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The below Parliamentary question was asked by Andrew Gwynne on 2015-11-03.

To ask the Secretary of State for Health, what assessment he has made of (a) changes in the number of cases of, and deaths from pneumococcal disease (b) the number of pneumococcal conjugate vaccine (PCV) vaccinations given each year and (c) the cost of delivering that programme of vaccinations on an annual basis since the introduction of PCV in 2006.

Jane Ellison

The total number of cases of invasive pneumococcal disease (IPD) and case fatality ratios (CFR) since 2006 are shown in table 1.

Table 1. Total cases of IPD and case fatality ratios (CFR).

Year	Total cases1	CFR2 (%)
2004/05	6,175	not available
2005/06	6,250	not available
2006/07	5,419	not available
2007/08	5,481	not available
2008/09	5,569	not available
2009/10	5,203	13.4
2010/11	5,265	13.6
2011/12	4,396	13.7
2012/13	4,477	13.1
2013/14	4,032	11.9

¹Total cases of laboratory confirmed IPD, England and Wales (excluding cases only confirmed by DNA detection and bronchiolar alveolar lavage (BAL) samples).

²Proportion of cases of IPD that were found to have died within seven days of IPD onset (excluding BAL) ascertained by tracing GP registration records. Data on CFR prior to 2009 are not available.

The current PCV offered to infants helps protect against 13 of the 95 known pneumococcal serotypes. The incidence of IPD caused by these serotypes has fallen by 90% in children younger than five years since the introduction in 2005 of PCV in the childhood immunisation programme. The vast majority of IPD cases in this age group are now due to non-vaccine pneumococcal serotypes. In addition, although the vaccine is only given to infants and young children, IPD due to the vaccine serotypes has declined in older children and adults through herd protection. Consequently, there has been a 36% decrease in the number of IPD cases across all age groups between 2005/06 (6,250 IPD cases) and 2013/14 (4,032 IPD cases) in England and Wales (Table 1) because of the infant immunisation programme.

Pneumococcal conjugate vaccination (PCV) was introduced in September 2006, with a catch-up campaign for children up to two years of age. The number PCV vaccinations given each year are shown in table 2.

Table 2. The number of children at 12 months of age vaccinated with primary PCV, and the number of children at 24 years of age who have completed the PCV schedule, by year, in England.

Financial year	No. children 12 months vaccinated with primary PCV	No. children 24 months vaccinated with completed PCV
2006/07 (Q3&4 only)	24,823	51,648
2007/08	430,518	350,049
2008/09	570,912	487,209
2009/10	599,786	561,106
2010/11	618,525	582,614
2011/12	641,645	615,203
2012/13	651,933	636,591
2013/14	640,971	642,023
2014/15	617,263	633,698

The complete course comprises three doses of PCV vaccine: these are given at two months and four months (the primary doses), and a booster dose at 12-13 months.

In 2014/15 the NHS incurred approximately £9 million delivering completed courses of PCV and Haemophilus influenzae type b / meningococcal C (Hib/MenC) vaccination. Costs in 2013/14 would have been similar. NHS England does not have details of delivery costs prior to 2013/14. This figure does not include the cost of the vaccine, which is procured centrally by PHE, and is commercially confidential.

The below Parliamentary question was asked by Andrew Gwynne on 2015-11-03.

To ask the Secretary of State for Health, what assessment he has made of (a) changes in the number of cases of, and deaths from rotavirus (b) the number of rotavirus vaccinations given each year and (c) the cost of delivering that programme of vaccinations on an annual basis since the introduction of the rotavirus vaccine in 2013.

Jane Ellison

The number of positive rotavirus laboratory reports each year since 2013 is shown in the table below. These data indicate that there has been a decrease of approximately 10,000 annual cases of rotavirus since the introduction of rotavirus immunisation in July 2013.

Table 1: The number of positive rotavirus laboratory reports recorded annually since 2013.

Year	Number of positive rotavirus laboratory reports
2013	14,950
2014	4,447
2015	5,035*

Source: PHE Second Generation Surveillance System (SGSS) laboratory reporting database

Note: *Figure to end October 2015.

Deaths from rotavirus in the United Kingdom are rare. However precise numbers of deaths are difficult to quantify accurately as mortality is usually low and reported simply as death due to gastrointestinal disease. It was previously estimated that there may have been up to three to four rotavirus associated deaths a year in England and Wales (Jit et al., 2007). Following a recommendation from the Joint Committee on Vaccination and Immunisation (JCVI), the independent expert committee that advises the Government on immunisation, the rotavirus vaccine was introduced in July 2013. Since then, there have been no reported rotavirus-related deaths in the eligible cohort.

Immunisation against rotavirus is offered as a two dose schedule to infants at two and three months of age. The table below indicates the number of rotavirus vaccinations given by year.

Table 2: Number of general practitioner (GP) registered patients who received (a) a 1st dose and (b) a 2nd dose of rotavirus vaccine between six and 24 weeks of age.

Year	No. vaccinated with dose 1	No. vaccinated with dose 2
2013*	not available	not available
2014	531,068	500,454
2015 (up to September)	428,591	406,485

Source: ImmForm

Note: *Although the immunisation programme was launched in July 2013, January 2014 was the first complete month where all of 25 week old cohort would have been eligible from the programme start.

In 2014/15 NHS incurred approximately £9 million delivering completed courses of rotavirus vaccination. This figure does not include the cost of the vaccine, which is procured centrally by Public Health England, and is commercially confidential.