Covid-19: Vaccination

Steve Baker Excerpts

Monday 14th December 2020 Westminster Hall

[Mr Steve Baker (Wycombe) (Con)]

I am delighted to serve under your chairmanship, Sir David, and to follow my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) and the hon. Member for Strangford (Jim Shannon). I thank the 589 Wycombe constituents who signed the petition.

I want to make three points. First, vaccines are a good thing. My hon. Friend the Member for Carshalton and Wallington made a passionate case for a vaccine. I only wish to add to it something said by the deputy chief medical officer, Professor Van-Tam:

“If we can get through phase one”—

of the priority list—

“and it is a highly effective vaccine and there is very, very high up take, then we could in theory take out 99% of hospitalisations and deaths related to Covid 19.”

That is his estimate. That is a tremendous thing, which reinforces the case that my hon. Friend made. I am 49 years of age, so I do not think I will be offered the vaccine any time soon, but I will certainly have a safe and effective vaccine when it is my turn, and I encourage others to do so. However, I will not gainsay those people who wish to refuse a medicine.

That brings me to my second point. Whatever we may think of other people’s opinions, we cross an ethical boundary if we compel people to take a medicine. It is clear from what my right hon. Friend the Prime Minister has said that there is no question of the Government compelling people to take a vaccine for this disease, and quite right, too. It is worth remembering that although the infection fatality rate for this disease is considerably worse than flu—I understand it is between 0.5% and 1%, and considerably worse for those vulnerable to it—it is not comparable to, for example, the haemorrhagic fevers. We are not talking about a 10% infection fatality rate. I dare say, if we were up at an 80% infection fatality rate, we would all support authoritarian measures without too much of a second thought, because such a serious disease would threaten our civilisation. This disease, dreadful as it is, has an infection fatality rate of about 1% overall, so there can be no question of coercing people directly to take the vaccine.

That brings me to the text of the petition, which states:

“I want the Government to prevent any restrictions being placed on those who refuse to have any potential Covid-19 vaccine.”

That goes a little further. That is not about stopping the Government from compelling people to take it; it is about ensuring that those people who, for whatever reason, do not wish to take the vaccine, do not lose their liberties as a consequence. I understand from people better versed in medical ethics that this is known as implicit coercion.

One can imagine a circumstance in which, for example, an airline chose to say to people, “You may not fly until you have had a vaccine.” A restaurant might say, “You cannot come in until you have had the vaccine.” On and on it would go, until reaching a point where unless people have had the vaccine, they cannot live what most of us would consider a normal life, going to restaurants, shops or whatever it may be. To me, that would be totally unacceptable.

Before moving on to why that would be unacceptable, I have to say that it would also be ineffective. There is a difference between a vaccine stopping someone from getting a disease and being killed by it and a vaccine that stops someone shedding the disease on to others. The harm principle in the philosophy of freedom is about constraining people’s liberties so that they do not harm others. That means there is a profound practical difference between the purpose of a vaccine being to stop people getting sick and the purpose of a vaccine being to stop people shedding the virus. At the moment, a number of businesses that are looking at restricting their customers to those who have been vaccinated have not understood that, actually, we do not yet know whether the vaccine will stop people shedding the disease.

I turn to something that the Secretary of State for Health and Social Care said in relation to the Pfizer vaccine. When asked how many people will need to be vaccinated before life can return to normal, he said:

“The answer to that is we just do not know. So the trials can tell you if a vaccine is clinically safe and if it’s effective at protecting an individual from the disease. What we can’ know, until we’ve vaccinated a significant proportion of the population, is how much it stops the transmission of the disease.”

That is my first point. I would say to businesses large and small, “Please don’t start seeking to restrict your customers’ ability to come and do business with you because they haven’t had the vaccine.” That is not an effective strategy, and the Secretary of State has explained why.

I want to come to what I think is the moral case. Some people argue that property rights should be so strong that property owners should be allowed to serve whoever they wish, but that is not the approach we take in an enlightened and modern civilised society. I am afraid the argument touches on some very difficult issues. For example, we do not allow people to say that they will not have same-sex couples in their bed and breakfast. We will not allow discrimination against the range of protected characteristics.

