grounded in rigorous and evidence-led cost-effectiveness analysis, and ensures that decisions are objective, consistent, and based on high-quality data on health benefits and costs.
Basing our approach on these factors avoids the uncertainty of less direct benefits, where the evidence and therefore the decision is likely to be less defensible. This approach is also informed by previous work on this topic.
For example, earlier work by the independent Cost-Effectiveness Methodology for Immunisation Programmes and Procurement (CEMIPP) considered, amongst other things, whether wider socio-economic impacts should be included in the framework used to assess the cost-effectiveness of vaccines. CEMIPP conducted a consultation as part of their wider work and drew upon a broad body of expert opinion. The group concluded that wider socio-economic impacts should not be included in vaccine cost-effectiveness assessments unless doing so becomes standard practice across all health technology assessments.
Additionally, in 2022, the National Institute for Health and Care Excellence (NICE) undertook a detailed appraisal of whether it should broaden the perspective it uses in its economic evaluations, including consideration of wider societal impacts. Following this review, and after examining both international comparisons, and the significant methodological and ethical challenges involved, NICE’s Board concluded that it should retain its current approach of using a health-sector perspective routinely, but with the flexibility to include wider societal benefits when they are especially relevant.
Whilst the expertise of the JCVI rightly centres on disease burden, vaccine efficacy, health outcomes and health-related costs, as outlined this is not a key reason for why the cost-effectiveness methodology for vaccines does not formally take into consideration wider socio-economic benefits.
Asked by: Baroness Ritchie of Downpatrick (Labour - Life peer)
Question to the Department for Education:
To ask His Majesty's Government what guidance they issue to schools in England on preventing, recognising, and responding to anaphylaxis.
Answered by Baroness Smith of Malvern - Minister of State (Department for Work and Pensions)
Schools are required under Section 100 of the Children and Families Act 2014 to make arrangements to support pupils with medical conditions, including allergies. They must have regard to the 'Supporting pupils with medical conditions at school' statutory guidance which sets expectations for training and emergency procedures. The guidance can be read in full here: https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3.
Governing bodies should ensure that staff receive suitable training to identify and respond to severe allergic reactions, such as anaphylaxis, and that policies and systems are effectively implemented. Ofsted assesses the effectiveness of these arrangements as part of school inspections.