Meeting of the Parliament (Hybrid)

Meeting date: Thursday, September 30, 2021

Official Report 1070KB pdf

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Autumn and Winter Vaccination Programme

The next item of business is a statement from the Cabinet Secretary for Health and Social Care, Humza Yousaf, on the autumn and winter vaccination programme. I will allow a little time for ministers to change seats. The cabinet secretary will take questions at the end of his statement, so there should be no interventions or interruptions.

14:52  

I am pleased to announce that the Scottish Government has today published “Scotland’s Autumn and Winter Vaccination Strategy”. I am sure that members will agree with me that the Covid-19 vaccination programme has been a resounding success. The national health service and many others mobilised at breakneck speed to match supply, thereby protecting the most vulnerable people in our society at a scale that has never been experienced in living memory.

It is easy to forget that it is only nine months ago that we began receiving relatively small volumes of vaccine. We have now administered an incredible 8 million vaccine doses across Scotland, which demonstrates the ability of our NHS and wider partners to respond in unprecedented circumstances.

Of people aged 18 and over, 92 per cent have had a first dose of a Covid vaccine and 86 per cent have had a second dose. That is a remarkable achievement, so I record my sincere thanks to everyone who has been involved in that herculean effort. Vaccination continues to play a critical role in helping to protect the people of Scotland and supporting our wider global effort to reduce the harm that is caused by Covid-19.

As part of our commitment to openness and transparency, we have sought to keep Parliament and the public informed of our plans and progress. Our “Scotland’s Autumn and Winter Vaccination Strategy” is part of that commitment and shows that we have exceeded the expectation, as set out in our original plans, to vaccinate 80 per cent of the eligible population. More than that, the strategy outlines our vision and commitment to continue, until at least spring next year, to offer a Covid vaccine to anyone who is eligible.

Finally, we have set out how we will deliver Covid vaccinations alongside our biggest ever annual flu programme, to help to protect as many lives as possible this winter.

I am pleased that, this morning, Audit Scotland published its independent report, “Covid-19: Vaccination Programme”, on Scotland’s Covid vaccination programme. It is an overwhelmingly positive report that highlights the remarkable success of the programme, and how we have ensured good collaboration and joint working across the board while developing new digital tools at extraordinary pace. I hope that members will get a chance to look through that insightful report.

The Audit Scotland report highlights that the programme has been

“effective in reducing the number of people getting severely ill and dying from Covid-19”.

It states:

“Vaccines have been delivered in a variety of ways to make it easier for more people to access them, and the level of vaccine wastage has been low.”

There is often much political and media commentary—understandably so, of course—when Audit Scotland produces challenging reports. I hope that attention will also be paid to this report, which states the excellent progress that we have made in the vaccination programme.

As we look ahead to the autumn and winter months, it is vital that we build on our achievements and continue to deliver Covid vaccinations, as well as seasonal flu vaccinations, to all those who are eligible.

A key feature of the Covid-19 vaccination programme has been that the evolving clinical advice has required the programme to pivot, often at quite short notice, to include new groups of people or to change the vaccines that we have used. That has included, for example, extending our offer to 12 to 15-year-olds, following advice from the Joint Committee on Vaccination and Immunisation and the four United Kingdom chief medical officers.

I thank our vaccinators for the care and sensitivity with which they are helping, in particular, younger people and their parents and carers to engage with the vaccination programme. It is important to reinforce the fact that choice remains central to our approach. A great deal of emphasis has been placed on access to good-quality information, supported by discussions at vaccination centres, to address questions or concerns that young people might have. That has been a key consideration that has informed our delivery. We deliberately started vaccinations for young people in community settings to enable them to be accompanied by a parent or carer and to have those really important discussions.

We are now administering a third primary dose of Covid vaccines to people who are severely immunosuppressed, and we have begun a programme of booster doses for those who are most at risk of severe disease. The booster dose is given at least six months after the second dose.

This year more than ever, we must ensure that people in the higher-risk age groups are protected against other seasonal respiratory illnesses, such as flu. Our immunity might be lower than usual due to lower levels of flu circulating last year as a result of the crucial public health measures that were in place at that time to protect the population from Covid.

We therefore launched, earlier this month, Scotland’s biggest-ever flu vaccination programme, with expanded eligibility criteria to include everyone over 50; health and social care workers, including independent contractors such as general practitioners and dental and optometry staff; teachers, nursery teachers and support staff; and prison staff and the prison population.