I can see that Ministers might face a temptation to say, “Let’s allow the acceleration of the roll-out of the vaccine by turning a blind eye to property owners insisting on people being vaccinated before staying in their bed and breakfast, or whatever it might be.” I can see that some Ministers might argue, on the basis of property rights, that shop owners, hotel owners and so on ought to have the choice—I understand the argument, because I am a classical liberal and I think about property rights—but I have to say to the Minister, who I am sure understands the argument, that we cross a Rubicon if we say that it is possible to discriminate against people on the basis of their health status. That would be a very sad and wrong basis on which to go forward as a country, even though I can understand that in the face of this disease, with all that that implies, there is pressure on Ministers, officials, members of the public and businesses—we all know what the costs are. It would be very easy to make an ethical mistake, which we could regret for a very long time.

For those two reasons—because it is not an effective thing to do, and because it is morally wrong to discriminate against people on the basis of their choice not to take a vaccine—I will stand with the petitioners in asking the Government to prevent any restrictions being placed on people who refuse to have any potential covid-19 vaccine. Of course it is a very serious disease, and of course we should all take the vaccine. I absolutely stand with my hon. Friend the Member for Carshalton and Wallington and the hon. Member for Strangford, who support vaccination. I will not give the least succour to the anti-vaxxers, but I say to the Minister that people have all sorts of strange beliefs in this world. If people do not want to take a vaccine, please let us not turn a blind eye to any kind of discrimination against them.

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

I am very pleased to participate in this debate about the covid vaccine, and I thank the hon. Member for Carshalton and Wallington (Elliot Colburn) for his comprehensive exposition of the matter before us.

We can all agree that it is simply not the case that either the UK Government or the Scottish Government have any plans to mandate the covid vaccine and make it compulsory. Indeed, the Scottish Government—and, I believe, the UK Government—have explicitly said that they will not utilise coercive measures to ensure compliance and increase vaccination rates. Before I go any further, I would like to say—I believe it has already been said—that we are in a very fortunate position to be able even to discuss and debate the roll-out of a vaccine. What a marvel! Six months ago, we would have been delighted to be in this position. Finally, we can see an end to the terrible damage and restrictions that this deadly virus has placed on all our lives. Too often, it has cost lives. Every Government, in the face of a pandemic or any threat to public safety or disease, must have the safety of their people at the forefront. That must be the overriding and principal concern. The public who, on the whole, have been extremely compliant with the restrictions, will overwhelmingly and collectively be breathing a sigh of relief that we now have a vaccine that will help to end —or begin to end—these terrible days. It will not just allow us to resume some kind of normality, but save lives, particularly of older people who are vulnerable to this terrible disease.

I will not be philosophical, because it is my personal view—perhaps I am an eternal optimist—that judging from the high levels of public compliance with the public health measures, which we have all found difficult, the take-up of the vaccine will be very high. Of course, individuals can choose to refuse it, but I honestly believe that the overwhelming majority will have it, just as the overwhelming majority of those eligible take advantage of the flu vaccine, and just as parents ensure that the vaccines to protect their children against rotavirus, diphtheria, hepatitis B, haemophilus influenzae, polio, tetanus and whooping cough are taken up.

Such vaccinations are given to children; in fact, that is the list of vaccinations given to children in the first 16 weeks of their life when they are at their most vulnerable. Without those vaccines, babies would be less safe and less protected from nasty, and potentially fatal, diseases. That is why parents take their children along to the local GP to have those vaccines administered. As always with vaccines, there may be a few uncomfortable side effects for a very small number of children or of any group receiving the vaccine. That is not new. The protection given to children, however, and those who receive vaccines against serious diseases far outweighs any discomfort that may subsequently be felt; and so it is for the very small number likely to have minor discomfort after the administration of the covid vaccine.

Although I appreciate that more tests are required to perfect a covid vaccine for children, because such vaccines are always tested on adults first, between the ages of one and 16 years old, five more vaccines may be administered to children. Older people may be offered several other vaccines from the age of 65 years. There is even a shingles vaccine. When pregnant, women are offered the whooping cough vaccine. Vaccines are entwined and embedded in various stages of our lives, and all of them are perfectly safe. There is a range of vaccines that are a normal part of our lives and which we accept readily, because we know that they are important for our health and wellbeing.

