Poliomyelitis Vaccine (Hansard, 28 April 1958)

§ 19. Mr. Edelman
asked the Minister of Health whether he will make a statement on the adequacy of the supplies of anti-poliomyelitis vaccine likely to be made available this summer in order to carry out the anti-poliomyelitis vaccination programme which he established at the end of last year.

§ 31. Mr. Janner
asked the Minister of Health whether he is aware that there was a sufficient supply of anti-poliomyelitis vaccine available in North America to meet the full needs of the population in this country who should be inoculated against the disease; and why he did not order sufficient of the vaccine in time to allow for the testing period to be completed.

§ Mr. Walker-Smith
For a general statement about the poliomyelitis vaccination programme and purchasing arrangements, I would refer the hon. Members to my reply of 21st April to the hon. Members for Stockton-on-Tees (Mr. Chetwynd), Leicester, North-West (Mr. Janner) and Erith and Crayford (Mr. Dodds).
Batches of vaccine from the two British manufacturers which were distributed to local health authorities last week total over half-a-million doses, and a batch of Canadian Salk vaccine of half-a-million doses will be distributed within the next few days. Over eight-and-a-half million doses of vaccine will then have been distributed in Great Britain since the start of the scheme, four-and-a-half million of them since the beginning of this year. Further vaccine should be distributed next month. These supplies will enable local health authorities to make good progress with vaccinations.
In addition to what is already in the pipeline, I am arranging for the purchase of a further quantity of American Salk vaccine in addition to the 7,800 litres and replacements previously ordered from Canada and the U.S.A. and will, of course, be making a fuller statement to the House on Thursday.

§ Mr. Edelman
While welcoming the energy of the Minister's improvisations to repair the breakdown in his programme, 13 is it not the case that his optimistic pronouncements on this subject have misled the public? Is it not the case that the most energetic local authorities can inoculate only at the rate of about 3,000 people a week even when vaccine becomes available? In those circumstances, and bearing in mind that the second inoculation must be spaced by at least three weeks, will not millions of parents still remain in a state of anxiety during June, July and August because of his failure?

§ Mr. Walker-Smith
No, I do not accept that there has been any failure. There have been certain interruptions in anticipated supplies—[Interruption.]—the right hon. Member for Battersea, North (Mr. Jay) laughs at that. It is almost incredible that anyone should wish to laugh in regard to this subject or should be quite so ignorant of the difficulties and complexities both of the production and the testing of this vaccine.

§ Mr. Isaacs
Thanks for the lecture.

§ Mr. Walker-Smith
Another right hon. Gentleman thanks me for my lecture. I can only say that I regret that these remarks were called for.
If I may return to the hon. Gentleman's supplementary question, there have been these interruptions in anticipated supplies from various sources and I am engaged in repairing and supplementing them. I thank the hon. Gentleman for his reference to my energy in so doing. I do not think he is right in his estimate of the capacity of local health authorities regarding the number of vaccinations which they can carry out, and I am confident that when we have—as I hope we presently will have—considerably larger batches of vaccine, the vaccination programme will be accelerated considerably.

§ Mr. Janner
Does the Minister recollect that many months ago he was asked why he was not purchasing adequate quantities of vaccine from North America? Is it not a fact that had he ordered the requisite quantity and made allowance for a breakdown, he would be in a position today to meet all the requirements, as America then had supplies and was able to supply him?
Is the Minister also aware that much of the vaccine that has been produced in America has been sold in Europe, and 14 that he has been scandalously negligent in not providing what is necessary for this country?

§ Mr. Walker-Smith
No. The hon. Gentleman is not wholly cognisant with the history and facts of this position. [Interruption.] The hon. Gentleman asked his question with great vigour, and I do not take any exception to that, but I must remind him of the circumstances. When the original imports of Salk vaccine were arranged the Government were acting tinder the advice of the Medical Research Council that the imports should be regarded as a temporary measure until adequate supplies of British vaccine became available. There was no reason at that time to foresee the interruption of British supplies on the scale which has unfortunately happened, because they had been coming forward regularly for some time before that date.
In any event, the stocking, which is really what the hon. Gentleman is suggesting, of Salk vaccine at that stage would have been inappropriate because it was not possible to make an estimate of the acceptability of Salk vaccine at that stage, having regard to the right of rejection. Secondly, the hon. Gentleman has entirely left out of account in his suggestion the consideration that the potency of this vaccine is not permanent. It is a perishable commodity.

§ Dr. Summerskill
Is the Minister aware that the statement which he made in the Written Answer to Questions last Monday on the supply of vaccine from Canada and the United States does not correspond with the statement of the Director of the Connaught Laboratories, which is the source of the Canadian supply; neither does it correspond with statements from the United States Public Health Service?

§ Mr. Walker-Smith
I am afraid I do not understand what the right hon. Lady has in mind. I understand from the newspapers that the House is to have the pleasure of listening to the right hon. Lady at rather greater length on Thursday. Perhaps she would be good enough to indicate to me before then a little more precisely what she has in mind and then I shall be happy to deal with the matter as fully and faithfully as I can.

