Respiratory Syncytial Virus: Vaccination Programme

Baroness Ritchie of Downpatrick Excerpts

Tuesday 9th September 2025 Lords Chamber

Asked by

[Baroness Ritchie of Downpatrick]

To ask His Majesty’s Government what assessment they have made of the adequacy of the respiratory syncytial virus vaccination programme in ensuring all infants receive an equitable offer of protection from the virus.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, first, I thank the Minister for being present to respond to this debate; the noble Lord, Lord Kamall, on the Opposition Benches, who used to be the Minister responding to my questions and debates on these issues; and the Government Whip, who also used to respond to some of my questions.

RSV is a major public health threat, and vaccination is a key tool to combat the risk to infants. Each year, thousands of infants and older adults are hospitalised, causing pain and distress to families and significant costs to the NHS and productivity. Vaccination against respiratory syncytial virus is proven to significantly reduce the risk of RSV-related lower respiratory illness and to minimise potential disease progression and complications.

The UK was one of the first countries in the world to recommend and implement a maternal and adult national immunisation programme when it was rolled out across the nations and regions in September last year. The two programmes have been widely hailed as significant successes, both achieving higher than expected uptake. The RSV vaccine has been offered to pregnant women in England since September 2024 to address the significant burden of RSV-related illness, hospitalisations and deaths, particularly among infants under six months of age and older adults who are at increased risk.

The latest government data for RSV vaccine coverage of pregnant women in England is encouraging. Of the 37,328 women reported as having given birth in the survey month of April 2025, 54% had received the vaccine. The highest coverage was reported in the south-east, with 63.4%, and the lowest in London, with 44.8%. Coverage also varied by ethnic group: the highest coverage was reported among the “other ethnic groups— Chinese”, with 70.6%, and the lowest was among the “Black of Black British-Caribbean” category, with 25.6%.

The UK’s maternal RSV vaccination programme is already delivering positive results for patients and the health system, supported by emerging real-world data from other countries. Recent UK data published on the immediate impact of RSV vaccination is very encouraging, both for the effectiveness of the vaccine in preventing sickness and in alleviating hospital pressures—a key priority for the Government and the health system.

A preprint study from Public Health Scotland reported vaccine effectiveness against RSV-associated hospitalisation of 82.91%, averting an estimated 228 cases of RSV-related LRTI hospitalisation in infants aged greater than 90 days. Estimates from the BronchStop clinical research group highlight vaccine effectiveness of 72% against RSV-associated hospitalisation for infants whose mothers were vaccinated more than 14 days before delivery.

It is interesting to note the positive data from Argentina. Alongside the UK, it was one of the first countries to roll out the programme. This data adds further weight to the benefit of maternal vaccination against RSV, with similarly positive effectiveness against severe disease, hospitalisation and deaths.

The analysis estimates that just over £14 million of the £80 million annual cost is due to productivity losses and about £1.5 million to out-of-pocket costs incurred by parents or carers. The remaining £65 million is healthcare costs, including 467,230 GP visits and 33,937 hospitalisations per year in the UK for children aged under five with RSV.

The data on the impact of the older adult programme is also positive, highlighting the benefit to individuals, the NHS and the economy. The burden of RSV in older adults is equally significant. Each year in the UK there are approximately 3.6 million cases of RSV in adults, leading to an estimated 600,000 GP visits, 460,000 NHS 111 calls and 24,000 hospitalisations. The annual cost to the NHS of looking after adult patients with RSV is considerable.

The early data from the RSV programme is positive but now is a critical time to focus on uptake across all vaccine programmes to help reverse the trend in declining uptake. Although these very early successes must be celebrated, they also must be set against the background of a concerning dip in uptake across many other childhood and adult vaccination programmes, an issue already identified by the Royal College of Paediatrics.

Therefore, we should be reinforcing our shared public health goal of continuing to ensure vaccinations are widely available and doubling down on efforts to ensure they reach everyone. I was deeply concerned at the weekend to learn that there was a doctor from the United States speaking at the Reform conference, denying and decrying vaccinations and vaccines, which I thought was totally irresponsible.

The gap in uptake between the highest and lowest geographical areas in the UK for maternal RSV, and the significant differences in coverage by ethnic group, highlight the urgent need to improve uptake where it falls well below expectations. Extra care and attention must also be given to those who may have valid questions about vaccination, particularly newer vaccines. According to the latest UKHSA figures, none of the main maternal and childhood vaccines in England reached the WHO target of 95% in 2024-25.

This follows hard on the heels of findings published recently that showed one in five children will start primary school without protection against diseases like measles, mumps and rubella. In response to questions about the worrying fall in uptake across vaccine programmes, Minister Dalton cited a lack of access as a key challenge preventing eligible people taking up vaccines; that was considered to be one of the impediments. The ambition of the 10-year plan to enable healthcare to be delivered closer to where people live can only be a good thing for vaccine uptake, particularly if this means vaccination can be delivered across a range of settings, from GP practices to pharmacies, and via midwives for maternal vaccination programmes such as RSV, which is fast becoming an exemplar case.

As we approach a year since the launch of the RSV programme, we must continue to ensure uptake improves to support public health, help minimise the burden on our health system and to minimise the financial impact on parents, carers and employers. In this regard, I am very concerned that there is an equitable distribution and an equitable accessibility to those vaccines for all parents, particularly with infants.

Therefore, I have certain questions for the Minister. First, what steps are the Government taking to ensure that all infants are able to access protection going into their first winter respiratory season, including those who were born too early for maternal antibodies to transfer and infants whose mothers choose to not participate in the maternal vaccination programme?

Secondly, what steps are the Government and the NHS taking to avoid exacerbating inequalities by reducing the current variation in uptake of the maternal vaccination programme across regions and ethnic groups? Finally, will my noble friend the Minister commit to ensuring that comprehensive real world data is systematically collected and analysed from the maternal RSV programme, and will she outline the steps that the department will take to use this evidence when shaping future health policy and immunisation strategies?

I would like to thank the Minister for being here this evening to respond. I look forward to her answers and an update on accessibility and—shall we say—equal accessibility to those RSV vaccines for children and infants throughout the UK.