I read that 70% of the population needs to be vaccinated with the covid vaccine before we can return to normality, although I take on board the point made by the hon. Member for Winchester about that. Regardless, I hope that take-up will be higher than 70% by the time the roll-out is complete.

Regarding ongoing restrictions for those who may choose not to take up the vaccine, as far as I am aware, only Qantas airlines has said that it will not carry passengers who cannot prove that they have been vaccinated. We do not know yet if that is a knee-jerk reaction, if Qantas will be a lone voice, or if individual businesses will seek to impose conditions on the public to access their services while the vaccine is rolled out. We shall see, but I honestly doubt that that will happen. It certainly seems unlikely that businesses will be able to legally insist that those whom they employ must be vaccinated.

A word of caution: nobody denies that people have the right to refuse the vaccine, but insurance companies will surely levy higher premiums for life and travel insurance for those who do not take up the vaccine, because they operate on the basis of risk. They make all sorts of decisions about the level of our premiums based on that information, so that is something to consider.

[Mr Baker]

My constituency is Wycombe, by the way. I agree with the hon. Lady on this point. If people make a choice about their own person that increases their own personal risk and then ask somebody to insure them for it, it is completely reasonable to charge a higher premium. But I will just say this to her, if I may, on the Qantas point. I agree with her that it is just Qantas so far, but people are afraid out there. Actually, I want the take-up of this vaccine to be as high as possible, so does she agree with me that we in this place, in order to provide leadership on a cross-party basis, need to appeal to business owners and others to be reasonable about what they do?

[Patricia Gibson]

Yes, I agree. The reason why I have talked about Qantas is that I do think that it is a knee-jerk reaction. People are afraid. I think that, as the vaccine is rolled out, as there is more information and as they see that more and more people are taking up the vaccine with no ill effects, the concerns that both business and the general public might have will all start to dissipate. Perhaps I am just the eternal optimist, but I genuinely believe that that will happen, because vaccinations are not new.

What I have heard from constituents and what I have read is that the overwhelming majority of people want to stop having to worry about this virus. They want an end to the restrictions that we face as soon as that is safely possible. They want a vaccine to help put this dark time behind us, and they want these things to be delivered as soon as that is possible.

Many have contacted me—I am sure that I am not alone in the Chamber in saying this—to ask whether, in the roll-out of the vaccine, we could include, as a priority, those who are living with a terminal condition, which makes their vulnerability to the virus very concerning. I share the view that those who are living with a terminal condition ought to be prioritised for receiving the vaccine. I throw that in, because it is important at this point, when we are talking about concerns about the vaccine, to say that there are also concerns about groups who feel they may be excluded from being prioritised, which is very important.

--- Later in debate ---

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve under your chairship in this debate, Sir David. Over 300,000 people have signed the e-petition that we are debating, which shows the strength of feeling on this matter, and I am very grateful to the hon. Member for Carshalton and Wallington (Elliot Colburn) for his leadership of this debate and for having taken it on on behalf of the Petitions Committee. It was the anniversary of his election to this place a couple of days ago, and he has made a significant impact over that year, although he will forgive me if I do not look back on that date with quite the same level of enthusiasm as he might. However, I thought he made an outstanding case about how detailed the process of a vaccine coming from conception to usage is. I hope those who are listening will have taken that on face-value terms, because it should give us all a lot of comfort.

Similarly, the word that I double-underlined was “marvel”. We should marvel at vaccination, and we should also marvel at the role of Britain in vaccination: whether in 1796, 1996 or 2020, and whether that is brilliant British scientists or enlightened British Governments of all persuasions. The thing I particularly reflect on is Britain’s role in vaccinations around the world, through the Global Vaccine Alliance and through our own bilateral aid arrangements. Hundreds and hundreds of thousands of deaths have been prevented because of our role in the process of vaccinations, and we should take a lot of pride in that. It is a real British success.

