The Covid-19 vaccination roll-out was an ‘extraordinary feat’, but disparities in vaccine uptake and vaccine hesitancy must be addressed before the next pandemic, the latest report of the Covid-19 Inquiry has warned. 

The rapid development of safe and effective vaccines, and the widespread, successful delivery of them across the UK during the unprecedented challenges of the pandemic should be viewed as an ‘overall success’, according to the inquiry’s chair Baroness Hallett. 

Despite this, the report also highlights that uptake of covid-19 vaccines was lower among those from minority ethnic, poor, disabled and immigrant communities.  

It further states that scepticism and hesitancy towards vaccines have served to undermine trust in both governments and health services, with this trust needing to be ‘rebuilt’ before the next pandemic. 

The findings are part of the fourth UK Covid-19 Inquiry report which examines the development and delivery of vaccines and therapeutics during the pandemic. 

She said: ‘The vaccination programme was an extraordinary feat. Effective vaccines were developed, produced and delivered to the majority of the population in record time.  

‘On any objective analysis, the risks of the Covid-19 vaccines were carefully managed and were far outweighed by the benefits. 

‘For the vast majority of the UK, the vaccines protected people against the most serious effects of Covid-19 and saved lives. They also played an important role in reducing the spread of the virus. They reduced the number of people who required hospitalisation or intensive care, thereby taking pressure off the healthcare systems of the four nations.’ 

While delivery of the vaccine roll out was broadly successful, data highlighted by the inquiry’s report reveals that there was a lower uptake of vaccinations, particularly among communities with greater levels of deprivation and in some ethnic minority groups. 

It stated that while 96 per cent of people listed as white British aged 50 and over had received one vaccine dose by 27 June 2021, this figure was 15 per cent lower among those from ‘white – other’, ‘Asian’, ‘Asian British – Pakistani’ and ‘Chinese’ backgrounds. 

Among those from ‘Black’ or ‘Black British – African’ this figure was 20 per cent lower and among ‘Black British – Caribbean’ 29 per cent lower. 

While acknowledging that both the UK government and devolved administrations had anticipated this disparity, the report calls for an increase in ‘targeted action’ aimed at engaging and improving trust between health services and these communities before the next pandemic.  

In her chair’s statement, Baroness Hallett said that while concern and hesitancy over vaccines was to a large extent driven by the rapid spread of misinformation online, a lack of trust in authorities and institutions also played a part.   

She said: ‘It is clear that a lack of trust and confidence in authority was also a significant contributing factor in the UK. Governments and health services must work with communities to rebuild trust and promote a better understanding of, and confidence in, vaccines.’ 

Responding to the report’s findings, BMA council chair Tom Dolphin welcomed the inquiry’s acknowledgement of the remarkable overall success of the UK vaccination roll-out, an outcome largely down to the courageous efforts of health and medical staff. 

He also accepted the report’s findings regarding vaccine hesitancy and a need to rebuild trust, adding that these needed to be addressed alongside broader health inequalities within society. 

He said: ‘Today’s report rightly highlights how the vaccination programme was one of the few success stories in the handling of the pandemic, and how, in large part, this was due to the dedication of healthcare staff, who went to great efforts to protect the public.  

‘In particular, GPs moved heaven and earth to quickly set up vaccination programmes to protect the most vulnerable in their local communities, using their proven track record of consistently running routine vaccination services year-in-year out. It’s vital that practices’ expertise and trusted relationships with local patients are fostered, and the value of continuity of care is not disregarded.’ 

He added: ‘The report illustrates the need to continue investing in research and development, as well as public health, community health and prevention, and the importance of engaging with communities, to ensure health messaging reaches the right people in the right way. 

‘We know that there were challenges with vaccine hesitancy, and there are still issues with vaccine uptake and trust in healthcare services, particularly among minority and deprived groups, and these need addressing not just in terms of preparing for a new pandemic but more broadly to tackle health inequalities.’  

The overall success in developing and delivering vaccines and other treatments during the pandemic was credited to UK’s status as a leader in biomedical science and research and to the efforts of ‘talented teams of doctors, scientists and researchers supported by the UK’s academic institutions.’ 

The report also commended the approach to vaccine development taken by Boris Johnson’s government, citing its willingness to invest ‘substantial sums of money’ into a wide range of potential vaccines and treatments. 

The report however also identified weaknesses in the UK’s preparedness and ability to respond, noting that the country entered the pandemic with insufficient capacity in drug and vaccine manufacturing.

To ensure that the UK is best placed to develop and deliver vaccines and therapeutic treatments ahead of any future pandemic, the report makes a raft of recommendations including:

– The formation of a pharmaceutical expert advisory panel to oversee the UK’s preparedness to develop, procure and manufacture pharmaceuticals;

– The development of targeted vaccination strategies and communications in order to increase vaccine uptake and reduce inequalities

– Improvements to monitoring and evaluation of vaccine uptake and delivery

– Increasing regulatory bodies’ access to healthcare records for the purposes of post-authorisation safety monitoring of new vaccines and therapeutics

– Reform of the Vaccine Damage Payment Scheme with an increase in the minimum payment awarded to those injured by a vaccine.

The report’s emphasis on preparedness for the next pandemic has previously been echoed by the BMA, with the association warning that many parts of the health service entered Covid-19 under resourced and understaffed.

Citing the findings of a YouGov poll published today [16 April] which showed that 71 per cent of doctors surveyed believed that the NHS was currently ‘poorly prepared’ to respond to a future pandemic, Dr Dolphin warned that the Government must not exclude medical professionals from planning. 

He said: ‘Overall, the vaccination effort, alongside the wider pandemic response and the need to maintain non-Covid care, required staff to go above and beyond. This pressure on the workforce and other services must be factored into any pandemic planning, a point that unfortunately seems lacking in today’s report. 

‘This morning we’ve seen data that suggests two-thirds of doctors don’t feel the NHS is prepared for another pandemic. It’s vital that the Government looks at the detailed findings of all modules of the Inquiry, as well as the recommendations, to ensure the country is on far better footing than it was in early 2020 when Covid first arrived.’