§ Dr. Summerskill
Perhaps the right hon. and learned Gentleman would be 15 good enough to answer this more simple question. As he knows, the number of people eligible for inoculation is 10 million and 50 per cent, of them have registered. That means that there will be 10 million inoculations to be given if they are all to have two inoculations. Can he say whether before June—that is before the time when poliomyelitis rears its very ugly head in this country—the 5 million registered will have had two inoculations?

§ Mr. Walker-Smith
I hope that that may be the case, but, as I have already explained, there are many unpredictable factors in this matter and we have to take account of them. If I have the opportunity on Thursday, I will give in greater detail than is possible at Question Time my expectations about the future and the basis upon which they rest.

§ 20. Mr. Edelman
asked the Minister of Health whether he is aware that there are 12,000 children on the waiting list for anti-poliomyelitis vaccine in Coventry; and when he expects to issue supplies of vaccine to the Corporation Health Department in order to provide for these unvaccinated children.

§ Mr. Walker-Smith
I am aware of the position in Coventry. As to the second part of the Question, I would refer the hon. Member to my reply to another of his Questions today.

§ Mr. Edelman
Is it not a fact that, even after the latest supply of vaccine that has been issued to Coventry, there will still be about 13,000 children on the waiting list, and more applications coming in daily? Is it not a fact that, as has been pointed out by my right hon. Friend the Member for Warrington (Dr. Summerskill), the Minister's forecast that the summer programme would be fulfilled for children under 15 and the priority classes will not, in fact, be fulfilled and that those children who have registered will not only not get a double inoculation but will not get a single inoculation?

§ Mr. Walker-Smith
As I say, I hope that the hon. Gentleman's anticipations will prove pessimistic. I hope that the process of vaccination, if the vaccine is available, will make more rapid progress than the hon. Gentleman thinks is probable. There is, of course, a considerable programme ahead of us, and 16 it is a little difficult to speak in terms of the precise date of completion. The hon. Gentleman will appreciate that registration is a continuing process; I do not intend to place any final date on registration.

§ 21. Mr. Edelman
asked the Minister of Health what steps he has taken to acquire adequate supplies of anti-poliomyelitis vaccine from sources other than British, United States and Canadian in order to ensure that the anti-poliomyelitis vaccination programme for this summer is fulfilled.

§ Mr. Walker-Smith
As adequate quantities of vaccine to supplement British production are being obtained from Canada and the U.S.A., the need for other sources of supply has not arisen.

§ Mr. Edelman
Does the Minister recall that last year—last summer—the Pasteur Institute was willing to supply large quantities of Lepine vaccine but that he took no action whatsoever? Does he also recall that the Prime Minister wrote to me last summer saying that there would be discussions between the Ministry of Health and French Health Authorities in order to make this vaccine available? Will the Minister say finally whether he or his predecessor, either directly or indirectly, ever gave any undertaking to Glaxo or Burroughs-Wellcome that he would give them priority over potential overseas suppliers of vaccine?

§ Mr. Walker-Smith
I am not aware of any undertaking such as the hon. Gentleman has referred to in regard to priority. He may be thinking of the recommendation of the Medical Research Council that British vaccine should be regarded as our main, permanent source of supply and that Salk vaccine should be regarded as a temporary supply, which is the same point as I made to his hon. Friend the Member for Leicester, North-West (Mr. Janner). In regard to French and other sources of supply, there would be many technical considerations involved before they could be brought into use, considerations which do not arise in the same sense with Canadian and American sources of supply. It seems better, therefore, to get our supplies from trans-Atlantic sources.

§ 23. Mr. Hastings
asked the Minister of Health how many children who have been selected for poliomyelitis vaccination and whose parents or guardians have agreed to this, are waiting for their first and second dose, respectively.

§ Mr. Walker-Smith
I would refer the hon. Member to my reply on 21st April, to the hon. Member for Leicester, North-West (Mr. Janner).

§ Mr. Hastings
Are the 10 million awaiting vaccination priority classes as defined by the Minister of Health a year or more ago? Are Salk and British vaccines generally equivalent? May a first vaccination of British be followed by a second vaccination of Salk, and vice versa?

§ Mr. Walker-Smith
Oh, yes, there is inter-changeability between these vaccines. We can have a first vaccination of British and a second of Salk, and vice versa. The latest figures take us to the end of February, because local health authority returns are bi-monthly. At that time 3 million persons awaited vaccination, but of course there will have been further vaccinations and further registrations since that date. I shall be in a position to give figures, up to the end of April I suppose, in about ten days' time.

§ 24. Mr. Chetwynd
asked the Minister of Health what is the cost of the purchase of anti-poliomyelitis vaccine purchased to date, giving separate figures for imported and other supplies; and what is the total estimated cost to complete the programme.

§ Mr. Walker-Smith
The total cost of supplies of poliomyelitis vaccine distributed to date in Great Britain is approximately £1¾ million; between one-third and one-quarter of this amount was paid for imported supplies. As registration is a continuing process, I cannot as yet estimate with precision the cost of the completion of the programme.