The hon. Member for Strangford (Jim Shannon)—we are a bit warmer than we were in this Chamber together last Thursday—made a poignant contribution, with a reminder about loss. We can sometimes get wrapped up in the figures behind all this, but each one of the people whom we have lost this year is a person with a family and a story. His contribution was also very poignant when it came to the vagaries and variances in all of our experiences, as well as the range of vaccines, a point that was also made by the SNP spokesperson, the hon. Member for North Ayrshire and Arran (Patricia Gibson). I hope that the 300,000 people who signed this e-petition, or those who choose to listen to this debate, will understand this vaccine as part of all vaccines, rather than anything distinct or different. Although it is the story of the day, it fits very much within the suite of things we think collectively are good for people, and it has gone through all the tests that have been described. I hope, again, that is something people will take comfort from.

I was very pleased to see the hon. Member for Wycombe (Mr Baker) in this debate. As the hon. Member for Strangford said, I always follow his contributions closely. Before becoming the shadow public health Minister, I was an Opposition Whip—I do not know what I had done, but I was an Opposition Whip for some time—and the major upside of that role, if there is one, is that Members get to sit in the Chamber and hear from colleagues of all persuasions—ones whose contributions they might not otherwise look out for. They hear about Southend being a city—I have never been there, and the only thing I think about with Southend, Sir David, is you talking about city status.

The hon. Member for Wycombe made what I think was my favourite speech this year, certainly from the Government Benches, on 30 January—I do not remember the date of everyone’s speeches; I have a good memory, but it is not that good. It was the day before we left the European Union, and the hon. Gentleman made a speech in the general debate on global Britain. I have to say, I thought the scheduling of that debate was difficult, because feelings were very strong and running very high. Some people were in Parliament Square celebrating; others were at home, commiserating. The hon. Member made a very important speech about the need for victors to be gracious and for the vanquished to look forward. I think that everybody could take something from that. I am not sure, 11 months on, whether we are quite there yet, but I hope so, and I think that we all, as leaders, have a role to take on.

[Mr Baker]

I am honoured by the hon. Member’s words, and am very grateful.

[Alex Norris]

I have not finished yet. The hon. Member concluded his speech that day with lots of references to Ronald Reagan, which sent me down a reading rabbit hole that I have not yet finished. I still cannot get the attraction, but the merits of Reagan are perhaps a debate for another day. However, I thought the hon. Member made a very strong case on both the pragmatic and the moral arguments. I will come back to some of the implied coercion points that he made.

I welcome the Minister to his place. This is certainly the first time I have opposed him. We all enjoyed William Shakespeare being one of the first to get the vaccine, but no one made the Stratford connection to him as Minister. I thought that was a missed opportunity. I will make a few points, and hopefully draw him out on a couple of them. We know that many basic freedoms have been curtailed over the last year, and we all want that to end as soon as possible. We know that there is a strong desire for things to get back to normal, but these significant measures and restrictions on freedom are necessary, and we have seen yet another reminder of that today.

Vaccines are the most effective public health intervention, either in relation to coronavirus or health in general, so the progress that has been made should cheer us. It is therefore important that a significant proportion of people take up the vaccination, especially those with the greatest vulnerabilities. The last time we debated the covid-19 vaccine in this place was just over a month ago. It was the day after the Pfizer/BioNTech vaccine had achieved success in phase 3 studies. Similarly, since then both the Moderna candidate and the University of Oxford AstraZeneca vaccine have achieved similar success.

That is a remarkable story in terms of time. We saw wonderful pictures of people receiving their first dose last week, and I understand that this week the vaccination programme is being extended to GP surgeries. It has been a whirlwind month, and I commend the Government for what they have achieved. It is no small feat, and I know that the Minister will take my attempts to seek clarity in that spirit. I am not seeking to throw rocks at the success, but we want some answers.

I am particularly keen to know the Minister’s assessment of the take-up required for the programme to be effective. I submitted a written question on that and received a holding answer, but he might indulge me today. If the Government are not keen to be drawn on what the figure is, which I can understand, perhaps he could explain why they do not think sharing it is helpful. In my head, I would have a totaliser. When we are fixing the community centre roof, and we need to raise money, we colour it in every time we receive another hundred pounds, but that might well not be the right approach, and I would be keen to know why.

