Putting the long-term interests of our youngest at the centre of policy making
Today, I led a debate in Parliament on the vaccination of 12-15 year olds against COVID. This important debate offered a good opportunity for MPs to consider the ethical, scientific and practical issues involved with the vaccination programme and in particular the decision to roll out the vaccine to those between 12 and 15.
Westminster Hall debate | General debate on the vaccination of children against COVID-19
Thank you Chairman
May I thank the Back Bench Business Committee for granting this important debate, and also draw Members’ attention to the three e-petitions which relate to this topic and have between them amassed over 100 000 signatures.
Mr Chairman, vaccination has transformed public health over the last two centuries. As a science teacher I remember teaching students about the amazing work of Edward Jenner who famously developed smallpox inoculation. 250 years later, vaccinations have again ridden to our rescue, with the rapid development and rollout of the COVID vaccine across the UK.
The phenomenal success of this vaccination programme can be seen clearly in the data.
- Of the 51 000 COVID-related deaths from January to July this year, 76% were of unvaccinated people and a further 14% had only had a single dose.
- Just 59 deaths - 0.1% - were of double vaccinated adults with no other risk factors.
- And 92% of adults now have COVID antibodies.
These figures are a ringing endorsement of the JCVI’s strategy to recommend vaccination based on the medical benefits and risks to the individuals concerned. The Government has repeatedly defended this strategy, and the independence of the JCVI, resisting calls to prioritise the vaccination of teachers or police officers over those with higher risk of serious illness. That was the right approach, and the UK has led the world in falling rates of deaths and hospitalisations. It was therefore surprising to say the least that the Government put political pressure on the JCVI to reach a decision quickly about the vaccination of children.
On 3rd September the JCVI announced that they were unable to recommend the mass vaccination of healthy 12-15 year olds. The reason for this was that although there are marginal health benefits of COVID vaccination to children based on the known risks of the vaccine, there is considerable uncertainty regarding the magnitude of the potential harms such as the long term effects of myocarditis. Writing in The Sunday Times, Paediatrician and JCVI member Adam Finn says ‘a high proportion of myocarditis patients show significant changes of the heart.
‘It is perfectly possible that these changes will resolve completely over time. But it is also possible that they may evolve into longer-term changes. Until three to six months have passed, this remains uncertain, as does what impact on health any persistent changes may have’.
According to the JCVI, for every one million healthy children vaccinated, two ICU admissions will be prevented and 3-17 cases of myocarditis caused. With two doses that rises to between 15 and 51.
Finely balanced indeed.
There is no rush to roll out the vaccine to children:
- we know children are not at risk from COVID
- teachers are no more at risk than the rest of the population
- the vast majority of vulnerable adults have been vaccinated
- over half of children already have antibodies.
- and there is no evidence that schools drive transmission - indeed recorded COVID cases are now at their lowest level since June despite schools being open for two weeks.
It is also unlikely that vaccinating children will have a major impact on infection rates in the population as a whole, with the JCVI saying that:
‘The Committee is of the view that any impact on transmission may be relatively small, given the lower effectiveness of the vaccine against infection with the Delta variant.’
But instead of accepting the JCVI’s assessment, and waiting for more evidence to emerge, the Government asked the Chief Medical Officer urgently to review the decision based on the ‘wider benefits’ to children including to education. Last week, the CMO announced that he would recommend child vaccinations on the basis of these ‘wider benefits’. This is a marked departure from the principle of vaccinating people for their own medical benefit, because these wider issues - educational disruption and concerns around mental health - are the consequences of policy decisions NOT scientific inevitabilities.
Children in the UK have already missed more education than almost any other country in Europe, despite comparable death rates. Since January 2020, British children have lost on average 44% of school days to lockdown and isolation. This is not a consequence of COVID infections in children, but rather a result of political decisions to close schools and to isolate healthy children. According to the Government’s own modelling, the vaccine could lead to 41 days of schooling saved per 1,000 children between October and March. This equates to an average of just 15 minutes education saved per child over this period, surely an insignificant amount, and negligible once accounting for the time taken to vaccinate and subsequent days off school to recover from side effects.
There is a much more simple way to stop harmful educational disruption, and that is to follow the advice of the Royal College of Paediatricians and end the mass testing of asymptomatic children. This unevidenced and unethical policy is costing tens of millions of pounds a week - I’d be grateful if the minister could confirm the exact cost - and is continuing to disrupt education.
Even the CMO acknowledges that a vaccination programme alone won’t stop school closures, so perhaps the Minister could clarify how the Government intends to end educational disruption.
And on the potential mental health benefits from reducing the fear of COVID,
it is not COVID infection that is causing children fear; it’s the uncertainty, frustration, loneliness and anxiety that they experience as a result of lockdowns and harmful messages such as ‘don’t kill granny’.