I urge all members to come together to thank all those who have been involved in the vaccination programme and those who will support it as we move forward—from the people who have worked tirelessly in our NHS and across local government to those in the Army who continue to help out, and the many volunteers who have stepped forward at this crucial time. I am also grateful to the many faith, third sector and community groups that have contributed so much to supporting our efforts to deliver an inclusive national programme. We could not have achieved this remarkable success without their help.

Today, I express my thanks to everyone who has stepped forward to be vaccinated, and to the vaccinators. The overwhelming response from the people of Scotland has been inspiring. The vaccines are highly effective at preventing severe disease, and people being fully vaccinated remains the best way for them to be protected against the virus. I urge anyone who is eligible but has not yet received a Covid vaccination to book an appointment or attend a drop-in clinic at the earliest opportunity. I say to anyone who is hesitant because they need more reassurance or, indeed, information, that our vaccination teams will be happy to discuss the benefits with them.

We have continuously adapted our vaccination programme and have incorporated into our planning and delivery the lessons that have been learned by regularly seeking feedback from those who are directly or indirectly involved in the programme. Vaccination, along with testing, remains our best route out of the pandemic, so it is crucial that people come forward.

As a result of the positive impact of the vaccination programme, the rate of increase in Covid-19 cases has been lower among those who are fully vaccinated than the rates among partially vaccinated and unvaccinated people. That demonstrates the protection that is offered by vaccination.

I think that many members know this statistic, but it is always worth repeating. At the start of the year, around 12 per cent of cases were ending up in hospital, but that figure is now 2 per cent. Across all age groups, the rate of hospital admissions has been higher among unvaccinated people than it has among vaccinated individuals.

Most younger adults will have received their second Covid vaccine dose in late summer or early autumn. There are currently more than 170,000 adults under 40 who have had their first dose but have yet to come forward for their second dose. I say to them that getting your second dose, if you are eligible, will give you longer-lasting protection from the virus, and helps play a part in keeping your friends, family and communities safe. My plea to those who have not attended the appointment for their second dose is this: do not leave the job half done; please attend a drop-in clinic or arrange an appointment for your second dose of the vaccine.

We have undertaken a range of national activity, as well as a range of targeted communications and engagement, to encourage people who have, for any reason, not had their second dose to complete their vaccination. That includes a personal letter from our chief medical officer.

We also continue to work with colleges and universities to maximise vaccine uptake among students who are not fully vaccinated. Clear communications are a key part of encouraging uptake, so we are working across social media channels to inform students of the benefits of being vaccinated. Academic institutions are being encouraged to work with student representatives to encourage uptake.

Following advice from the JCVI and the four UK chief medical officers, all children aged 12 to 15 are now being offered a dose of the Covid vaccine. Health boards have begun to offer vaccination to as many children as possible. Drop-in clinics opened for 12 to 15-year-olds to attend with their parents or carers last week. This week, eligible children and young people will be offered an appointment either at school or at a community clinic. Most young people in that age group will receive a blue envelope with a scheduled appointment time and the national information leaflet. The appointment will be at a community clinic in their health board area.

Some regions are not using the blue envelope or community clinic model. They are NHS Borders, NHS Dumfries and Galloway, some parts of NHS Highland and some islands boards. In those health boards, a school-delivery model began earlier this week, with the leaflet, letter and consent form going home in schoolbags. I encourage parents, carers and young people to read the materials that are being provided and to reach an informed decision.

I am pleased to report that the roll-out of our seasonal flu programme has begun and is progressing well. We launched our childhood and schools vaccination programme on 6 September, and primary and secondary school pupils started receiving their flu vaccine from that date. On 20 September, NHS boards began to vaccinate residents in care homes, and the health and social care workers online portal for booking appointments went live on 21 September. As members will be aware, we have prioritised those who are at the highest clinical risk and pregnant women.

I am already over time, so I will end by saying that we are working closely with NHS Scotland partners, local authorities and health and social care partnerships to proactively manage current system pressures. There are system pressures in terms of the workforce and we have been clear that conditions are likely to remain challenging. I will, I hope, make a statement to Parliament next week setting out the immediate actions that the Scottish Government can take to assist with mitigating some of the pressures on our health service.

Based on the success and good practices of the Covid programme, we will continue to improve, build and adapt vital resources to deliver the future vaccination programme.

I thank all those who have been involved in making our vaccination programme an incredible success, and I look forward to taking questions from members.

The cabinet secretary will now take questions on the issues raised in his statement. I intend to allow around 20 minutes for questions, after which we will need to move on to the next item of business. I encourage all members who wish to ask a question to press their request-to-speak button now or as soon as possible.

I thank the cabinet secretary for advance sight of the statement.