§ Mr. Chetwynd
Can the Minister give the House an assurance that the availability of this vaccine, both from home supplies and overseas, has not been held up or delayed in any way by a shortage of dollars or lack of resources for development of production at home?

§ Mr. Walker-Smith
There is no particular difficulty in regard to money. As the hon. Member will see if he looks at the figure in the Estimates for 1958–59—the financial year which has just started—£2 million is included for this purpose and represents 10 million doses. If it should be necessary to have more vaccine, I am sure the House will be sympathetic to the submission of a Supplementary Estimate for that purpose.

§ 25. Mr. Chetwynd
asked the Minister of Health the nature of the tests used before imported anti-poliomyelitis vaccine is issued to local authorities; and how long they take.

§ Mr. Walker-Smith
Salk vaccine is tested by the manufacturers for safety, potency and sterility in the country of origin. The United States Government arrange, in addition, for safety tests and for potency tests. The potency tests are on monkeys and the safety tests on tissue cultures and on monkeys.
The tests carried out by the Medical Research Council in this country comprise safety, potency and sterility tests, involving safety tests on monkeys and on tissue cultures, and potency tests on monkeys. The Medical Research Council tests may take up to twelve weeks, but are often completed in ten or less.

§ Mr. Chetwynd
Whilst recognising the absolute need for safety in this matter, is it necessary to have a duplication of these tests and is it necessary for them to take quite so long?

§ Mr. Walker-Smith
The question about the necessity for duplication on tests merits consideration in the circumstances. It is a fact that the record of the American tests has been increasingly reassuring over recent periods.

§ 26. Mr. Lipton
asked the Minister of Health how many children await poliomyelitis vaccination in the London area; and when he estimates that they will be vaccinated.

§ Mr. Walker-Smith
The number of children in London awaiting poliomyelitis vaccination on 31st March was 132,155, and a further 26,938 were awaiting their second injection. I cannot give any precise estimate of the date when they will all be vaccinated, but for the general progress of the scheme I would refer the 19 hon. Member to my reply today to the hon. Members for Coventry, North (Mr. Edelman) and Leicester, North-West (Mr. Janner).

§ Mr. Lipton
Does that not leave the situation rather vague, which is all the more disquieting in view of the lack of public confidence in the ability of the Minister to cope with this problem at all?—[An HON. MEMBER: "Send for Lipton."] That is not a bad idea. Would the Minister not find it possible to make a rather more precise statement in the not too distant future?

§ Mr. Walker-Smith
If the hon. Member had been listening with his usual attention to my earlier replies, he would have realised the answer to his two questions, first, that I am hoping to make a fuller statement on Thursday if I have an opportunity on that occasion, and, secondly, that I cannot give a precise date for the completion of the programme because registration is a continuing process. I did say both those things before.

§ Dr. Summerskill
Is the Minister aware that, on 16th April, those in London responsible for holding poliomyelitis clinics were informed that their presence was not necessary as no vaccine was available, and that on 22nd April a few were recalled because they were told there was a limited amount of vaccine available? How can he come to the House six days later and tell my hon. Friend the Member for Brixton (Mr. Lipton) that he has so little knowledge of this subject and of the future position?

§ Mr. Walker-Smith
Because the right hon. Lady has not given an exact précis of my answer. I did not say that at all. In fact, 27,550 doses have been issued in London since the date to which she referred. There will be a very early distribution of more out of the general assignment to which I have referred. There will then be further vaccine supplies forthcoming next month. As I have said, I hope to have something further to say on Thursday.

§ Mr. Lipton
In view of the unsatisfactory reply in reference to London, I beg to give notice that I hope to raise the matter on the Adjournment.

§ 32. Mr. Janner
asked the Minister of Health when he expects to have sufficient 20 anti-poliomyelitis vaccine available to protect public officials who in the course of their employment are put in danger of contracting the disease in consequence of having to render services to or for persons who have already been infected.

§ Mr. Walker-Smith
Certain special groups are already eligible for vaccination. The position as to the supply of vaccine is dealt with in my reply to another Question by the hon. Member. The groups include the staffs of hospitals treating poliomyelitis cases in the infectious stage, family doctors and ambulance staff. The eligible groups are kept under frequent review in the light of expert advice, but I cannot at present say when further groups will be brought within the scheme.

§ Mr. Janner
Is the Minister aware that there is considerable anxiety on the part of other officials who have to deal with these cases lest they should be subjected to the disease? Is it not a fact that the Leicester man asked to be vaccinated, was refused and consequently died because he contracted the disease? How does the Minister account for the fact that he is not prepared to provide sufficient vaccine for everybody who comes into contact or is likely to come into contact with these cases, when he says that he is in a position to supply sufficient vaccine for everybody concerned?

§ Mr. Walker-Smith
Because, as I have indicated to the hon. Member previously, I am advised on the question of these priority groups by the Joint Committee on Poliomyelitis Vaccine under the Chairmanship of Lord Cohen of Birkenhead, and that Committee has recommended the groups. It has not recommended—at any rate so far—the inclusion of other groups of public officials in the priority arrangements.