Children need not fear catching COVID, but they have every right to fear policy decisions that cause them significant harm, and sadly we can’t vaccinate against those.Nonetheless, the decision has been made, and we have to be very clear that the risks to children of both of COVID and the vaccine are very small. Concerns should now focus on making sure that necessary safeguards are put in place as vaccination is rolled out.
The previous Vaccines Minister assured MPs that there will be no differential treatment of children in schools as a result of their vaccination status. This is crucial, because any suggestion that unvaccinated young people may be denied education or subjected to social disadvantage will inhibit the ability of both parents and children to make a free and objective decision. Whilst I appreciate Ministers’ commitments, children are already facing discrimination in some schools over mask wearing and testing. We must also make sure that travel rules that differentiate between vaccinated and unvaccinated children do not amount to coercion.
So can the Minister say how we will ensure that there is no discrimination in practice and not just in theory?
Vaccination must be a free decision and it must be an informed decision. Choosing to have or to not have the vaccine are both perfectly reasonable and sensible decisions where children are concerned So we must ensure that correct and impartial information is communicated. Parental consent must also be respected; much has been said on this subject but the heart of that matter is that the concept of parental responsibility is foundational to society.
I am optimistic that protections can and will be put in place. Nonetheless, the way that the decision to vaccinate healthy 12-15 year olds has been made should give us pause for thought. For no other cohort has the Government questioned the JCVI’s advice. Why have we departed from this stance when it comes to children, and looked for reasons other than direct medical benefit to press ahead? When there are concerns about future health of our children, why haven’t we waited for more evidence to emerge?
Rather than an isolated incident, I fear that this situation epitomises a worrying attitude to children that has been evident since the very start of the pandemic.
Throughout the last 18 months, ‘protect the vulnerable’ has been our clarion call. We have rightly made significant efforts to protect elderly people and those who are particularly susceptible to COVID. But children - who can’t vote, don’t own property and have no legal agency - are also very vulnerable. Yet during the pandemic, we have asked this group of vulnerable people to make huge sacrifices to protect the rest of us. The harms of lockdown for our children are significant and for many will be irreversible: lost education, missed opportunities, abuse and horrific online harms.
The number of children presenting in A&E with acute mental health conditions has risen 50% since the start of the pandemic. A climate of fear and uncertainty has robbed children of the structure, routine and security that we know they need to thrive, and placed upon them a heavy emotional burden in inferring that they may be responsible for the deaths of those they love.
We’ve pretended that online learning is somehow a substitute for being in school and closed our eyes to the consequences of social isolation for children and young people. Of course we should raise our children to take responsibility for their actions, but as adults we should always shoulder the greater burden.
We’ve imposed absurd rules on our young people, right down to deciding who they can play with at break time and whether they’re allowed to get changed for PE. Yet we’ve seen little action to urge adults to take responsibility for their own COVID risk by losing weight, something which would have had a far more significant impact in reducing deaths and hospitalisations.
Even now, adults are allowed to move freely from home to work to pub with no restrictions, yet children are still subject to asymptomatic testing, many forced to wear masks and missing out on important opportunities. We cannot expect our children to face greater restrictions than we ourselves are willing to bear.
As a mother, I have despaired as I have watched the impact of draconian restrictions on my children and others. The stories I have heard from constituents, particularly parents of disabled children and those with additional needs - are horrifying. Millions of families have had to endure this, and I want to pay tribute to UsForThem who are working tirelessly to stand up for children and campaign for their lives to be allowed to return to normal.
But what has saddened me most is the negative attitude to children that seems to have pervaded so much of our public discourse, especially the view that teenagers have behaved irresponsibly throughout the pandemic. This view is just not borne out by evidence. A study by King’s College shows that, despite half of adults saying that young people had been selfish by ignoring restrictions, all age groups have been “remarkably compliant” and perceptions of selfishness are driven by “fake stereotypes”
Mr Chairman we seem to have forgotten what it means to be a child, we have forgotten that playing with other children, taking risks, feeling valued and enjoying physical contact with others are vital to healthy development.
As a society I fear we’re becoming like Grandma from Roald Dahl’s George’s Marvellous Medicine:
‘You know what’s the matter with you?’ the old woman said, staring at George over the rim of the teacup with those bright wicked little eyes.
‘You’re growing too fast. Boys who grow too fast become stupid and lazy.’
‘But I can’t help it if I’m growing fast Grandma’ George said.
‘Of course you can,’ she snapped. ‘Growing is a nasty childish habit’
Things did not end well for Grandma, and things do not bode well for us if we fail to understand the nature and importance of childhood.
Children are not disease spreaders, they are not a buffer for our health care system, and they are not an economic inconvenience. They are a blessing, they are our hope for the future and their nurture and their welfare should be our primary responsibility.
I am heartened by the care that has so far been taken by the JCVI, the CMO, and Ministers to reassure children and parents about the decision to vaccinate our young people. But looking forward, we must recommit to putting the genuine and long-term interests of our youngest and most vulnerable citizens at the front and centre of policy making and prioritise their welfare as we recover from the pandemic.