I say to anyone who is watching at home and who is eligible for the Covid vaccination or flu vaccination that they should please get it, because it will save lives. I have had both of my Covid vaccinations, and I will be getting my flu vaccination.

Tess White has a disabled constituent who will have to travel from Inverbervie to Stonehaven, which will take him an hour from door to door. Will the cabinet secretary set out a maximum travel time for patients, especially those in rural areas? Will he also explain why he is going to give us an update in a week, and not now, on vital information about mitigating pressures, maximising capacity and supporting our system response, which is key to delivery?

I thank Dr Gulhane for his question and the plea that he made, given that he is not only an Opposition politician but a practising GP. That is a really important call to make to people.

I would be happy for Tess White to forward me details of her disabled constituent. Health boards are working extremely hard to ensure that drop-in clinics are available as close to people as possible. If that is not happening, I am more than happy to take the matter up with the relevant health board. There are drop-in centres across the country, but I would not expect somebody to have to travel for an hour. That seems an excessively long journey for somebody to have to make.

My statement to Parliament will hopefully be in less than a week. We have already taken action to mitigate some of the winter pressures that we are facing, and there will be a further update on that.

The demands on the NHS are currently at crisis point, and delivering the flu vaccination programme and the Covid vaccine booster programme at pace will be critical. Will the cabinet secretary commit to doing the flu programme at least before Christmas rather than by March, to better protect the NHS?

I welcome the development of the long-term sustainable vaccination workforce, although that will take time. In the meantime, locum pharmacists do not appear to be being used to the same extent as locum GPs or nurses. Will the cabinet secretary commit to using locum pharmacists as well as commercial pharmacies to deliver the vaccination programme?

The cabinet secretary will be aware that vaccine uptake is lower in disadvantaged areas. Will he ensure that the vaccination centres that were closed are reopened so that vaccinations are delivered as locally as possible?

In relation to the on-going booster or third dose campaign—the continuing Covid evergreen campaign, as we might call it—and the flu vaccination programme, we are talking about 7.5 million vaccine doses over the course of autumn and winter. In the space of a few months, we will try to deliver 7.5 million doses, which is just below the 8 million doses that we have delivered over the past nine months, so an incredible effort is needed. Nevertheless, we are confident of meeting the timescales that we have set out in the strategy. Of course, if we can go any quicker than that, as Ms Baillie requests, I promise her that we will. As she referenced in the second part of her question, the NHS faces severe pressures, so we have to make sure that we are doing that at pace while also managing those challenging pressures.

I will look again at the issue of locum pharmacists. My sister, who is a locum pharmacist, raised the issue with me in my first week as health secretary. That is also a conversation for me to have with the chief pharmaceutical officer, Alison Strath. I will take that issue away, because anything that we can do to maximise our workforce is a good idea.

On the final point that Ms Baillie raises, I have very regular engagement with health boards. If there is more that they can do to open up additional vaccine centres—I am sure that that is an issue that they proactively look at—I will raise the matter with them. However, it is not just about access. Ms Baillie would agree that, for doses 1 and 2 of the vaccine, there was very good coverage of local drop-in centres across the country.

We have to do more on communication. We are doing what we can by working with the third sector. We are working with faith leaders and ethnic minority organisations such as BEMIS, which has been excellent, to reach those groups in which the level of uptake is lower. Any suggestions that members have on the matter will be met with an open mind.

I ask the cabinet secretary to address the issues that rural people face in relation to the roll-out of the Covid and flu vaccinations. What advice does he give to health boards about people from rural areas having to access the urban centres where vaccination programmes are being rolled out?

Gillian Martin makes a fair point. People can find local clinics on their NHS board’s website, and we have a landing page on NHS Inform that takes them to their health board area and allows them to see the drop-in clinic that is nearest to them.

I know that there is a particular issue in rural areas in that what can seem to be a relatively short distance can actually, due to public transport links and so on, involve a much longer journey, particularly at weekends. I am therefore more than happy to speak to rural health boards about the issue. I make an open offer that, if MSPs have cases in which the journey time seems unreasonable, such as the one that Dr Gulhane raised on behalf of Tess White, they can write to me directly and I will be happy to raise those cases with the relevant health board.

I, too, place on record my thanks to all those in our health service who participated in delivering the vaccination programme. It has clearly saved lives and will continue to do so.

Today’s Audit Scotland report on the vaccination programme states that the programme

“has so far been reliant on temporary staff and volunteers.”

The report notes:

“Work is currently taking place to establish the size of the workforce needed.”

