Module 4 ‘In-Brief’ summary – Vaccines and therapeutics

Report and Recommendations In Brief

The UK Covid-19 Inquiry is an independent public inquiry examining the response to, and impact of, the Covid-19 pandemic and to learn lessons for the future. Its terms of reference were set by the then Prime Minister Boris Johnson. 

The scale of the pandemic was unprecedented; the Inquiry has a huge range of issues to cover. The Chair of the Inquiry, Baroness (Heather) Hallett DBE, decided to address this challenge by dividing its work into separate investigations known as modules. Each module is focused on a different topic with its own public hearings where the Chair hears evidence.

Following hearings, recommendations for change are developed and put into a Module Report. These reports contain findings from the evidence collected across each module and the Chair’s recommendations for the future. The following reports have already been published:

• Module 1 – The resilience and preparedness of the United Kingdom
• Modules 2, 2A, 2B and 2C – Core decision-making and political governance
• Module 3 – The impact of the Covid-19 pandemic on the healthcare systems of the United Kingdom

The fourth module considers the development and deployment of vaccines and therapeutics (sometimes referred to as ‘drugs’) in the UK during the Covid-19 pandemic.¹ Public hearings took place between 14 January and 31 January 2025.

Future reports will focus on the following areas: 

• Module 5 – Procurement and distribution of key equipment and supplies
• Module 6 – The care sector
• Module 7 – Test, trace and isolate programmes 
• Module 8 – Children and young people 
• Module 9 – The economic response to the pandemic
• Module 10 – The impact on society

Module 4: Vaccines and therapeutics

The UK authorised and delivered effective vaccines to the public within a year of the UK’s first case of Covid-19 in January 2020. The delivery of the first vaccine kickstarted a UK-wide vaccination roll out which exceeded targets for population coverage. One of the vaccines had also been developed in the UK.

One study estimated that, by March 2023, the lives of 475,000 people aged 25 or older had been saved as a result of Covid-19 vaccinations in England and Scotland. (Wales and Northern Ireland were not included in the study.)

Therapeutics were also introduced within months of the pandemic being declared. By June 2020, the drug dexamethasone (an anti-inflammatory) was being used to save the lives of Covid-19 patients in hospital. 

These achievements showcased many of the best attributes of the UK’s health and scientific research systems, including: 

• the rapid discovery and development of vaccines and therapeutics, based on the UK’s position as a world-leader in biomedical science;
• the rapid establishment of specialist vaccine and therapeutics taskforces, which brought together national expertise and acted decisively;
• the whole-population delivery of vaccines, according to a clear order of prioritisation, coordinated and efficiently managed by the public health systems in each of the four nations; and 
• the UK government’s at-risk approach to funding research and development of a wide range of possible vaccines, knowing that some would not be successful. This created as many opportunities as possible for the UK to procure an effective vaccine. 

By July 2021, almost 87% of the adult population in England had received at least one vaccination dose. In Scotland and Wales this was about 90%, and in Northern Ireland it was nearly 82%. The dedication of health and care staff to deliver vaccines at an unprecedented rate, and the public resolve to participate to protect those around them, were major factors in so many people taking up the vaccine offer. 

However, there were a number of groups for whom the programme did not work well and who were unable, or did not want, to take up the offer of a vaccine. There was lower uptake of vaccinations in communities with greater levels of deprivation and in some ethnic minority groups. This disparity in uptake was predictable. Before the next pandemic, more targeted action should be taken to communicate with these groups and build confidence in the safety of vaccine programmes. 

Vaccine hesitancy is on the rise across the world and in the UK. The use of social media and instant messaging means that false or misleading information can spread rapidly. The UK must take action now to counter it. 

One concern that fuelled the mistrust of vaccines was the issue of safety. Despite the urgency of the task and the speed at which vaccines were developed, the Inquiry finds that the steps taken by the UK government and regulatory bodies did not compromise the UK’s rigorous safety standards. To further strengthen this, regulators should have access to up-to-date patient data to allow for quick and comprehensive monitoring of the effects of new vaccines or therapeutics on the population.

The vast majority of those who received the vaccine experienced minimal or no side effects. However, there was a small group for whom vaccines led to serious injury or death. The Inquiry heard powerful evidence from some of those injured and from some of those who lost loved ones. Similar experiences were described through the Inquiry’s listening exercise, Every Story Matters. It is imperative that a sufficiently supportive government scheme is in place to help people who suffer serious injury following vaccination and loved ones who need to make a claim following bereavement. The current scheme – the Vaccine Damage Payment Scheme – is not sufficiently supportive. It requires urgent reform. 

It was fortunate that the timing of the Covid-19 virus coincided with the outcome of decades of global research about technologies that could quickly be adapted and used to create vaccines. However, the UK also entered the pandemic without sufficient therapeutics and vaccine manufacturing capability. Action has already been taken to respond to some of the issues exposed in the pandemic. However, more needs to be done to ensure the UK’s research capabilities remain at the cutting edge of vaccine and therapeutic development. The UK must not allow the relationships, infrastructure and expertise that were so successful during the Covid-19 pandemic to wither.

Recommendations 

In order to ensure that the UK is in a strong position to develop and deliver vaccines and therapeutics to fight the next pandemic, the Inquiry recommends: 

• establishing a pharmaceutical expert advisory panel to oversee the UK’s preparedness to develop, procure and manufacture pharmaceuticals (vaccines and therapeutics); 
• producing targeted vaccination strategies and communications, in order to increase vaccine uptake and reduce inequalities. This should include consulting with local networks about communication campaigns and delivery approaches; 
• improving monitoring and evaluation of vaccine uptake and delivery, in order to understand the measures proven to be effective in increasing vaccine uptake; 
• facilitating regulatory bodies’ access to healthcare records for the purposes of post authorisation safety monitoring of new vaccines and therapeutics; and
• reforming the Vaccine Damage Payment Scheme 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 Chair expects that all recommendations are acted upon and implemented within the time frames set out in the recommendations. The Inquiry will monitor the implementation of the recommendations during its lifetime. 

A comprehensive description of the recommendations can be found in the full Module 4 Report, with a full list in Appendix 3.

To find out more or to download a copy of the full Module 4 Report or other accessible formats, visit: https://covid19.public-inquiry.uk/reports