Asked by
To ask Her Majesty’s Government what action they have taken in
response to the national incident declared due to the polio virus
being found in London sewerage systems.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
The established UKHSA public health response mechanism has been
stood up in line with national polio guidelines. This national
incident means that a national team has been set up to manage and
co-ordinate these actions across areas, which is standard
procedure for many of the health threats that the UKHSA foresees
and manages. Although samples have been detected in London, the
UKHSA is working to ensure that other areas are aware and are
taking actions necessary to protect populations, including
encouraging people to take the vaccine.
(Lab)
My Lords, while the risk to the public is considered low, the
declaration of a national incident will of course give cause for
concern, so the Government need to communicate swiftly and
clearly about the situation and to ensure that children in
particular are vaccinated against polio, especially as there is
lower vaccine coverage in London among younger children. What is
being done to address this situation and how will the Government
roll out their messaging, working with local authorities,
schools, the NHS and GPs, who already have added pressure from
being contacted in greater numbers by the public who are
concerned about vaccinations? Can the Minister reassure your
Lordships’ House that he is working closely with the Treasury to
ensure a properly funded communications and vaccination campaign?
(Con)
We should start by being clear about what has been found. As part
of routine surveillance, the MHRA analyses sewage from a number
of treatment works and looks at what may be identified—it is
world-leading in this. We should pay tribute to the UKHSA for its
world-leading work and for being ahead of the game in spotting
potential health risks early. It is normal for one to three
vaccine-like polio viruses to be detected each year in UK sewage
samples, but those are usually one-off findings. In this case, a
vaccine has been detected; it is probably related to someone
having had the polio vaccine and having shed it as part of their
faeces. A couple of things will now happen. First, the MHRA will
go further down the system to see whether it can isolate where
that came from. Secondly, the messaging is quite clear: you must
get your vaccine. Most people get their vaccines as part of a
routine. They get it twice in preschool and then at school at 14
as their final booster. However, there are some areas of low
vaccination, and we are making sure that we are rolling out that
message along all the channels mentioned by the noble Baroness.
(Con)
My Lords, the World Health Organization pronounced Europe free of
polio 20 years ago, but that was clearly not the case globally.
Its emergence here is surely a reminder that a highly infectious
disease anywhere can become a highly infectious disease
everywhere. Is it not also a reminder of the need therefore for
vigilance against such infectious diseases, which are not beaten
until they are fully beaten globally? There are other diseases
such as TB where there is not even a vaccine. Will my noble
friend consider the importance therefore of renewing the UK’s
commitment to the Global Polio Eradication Initiative to ensure
that, once and for all, this beatable disease is beaten?
(Con)
My noble friend makes a very important point. Even though a
number of countries have been declared polio-free, including the
UK because of our high level of polio vaccination, we should be
clear that it has been detected and it has derived from someone
having had a polio vaccine, probably an oral vaccine—the sugar
cube that many of us will remember from our youth, rather than
the injection that a person receives now as part of their 6-in-1.
That has the potential to spread, and it is why the UKHSA is
monitoring it. The important message is to remind everyone: check
your red book, check your medical records, check your vaccination
record. If you have not been vaccinated against polio or have not
had the booster, go to your GP and get it as quickly as possible.
(LD)
My Lords, what is unusual about these detections is that several
positive ones have come from the same sewage facility over a few
months. It is worth noting that this kind of polio virus
community transmission in London has not been detected since the
1980s. Genomic testing has subsequently revealed that these
positive samples are all related, suggesting the virus has been
spreading through one or more individuals in London over recent
months. Can the Minister give us more detail and tell us what
action is being taken by local public health scientists and local
authorities? Does the department consider it may be part of a
trend? Many noble Lords can remember polio vaccinations—I had a
vaccination and then my younger brother had a sugar lump, which I
thought was distinctly unfair. Is there a plan to start
vaccinations in the area?
(Con)
Vaccination is already part of a national plan. People should be
vaccinated at certain ages—I think it is in the first few months,
and then in preschool and then at about the age of 14, when they
get their booster at school. A couple of things could have
happened. Someone may have travelled overseas, had the oral polio
vaccine and then excreted it into the system—and it has happened
on more than one occasion. On top of that, the important message
is: check your records and make sure that you are vaccinated. It
is not a matter of trying to get a new vaccine; it is already
part of NHS routine. We encourage more people to come forward.
(CB)
Can the Minister clarify further what we will do to encourage
vaccinations, while schools are still open, for 14 year-olds and
for the 11% of under-twos in Greater London who are not
vaccinated at the moment?
(Con)
Part of the public health message has been focused on making sure
that people come forward, even before this was detected in the
sewage works. One thing we saw as a result of lockdown was that
some parents in some areas had not taken their young children to
their doctor to have the vaccine. Let me be clear: at eight, 12
and 16 weeks, a child gets a 6-in-1 vaccine; at three years and
four months, as part of the 4-in-1 preschool booster, they get
it; and at 14 years they get one at school as a teenage booster.
Some of those are pre school. We are encouraging people to check
their red book, check their vaccination record and make sure they
take their child in for their vaccine.