I notice that there is reference to that in the deployment plan. The cabinet secretary is—

Question, please, Ms Webber.

Right. The cabinet secretary has acknowledged those pressures. How many members of staff does he envisage will be required to sustain not only the Covid vaccination programme but the flu one?

I thank Ms Webber for the question, because it is incredibly important. As she will know, page 19 of the strategy gives information on the workforce, with details of how many vaccinators we have had to date and how many volunteer hours have helped in the vaccination effort. I will not give a number of staff just now because, obviously, it depends on the diversity of the workforce. However, I will say that the Government is leaving no stone unturned in trying to meet the very ambitious targets for our vaccination programme for the autumn and winter, which I have already talked about in answer to Ms Baillie.

Will the cabinet secretary provide an update on how Scots who have been vaccinated outside Scotland—including my constituent who lives in Ecclefechan but who works for the NHS in England, where they were first vaccinated—can obtain proof of vaccination status?

A number of things can be done. First and foremost, when the certification scheme comes into force, at 5 am tomorrow, anybody who has been vaccinated outside Scotland will be able to use certification proof from anywhere in the common travel area—for example, they will be able to use the NHS England app. Data exchange with a number of countries in the common travel area, including England, is already available

From tomorrow, we will launch an online form for people to complete if they have been vaccinated in England, Wales or Northern Ireland but they live in Scotland. If an individual’s vaccination in another part of the United Kingdom is not showing—there might well be errors; members have contacted me about that—they should phone the Covid vaccination status helpline on 0808 196 8565. The aim is to fix such issues within 14 days.

I am at a loss to understand why the JCVI does not consider police officers as a priority group. Given the incredible efforts that Police Scotland and serving police officers will make in policing COP26—the 26th United Nations climate change conference of the parties—with up to 25,000 people attending, which will expose officers to considerable risks, does the Government plan to ask the JCVI to include police officers as a priority for the vaccine booster, which they should be?

I know that Pauline McNeill asked that question with absolute sincerity. As a former justice secretary, I also know the incredible efforts that our police officers—men and women—make right across the country, and she is right to refer to the incredible impact that they will have in relation to our arrangements around COP26.

It is right that the JCVI gives us its clinical expertise, and it is my understanding that very high numbers of police officers have taken up the offer of vaccination. We will continue to listen to the advice of the JCVI on who should be prioritised in relation to vaccination and immunisation.

What advice would the cabinet secretary give to somebody who is thinking of declining their third or booster jag because they would like it to go to somebody in the developing world?

I would ask them not to delay. I can understand what might seem like good intentions on their behalf but, to give them some assurance, we are working with international partners and the UK, Welsh and Northern Irish Governments in relation to the Covid-19 vaccines global access—COVAX—scheme, and I have had many good conversations with other health ministers in the UK about what contribution Scotland can make to that global effort. If a person does not go for their booster dose, their third dose or, indeed, either of the first two doses, that does not automatically guarantee that the dose will end up somewhere in the developing world. People should be assured that we are working with international and domestic partners and the World Health Organization in relation to the COVAX scheme. If a person is eligible for the first, second, third or booster dose of the vaccine, they should step forward, please.

On the issue of the Scottish National Party’s shambolic plans for Covid certification, very little has been said so far about how fraud will be combated. Can the cabinet secretary say how, in the absence of a photographic component, the system proves that the person who presents the passport is, in fact, the same person to whom it was issued? As far as I can see, it does not and, from tomorrow, the system will be wide open to fraud through impersonation.

I do not agree with Craig Hoy’s characterisation of the scheme as “shambolic”, of course. The courts have made it clear that, in their judgment, they believe that we have taken the appropriate steps in relation to launching our scheme tomorrow.

There are a number of security features on the Covid certificate. The QR code cannot be altered, of course. I find it slightly distressing that Craig Hoy is now suggesting that people should have to prove and show their identity alongside a paper copy of their vaccination status. We are not calling for that. I respect the fact that Mr Hoy disagrees with me, but he should not be trying to create confusion or, indeed, making inaccurate claims about the certification scheme.

We know that winter pressures on the NHS exist in all years, notwithstanding Covid being in the mix for this year coming. Will the cabinet secretary please emphasise to people how important it is that the flu jab is taken up in order to protect our NHS over the winter period?

In short, yes. That is absolutely vital. The information and advice that I have received from my clinicians is that, where we can, we will try to co-administer the booster and the flu vaccine but, in some cases, the timelines will not necessarily match up. We will not delay the flu vaccine, which is really important, given that we fear the worst, as we think that people’s immunity to flu is lower because not much flu circulated last year. To protect our NHS and individuals, it is vital that people come forward and take up the offer of the flu vaccine as soon as their priority group is eligible.