The vaccine is one thing; a vaccination programme is another. We have rightly been very critical of the big logistical challenges for the Government both in the roll-out of personal protective equipment and the implementation of test and trace. We cannot afford a situation where vaccines complete the set. I recognise that the early signs have been positive, but I wish to pick up on a couple of bits. We have been made aware of some care-home and hospital staff being at risk of missing out due to requirements of the IT system. Have those loopholes been closed yet? Has that been clarified?

Similarly, GPs have raised concerns with us about the new rules being brought in late in the day, so that vaccinations will take twice as long, as patients need to be observed for 15 minutes. Again, that might be on very good public health grounds, but I am keen to know from the Minister what they are. We know that general practice per designated site has to deliver at least 975 vaccinations over a seven-day period. I did not receive a convincing answer when I raised this last month with my opposite number, the Minister for Prevention, Public Health and Primary Care, but what is the assessed impact on other GP services and how will we ensure that practices can meet their normal case load? I would be very keen to hear those points addressed.

Turning to the substance of what these 300,000 people have asked us to discuss, at the root it is about vaccine hesitancy. It is very easy to talk about the anti-vax elements. I am glad that colleagues have not majored on that, because to an extent that is a straw man. Multiple hon. Members made contributions about just how thin the basis for those conspiracy theories or anti-vax sentiments are. We could spend all day deconstructing them and never lose the argument, but that concerns only a very small proportion of the British people.

We know from polling, and from our constituency mailbags, that those people are a very small group indeed. There is a much more significant and noticeable chunk of people—though far from a majority—who are vaccine-hesitant, and entirely reasonably. Some might simply not want to have it, as the hon. Member for Wycombe said, and we ought to respect that. Others might not want to do so because of safety concerns—something I have heard from lots of constituents. They want to know that any vaccination, be it for covid-19 or anything else, is safe, so we as political leaders have a really important role in giving constituents the confidence that they seek. That will hopefully come from people observing the debate, and from our public engagements in general.

I know people will be watching this debate. I do not always think that about the debates we have; I suspect my 30-minute Adjournment debates do not pull in the big numbers. My message to people watching is that if they are unconvinced by what we are saying, which is perfectly reasonable, they should ask, ask, ask. If they get a question answered and are still not happy, they should ask the next one. I would certainly say that to my constituents. We will seek to get them information through all the available channels, if that is what it takes for them to feel confident about receiving the vaccine.

I agree with a number of hon. Members that the sentiment of the petition slightly misses where we are at the moment. There is a pretty broad political consensus against compulsion, coercion or inconveniencing people into submission. I know what our position is as the Opposition, but no one studies what the Government say more closely than we do, and I have never detected a desire for mandatory vaccination in what they are saying. We all want to have confidence, and to know that the roll-out has been done through the proper process, rather than in any other way, and like other hon. Members who have spoken, I hope that business will take the same view. The Government might have a role in that, and I would be interested to know the Minister’s reflections on the contribution from the hon. Member for Wycombe. I would say gently to businesses that compulsory vaccination will almost certainly not do what they want it to do. It is therefore important to take some time and have a cool head on this issue.

People’s unwillingness to take the covid-19 vaccine has a knock-on effect on vaccine hesitancy more generally. In fact, this is probably the FA cup final of vaccine hesitancy. Last year, vaccine hesitancy was in the World Health Organisation’s top 10 threats to global health—it was up there with a future pandemic. It is something that we have to address, whether it is related to covid-19 or not. In Denmark in 2013, false claims in a documentary about the human papillomavirus vaccine led to a decline in uptake of around 90% among some cohorts. Similarly, between 2014 and 2017 in Ireland, vocal attacks on the HPV vaccine from the anti-vaccine lobby led to a drop in uptake from 70% to 50%. These things matter.

What we see through those developments, and through our experiences in this country, is that the best method of countering those views is through proactive, positive health-promoting campaigns. I know that is something the Government are doing, and it is very welcome—we will support them in that. It is almost certainly too early to have enough data to be able to talk about the efficiency of such things, but we want the Government to keep pushing hard on this issue. That is what our constituents want us to do—to explain and, as I say, make ourselves available to answer any questions that they have.

We have had an extraordinary year fighting the virus. There is now clearly a path for us to take—a light at the end of the tunnel, or however people want to characterise it. We need to pursue it with the same vigour with which we attacked the previous year. If we do, we might just get out of this thing.