(Lab)
My Lords, one of the paradoxes of ministerial Statements on
issues such as this is that the more transparent Ministers are,
the more the risk that it will create a sense of concern in the
public. The history of public health problems over the past 50
years gives us the knowledge that the best way to deal with these
issues is the maximum transparency at the most regular and
immediate opportunities. That is the way ultimately to relieve
concern and I recommend it to the Minister. On a specific issue,
can the Minister give a little more detail on the decline in
vaccinations throughout the country, particularly in London,
during the Covid pandemic? I assume that the natural concern with
vaccination for Covid led to a fairly substantial decline in
vaccinations for other diseases. Can he give us a little more
information on that?
(Con)
First, I thank the noble Lord for his recognition of one of the
challenges of ministerial office, as he will know from his own
experience. It is important that we recognise that
vaccine-derived polio has the potential to spread, but it is rare
and the risk to the public overall is limited. The majority of
Londoners are fully protected against polio and will not need to
take any more action, but the NHS will begin reaching out to
parents of children under five in London who are not up to date.
But we are asking for it both ways and for parents to check their
records. Let us be clear that the UK is considered to be free
from polio, but we recognise a potential risk given our
world-leading surveillance of sewage.
On the noble Lord’s specific question, we are quite clear that
people must come forward for all vaccines. Sometimes during
lockdown people were unable to see a doctor or nurse in person,
and the NHS is catching up with that anyway, but the NHS will
keep sending the message to try to identify people who have not
been vaccinated. At the same time, we are encouraging people to
check their records. Let us be clear: we detected this very early
in the chain, and it has perhaps come from someone who took an
oral vaccine overseas and has excreted it into the system.
(Con)
I congratulate the UKHSA and the Environment Agency on the
investment they have made. When was the polio first
detected—there are reports that it was detected as early as
February—and when might they be able to narrow down the area in
which it has been found?
(Con)
I thank my noble friend for that question. There is routine
surveillance that happens anyway. However, in this case they have
detected it in more than one surveillance. Quite often, it is
seen as a one-off and then not seen again for some time; in this
case, it has been detected at each interval of the surveillance.
We know it is from the Beckton Sewage Treatment Works—in that
part of London. I must be careful about the words I use here:
clearly, it is mixed up with a lot of other stuff, and we must
now work out how we go along the pipe, as it were, and
investigate individual pipes to see whether we can locate the
source. In theory, it might be possible to find individual
households or streets but it is too early to do so. What we are
doing here is really world-beating: it is a first and shows that
we are ahead. However, one issue in being ahead is that we detect
things that would not have been detected earlier, and people are
worried about them.
(CB)
My Lords, does the Minister recognise the stark difference at the
moment in the quality of vaccine records’ availability? I declare
an interest in that a consultancy of which I am a director works
with Palantir, which has been part of the extraordinary change in
the Covid vaccine records. Does he recognise the need to update
the rest of the NHS so that the information on hand to patients,
which has been so valuable in the system here, is more widely
available for polio and other vaccines?
(Con)
The noble Lord makes a really important about the future of the
NHS and our health services. Last week, the Government published
the Data Saves Lives strategy, which is what it says on the
cover. One of the first issues we must tackle is digitising the
NHS as much as possible. Digitisation is one of my three
priorities, alongside sharing data. First, this will ensure that
we can identify population health issues and patterns in
conjunction with AI; secondly, giving appropriate access to
researchers allows us to continue to be world-beating in
identifying such issues. In future, it may well be that we can
get a sample, use a bit of AI—thanks to other data sets—and
locate more accurately. At the moment, we are really at the
cutting edge of this. What will be vital to it is the
digitisation, sharing of and access to data across the system.
(CB)
My Lords, is it known how many countries are using the live
vaccine, which is different from the vaccine we are using?
(Con)
I am aware that there are still some countries that use the oral
polio vaccine, as opposed to the IPV we use in this country. I do
not have the exact numbers with me. If the noble Baroness with
allow me, I will go back to the department, see if that
information is available and then write to her.
(Non-Afl)
My Lords, water quality in east London is appalling enough
without this scare. I spoke with three of my neighbours
yesterday, all with very young children, and not one was aware of
this campaign. What steps are being taken to ensure sufficient
and urgent awareness is created among East End multilingual
communities, who are already struggling with a daunting array of
health and well=being information?
(Con)
As it happens, I was at an event yesterday at which a GP from
east London was present; we were talking about the whole range of
issues, not just this specific issue. Let us be clear: no one has
got polio and no cases have been identified. We have found it in
the sewage, and it probably came from someone who had the oral
vaccine overseas, came to the UK and excreted it into the system.
there are no cases of polio at the moment—we should be absolutely
clear about that—but we are saying that this is a warning that
people should ensure that they get vaccinated and check their
records.
The noble Baroness makes a really important point about health
disparities and there are lots of issues we must tackle. I have
said many times that we must see how we can work on a
community-led solution, rather than having someone in Westminster
or Whitehall who thinks they have all the answers. To be honest,
we have to show due humility and say that people sitting in this
House can sometimes be out of touch with those communities.
(Con)
My Lords, as my noble friend has said, the polio disease still
exists in other parts of the world. When immigrants come from
different parts of the world—not just from Europe—are they
examined, checked and given polio injections immediately, or does
it take time?
(Con)
I thank my noble friend for that question. I am not sure of the
exact details on when they are informed but let me go back to the
department and ask. What I do know is that, when immigrants come
to this country and register with their local GP, there is a
health check and, quite often, a questionnaire to raise awareness
about what vaccines or treatments they may have had and to ensure
that they are as up to date with their vaccinations as the
existing populations.