Several pharmaceutical companies are in advanced clinical trials of second-generation vaccines that particularly target vaccine escape in variants such as the delta variant. Can the cabinet secretary reassure members that the current first-generation vaccines are highly effective at preventing serious illness? Can he also say how we will fold those second-generation vaccines into the booster programme when they become available?

I thank Alex Cole-Hamilton for a very good question.

On his first point, the vaccines are, of course, highly effective. There is plenty of data and research to show the efficacy of the current vaccines.

I have regular conversations with other health ministers, across the four nations, as we wait for Medicines and Healthcare products Regulatory Agency approval, once the clinical trials have been completed. I think that we are expecting the results of the COV-Boost trial in the middle of next month. Once we receive the results, it is, of course, for the JCVI and others to give details of how the vaccines should be deployed. We are well plugged into that, and we hope to get the results of the COV-Boost trial in the middle of next month, I think. I will come back to Alex Cole-Hamilton with further details on that.

As the cabinet secretary will be aware, people who are vulnerable to flu, such as those with mild to moderate asthma and young children, were not in the original priority groups for the Covid vaccine. I am concerned that, as the flu and Covid booster vaccine programmes are run simultaneously, there is a risk that some people may incorrectly assume that they are not eligible for, or do not need, a flu vaccine. How will the Scottish Government ensure that those who are eligible for the flu vaccine are aware of that and attend their appointment?

That is an excellent question from Gillian Mackay. There can be some confusion, and a number of vaccination programmes are under way. We have talked about a third dose, and we talk about a booster dose, a flu vaccine and so on. Gillian Mackay is absolutely right.

We have already done work with communication colleagues to consider how we can simplify the message, target it at those who we think are eligible and ensure that nobody has missed out. We are urgently working on that. As I say, we have done some work already, and Gillian Mackay will have seen some of the communications. I think that the message can be made a bit sharper and crisper, so we are actively exploring that very issue as we speak.

When is the anticipated completion date for all Covid booster vaccines to have been administered?

In some respects, it is an evergreen offer. As Evelyn Tweed will be aware from my statement and from previous statements regarding the booster programme, the booster dose cannot be given until six months after the second dose. We will continue to offer that. It is not possible, in some respects, to have a definitive completion date, but we aim to provide boosters to those who are eligible as close as possible to the six months from receiving the second dose. We will keep that programme rolling on, much as we are doing for the primary doses of the vaccine.

The pandemic has clearly shown the inequalities that our communities still face. One of those is inequality of internet access. The Scottish Government’s vaccination strategy is clear in its push for online bookings, but the cabinet secretary knows that many of our constituents are still unable to gain internet access, either at home or at their local libraries. That is a real issue, particularly for older residents.

How does the Scottish Government intend to reach out to those with no internet access? Will the Government commit more resources for hard-copy letters to be sent?

Before answering his question, I pay credit to Mr Choudhury personally, as I know he has been involved in the ethnic minority community in Edinburgh, in particular through the work that he has done with the Edinburgh and Lothians Regional Equality Council—ELREC—over a number of years, to ensure that vaccine uptake is high among ethnic minority communities. I thank Mr Choudhury for his personal efforts in that regard.

I give Mr Choudhury an absolute assurance: for those who do not register with the portal, there will be a de-duplication process and letters will be sent out. We absolutely have the resource for that. Based on his question, however, I will go away and see whether there is anything further that we can do for people who may be digitally excluded.

Vaccination and testing are both crucial tools for ensuring that our schools remain safe for staff and pupils. Teachers are eligible for the flu jab this year, but they are not being prioritised for the Covid booster jab. Will the cabinet secretary look again at that decision, and will he commit to not introducing charges for lateral flow tests?

I would have real concerns about moving away from our universal offer of lateral flow tests. That is absolutely not within the Government’s purview at the moment at all. I know that that has been raised by the UK Government as part of its winter plan, but I have put it on record to the UK Government that I think that is a wholly inappropriate step to be taking. In fairness to the UK Government, I do not think that it is looking to do that immediately.

On Mercedes Villalba’s first question, much as I said to her colleague Pauline McNeill, we take advice from the experts on vaccines and immunisation: the JCVI. If it changes its advice, we will of course listen to that.

I put on record my thanks to our teachers for the incredible work that they have done throughout the pandemic to ensure that our children’s education is not disrupted. I encourage teachers to step forward for their booster vaccinations when they are eligible, which is six months after they received their second dose.