Background to the report

COVID-19 vaccines first became available at the end of 2020. Since then, vaccination has been central to the government’s pandemic response. The UK Health Security Agency (UKHSA) estimated that by the end of September 2021, vaccinations may have averted as many as 128,000 deaths and 262,000 hospitalisations by September 2021.

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A number of national and local bodies have been involved in the COVID-19 vaccine programme (the programme), including:

  • The Vaccine Taskforce (the Taskforce), created in April 2020, one of whose objectives is to secure vaccine supplies for the UK.
  • Initially, the Taskforce delivered its responsibilities on behalf of the Department for Business, Energy & Industrial Strategy (BEIS). From August 2021, the Department of Health & Social Care (DHSC) assumed accountability for Taskforce activities relating to procurement, clinical testing and development. DHSC is also responsible for planning how to administer the vaccine to the public in England.
  • NHS England and NHS Improvement (NHSE&I) leads on operational delivery of COVID-19 vaccinations in England. It has worked with Public Health England (PHE) on vaccine supply, storage and distribution within England. From October 2021, PHE’s responsibilities transferred to the new UKHSA.
  • A range of local healthcare providers – NHS hospitals, GPs and community pharmacies – have administered vaccines in their own premises and other settings including dedicated vaccination centres.

In implementing the programme, the government has followed advice from the Joint Committee on Vaccination and Immunisation (JCVI) and the Chief Medical Officers. As with other vaccines, the Medicines and Healthcare products Regulatory Agency (MHRA) has to approve COVID-19 vaccines before they can be used and monitors safety after approval.

Scope of the report

In December 2020, we published our Investigation into preparations for potential COVID-19 vaccines. This report extends our examination up to the end of October 2021, by which time four vaccines had been approved for use and the rollout of first and second doses of COVID-19 vaccinations to adults had taken place. The programme had also commenced rollout of first doses to 12- to 17-year-olds, and booster vaccinations.

This report evaluates the government’s COVID-19 vaccine programme focusing on events up to the end of October 2021 and assessing whether the programme is well placed to meet its objectives in full. The report focuses on England, with the exception of procurement which the government has done on a UK-wide basis.

Report conclusions

Initiated in 2020, the vaccine programme has operated at unprecedented pace, scale and complexity, and in conditions of profound uncertainty, to achieve the pressing objectives of supporting the creation of vaccines, securing access to them, and administering them to the population as quickly as possible. It is through the collective efforts of many national and local public bodies, scientists, vaccine manufacturers, and individual staff and volunteers, as well as government’s power as a coordinator and funder, that so many of the programme’s objectives have been met and in some areas exceeded. The evidence indicates that the programme has saved lives and reduced the incidence of serious illness and hospitalisation.

Given the unprecedented circumstances of the pandemic and the programme’s achievements up to October 2021, we assess that it has provided value for money to date. Much about COVID-19, the vaccines market and the UK’s future requirements remains unpredictable but far more is now known than in 2020. The programme needs to identify a clear path to a future sustainable model, securing the benefits of its many innovations and ensuring it has a full picture of costs and workforce requirements as it takes key decisions. It needs to challenge anew all elements of its cost base and adapt accordingly. Most importantly, it needs to maintain the high levels of vaccine uptake it has achieved among the general population and increase levels for groups where uptake still lags behind.

“The vaccine programme has been successful in getting early access to what were brand new COVID-19 vaccines, securing supply of them, and administering them to a large proportion of the population at unprecedented speed.

“The programme must now redouble its efforts to reach those who are not yet vaccinated while also considering what a more sustainable model will involve as it moves out of its emergency phase.”

Gareth Davies, the head of the NAO


Publication details

Press release

View press release (25 Feb 2022)

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