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Investigation into preparations for potential COVID-19 vaccines

Today the National Audit Office (NAO) reports that government has worked quickly to secure potential COVID-19 vaccines, successfully signing deals for five vaccines providing up to 267 million doses at an expected cost of £2.9 billion.

The Department for Business, Energy and Industrial Strategy (BEIS) chose to purchase different types of vaccines from a range of pharmaceutical companies, to create a diverse set of options, recognising the uncertainty over which ones, if any, might prove to be safe and effective. It originally intended to purchase up to 12 vaccines, later reducing the number to up to nine as its understanding of requirements and costs developed.

The total cost to the taxpayer of government’s efforts to purchase and deploy vaccines is uncertain. The current estimate is up to £11.7 billion which includes the costs of purchasing and manufacturing vaccines for the UK, deploying them in England and investing in global efforts to purchase vaccines. 

It has signed contracts with five pharmaceutical companies,2 providing some priority access in four out of five cases to address the risk that global demand may outstrip supply initially. Non-binding agreements are also in place with two other pharmaceutical companies.3

BEIS agreed upfront payments of £914 million in the five contracts it signed, prior to any vaccine being approved by regulators. These payments have been used to start manufacturing and to support clinical trials. In all contracts, the payment will be used against future purchases of the vaccine if it is approved as safe and effective. Only one of the contracts BEIS has signed provides for the full upfront payment to be refunded should the vaccine fail to achieve regulatory approval. Two other contracts contain provisions for BEIS to recover some of the upfront payments if the contract is terminated, but for the remaining two contracts the upfront payments are non-refundable.

Many pharmaceutical companies requested immunity in the event of liabilities or legal action relating to their vaccines, meaning the taxpayer may have to pay the costs of claims against them. In four out of the five contracts agreed so far, no cap has been applied to the amount that government could pay in the event of a successful claim against the pharmaceutical companies.

Government has made changes to how investments are approved so that decisions could be made faster and to increase the chances of purchasing vaccines, reducing the time taken for investment decisions from four weeks down to seven to nine days for proposals from the Vaccine Taskforce.

As part of the Spending Review in November 2020, BEIS calculated it needed £519 million to provide UK-based manufacturing capacity for vaccines. By December 2020, it had committed £302 million of this to a range of manufacturing projects.

NHSE&I is planning a vaccination programme with high levels of uncertainty because information about the COVID-19 vaccines is constantly changing. Each potential vaccine requires different plans for rolling it out to the public because each has different characteristics. These include the temperature it should be stored at, its shelf-life once open, and how it should be prepared before it is administered. BEIS has shared the information it has about the characteristics of each potential vaccine with NHSE&I, but characteristics are still uncertain and subject to change as clinical trials continue for some vaccines.

In September 2020 NHSE&I calculated that if every adult in England needed to be vaccinated with two doses of a COVID-19 vaccine, its vaccination workload would increase by 740%. NHSE&I calculated that it may need up to 46,000 staff consisting of 26,000 vaccinators and 20,000 administrative staff to deliver the COVID-19 vaccination programme based on a 75% take-up rate. NHSE&I is continuing to keep its deployment plans under review to ensure it can respond to the latest information about which vaccines have been approved, how many doses will be available and when, which groups in society need to be can be vaccinated, how many doses of vaccines will be available and when and how those vaccines need to be deployed.

As at 8th December 2020, NHSE&I is planning on the assumption it could vaccinate up to 25 million people with two doses throughout 2021 – combined with an expanded flu vaccination programme, this would be an increase of 64.1 million vaccinations compared to 2019-20. NHSE&I is continuing to review and update its assumptions about how many staff will be needed to support COVID-19 vaccinations in 2021.

NHSE&I has developed delivery models that take account of the range of different possible characteristics of the vaccines BEIS has bought, the different groups that will require vaccinating and regional needs. It has concluded that it is not possible to deliver both the COVID-19 and seasonal flu vaccination programmes solely through existing arrangements such as GP practices and community pharmacies. It has developed three new models including offering vaccinations at large sites such as sports stadiums; mobile sites similar to polling stations; and roving units to take the vaccine to particular locations such as care homes.

"Developing and securing an effective vaccine is central to reducing the impact of COVID-19 on society and saving lives. Government has worked quickly and effectively to secure access to potential vaccines, using the available information to make big decisions in an inherently uncertain environment.

"With one vaccine now approved for use and its roll out started, significant challenges remain. Efficient delivery to the UK population presents complex logistical challenges and requires excellent communication with the public." 

Gareth Davies, head of the NAO

Notes for Editors

  1. Vaccines will be bought for the UK, Crown Dependencies and Overseas Territories. Scotland, Wales, Northern Ireland, Crown Dependencies and Overseas Territories are each responsible for deploying the vaccine to their own populations.
  2. Contracts are in place for the vaccines developed by: Astra Zeneca UK Limited and the University of Oxford for 100 million doses, signed in August 2020; Valneva SE for 60 million doses, signed in September 2020; Pfizer Inc and BioNTech for 40 million doses, signed in October 2020; Novavax, Inc for 60 million doses, signed in October 2020; and Moderna Inc for 7 million doses, signed in November 2020.
  3. Non-binding agreements are in place with Janssen Pharmaceutical NV for 30 million doses and Sanofi S.A. and GlaxoSmithKline Biologicals S.A. for 60 million doses.
  4. Press notices and reports are available from the date of publication on the NAO website. Hard copies can be obtained by using the relevant links on our website.

About the NAO

The National Audit Office (NAO) scrutinises public spending for Parliament and is independent of government and the civil service. It helps Parliament hold government to account and it uses its insights to help people who manage and govern public bodies improve public services.

The Comptroller and Auditor General (C&AG), Gareth Davies, is an Officer of the House of Commons and leads the NAO.

The NAO audits the financial accounts of departments and other public bodies. It also examines and report on the value for money of how public money has been spent. In 2019, the NAO's work led to a positive financial impact through reduced costs, improved service delivery, or other benefits to citizens, of £1.1 billion.

Contact

NAO Press Office
+44 (0)20 7798 7400 or email pressoffice@nao.org.uk