The Chair of the UK Covid-19 Inquiry, Baroness (Heather) Hallett, has today published her fourth report. It concludes that the development and rollout of Covid-19 vaccines was “an extraordinary feat” and the vaccine and therapeutic programmes were “two of the success stories of the pandemic” – but that governments and health services must now work to rebuild public trust in vaccines.
Module 4, the fourth of the Inquiry’s 10 investigations, examined how vaccines and therapeutics were developed, authorised and delivered across the four nations of the UK during the Covid-19 pandemic.
Today’s report, ‘Vaccines and Therapeutics’ (Module 4), finds that decades of global research and preparation – including to develop mRNA vaccines and vaccine platform technologies – were fundamental to the UK’s Covid-19 vaccine response. This groundwork, which would ordinarily take between 10 to 20 years, allowed the UK to authorise and roll-out effective vaccines within a year of its first identified Covid-19 case.
In 2021, approximately 132 million Covid-19 vaccinations were given across the four nations, making it the largest vaccination programme in UK history. By June 2022, about 87% of the UK population aged over 12 years had been vaccinated with two doses.
However, vaccine uptake was lower in communities with greater levels of deprivation and in some ethnic minority groups. The Inquiry finds that these disparities were predictable and must be addressed before the next pandemic.
It also finds that the current Vaccine Damage Payment Scheme is not sufficiently supportive of those who suffered serious harm as a result of vaccination and requires urgent reform.
The report highlights the vital role of therapeutics. The drug dexamethasone was being used to save the lives of hospitalised Covid-19 patients by June 2020, within hours of trial results confirming its effectiveness. By March 2021, it is estimated to have saved 22,000 lives in the UK and one million across the globe.
At the start of the pandemic it was fortunate that the UK was a world leader in biomedical sciences. In order to be prepared for future pandemics, the Inquiry concludes that it is vital that investment in life sciences is maintained.
Lack of confidence in Covid-19 vaccines was a global issue, driven by the spread of false information online and compounded by the fact that the vaccines were new and developed quickly. An underlying lack of trust in governments across the UK and health systems across the UK made some communities more susceptible to false information about the Covid vaccines.
In the Module 4 report, the Chair recommends that action is taken across all four nations to build trust within communities with lower vaccine uptake and to improve access to vaccines before the next pandemic.
This fourth UK Covid-19 Inquiry report concerns the development of Covid-19 vaccines and the implementation of the vaccine rollout programme in England, Wales, Scotland and Northern Ireland.
The vaccination programme was an extraordinary feat. Effective vaccines were developed, produced and delivered to the majority of the population in record time.
However, while the majority of people took up the offer of vaccination, there was lower uptake within communities in areas of higher deprivation and in some ethnic minority communities. Governments and health services must work with communities to rebuild trust and promote a better understanding of, and confidence in, vaccines.
Tragically, a number of people suffered harm as a result of having a vaccine. This was a small minority compared to the overall scale of the vaccination programme, but of no less importance to the individuals affected and their families.
We cannot know when, but there will be another pandemic. My recommendations, taken as a whole, should mean that the UK is better prepared for that pandemic. I urge governments across the UK to work individually and collectively to implement these recommendations, in full and in a timely manner.
A four-page brief summary of the report can be found on the Inquiry’s website and is available in a variety of languages and accessible formats.
In total, 43 witnesses gave oral evidence during Module 4 public hearings held in London in January 2025. The Inquiry heard from healthcare professionals, policy-makers and relevant experts. The Inquiry also heard from serving and former senior politicians, leading scientists, key medical professionals and civil servants.
Some of Baroness Hallett’s conclusions are as follows:
- The UK’s vaccine and therapeutics response was, in many ways, a success story. The UK developed the Oxford/AstraZeneca vaccine and authorised two further vaccines within a year of its first identified Covid-19 case, going on to deliver the largest vaccination programme in UK history, with one study estimating almost 450,000 lives were saved in England alone.
- The UK’s rigorous safety standards were not compromised. Despite the urgency of the task and the speed at which vaccines were developed, the steps taken by the UK government and regulatory bodies did not compromise the UK’s rigorous safety standards. Vaccines were subject to rigorous trialling and regulatory approval before rollout, with safety concerns identified quickly and monitored.
- Lower vaccine uptake in some communities was predictable and more must be done to improve uptake. It was lower in areas of higher deprivation and in some ethnic minority communities, with concerns about safety and side effects a key factor, compounded by a wider lack of trust and confidence in authority.
- Vaccine hesitancy is rising and governments must act now to rebuild trust. The rapid spread of false and misleading information online has fuelled hesitancy globally, but a lack of confidence in authority was also a significant contributing factor in the UK and governments and health services must work with communities to address this before the next pandemic.
- There were rare cases of people suffering serious injury or death as a result of vaccination and the current support scheme is inadequate. Representatives of vaccine-injured and bereaved groups described feeling silenced, ignored or treated as vaccine deniers and the Vaccine Damage Payment Scheme must be reformed as soon as possible.
- The UK entered the pandemic without sufficient manufacturing capability and this must be addressed. Strategic thinking across government is needed to ensure a diverse range of vaccine and therapeutic technologies are at the UK’s disposal in the event of a future pandemic.
Baroness Hallett calls for the prompt and thorough implementation of five key recommendations to ensure the UK is better placed to develop and deliver vaccines and therapeutics in any future pandemic:
- Establishing a pharmaceutical expert advisory panel. The panel should oversee the UK’s preparedness to develop, procure and manufacture vaccines and therapeutics;
- Producing targeted vaccination strategies and communications. This should include consulting with local networks about campaign and delivery approaches, in order to increase vaccine uptake and reduce inequalities;
- Improving monitoring and evaluation of vaccine uptake and delivery. This would help in understanding the measures proven to be effective in increasing vaccine uptake;
- Facilitating regulatory bodies’ access to healthcare records. This is for the purposes of post-authorisation safety monitoring of new vaccines and therapeutics;
- Reforming the Vaccine Damage Payment Scheme. This must take place as soon as possible, with an increase in the minimum payment awarded to those injured by a vaccine and a fairer system for determining payment.
The Inquiry has published reports for Modules 1, 2, 3 and 4. Baroness Hallett notes the action taken by the four governments of the UK to date – including the publication last month of the UK government’s new Pandemic Preparedness Strategy – and trusts that all recommendations will be implemented promptly and in full. Progress on the implementation of recommendations can be tracked on the Monitoring of Inquiry Recommendations page on the Inquiry’s website.
A further six reports will follow. Summer 2026 will see the publication of the Module 5 report, examining ‘Procurement’. Reports will be published in the autumn for Module 6, investigating the ‘Care Sector’ and Module 7, investigating ‘Test, Trace and Isolate’.
The remaining three reports will be published in the first half of 2027.
Read the full Module 4 report, the In Brief summary and other accessible formats on our website.