Source · Select Committees · Public Accounts Committee
Eleventh Report - The rollout of the COVID-19 vaccine programme in England
Public Accounts Committee
HC 258
Published 13 July 2022
Conclusions (21)
6
Conclusion
While vaccine wastage was well below assumptions in 2021, NHS England believes the level could increase in 2022, which would be regrettable. Up to the end of October 2021, the NAO estimated COVID-19 vaccine wastage levels for England of under 5%, a remarkable figure—especially considering the Pfizer vaccine’s transport and …
1
Conclusion
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department of Health and Social Care (the Department), the Department for Business, Energy and Industrial Strategy (BEIS), NHS England and NHS Improvement (NHS England), the UK Health and Security Agency (UKHSA) and the …
8
Conclusion
We asked the Department how learning would be applied to future emergency response planning. The Taskforce noted that a success factor had been the closer working relationships with vaccine manufacturers, which were critical to the speedy supply and deployment of vaccines. It indicated that this could be important for future …
11
Conclusion
We asked officials about their strategy with regard to the unvaccinated. UKHSA and NHS England told us that the basic public health message remained clear—that everyone was encouraged to get vaccinated—and that they continued to work with local government, local public health experts and community leaders to target the unvaccinated …
12
Conclusion
NHS England said it had built on approaches recommended by the Scientific Advisory Group for Emergencies and the World Health Organisation to achieve the excellent uptake to date.27 But it acknowledged that the country was no longer in a state of emergency and that many restrictions had now been lifted. …
13
Conclusion
Not Addressed
However, effective targeting is now essential because those who are not fully vaccinated are concentrated in particular social groups. According to NHS England, many unvaccinated people are young city-dwellers, with just five cities accounting for a quarter of the total number of unvaccinated people.30 Data confirm that young people are …
Government Response Summary
The government disagreed with the committee's recommendation to reduce the overall number of unvaccinated adults to 2.5 million and achieve an 80% uptake for first boosters among adults within four months. They stated they continue to focus on reaching out to the unvaccinated and not fully vaccinated and are using walk-in and mobile vaccination clinics to enable easy access.
15
Conclusion
There has also been particularly low uptake of the vaccine among pregnant women. As of February 2022, analysis by UKHSA showed that only 58% had received 2 doses.34 The Royal College of Nursing told us that lessons needed to be learnt from the mixed messaging and confusion around the vaccination …
16
Conclusion
Not Addressed
Additionally, Mencap raised concerns with us about specific difficulties in identifying and prioritising people with severe and profound learning disabilities.38 It said there was a need for more accessible communications for this group and to tackle needle phobia, which had not always been consistently or effectively addressed to date.39
Government Response Summary
The government agrees with the Committee’s recommendation that NHS England and UKHSA should urgently evaluate which approaches are most effective for increasing vaccine uptake, communicate again with local areas about what works, and provide support to them to deploy the most effective approaches, but focuses its response on the recommendation regarding vulnerable groups generally and does not address Mencap's specific concerns about those with severe and profound learning disabilities.
17
Conclusion
We asked the Department if communication campaigns had positively impacted vaccine hesitancy among any of these groups. The Department told us that there had been a positive shift in general but conceded that there remained more to do.40 NHS England described a range of targeted approaches that local and national …
18
Conclusion
As part of an earlier inquiry in January 2021, the Taskforce told us how its portfolio strategy aimed to “optimise the chances of success” in securing access to vaccines at a time of huge uncertainty about whether effective vaccines were even feasible.42 The strategy worked well, giving the UK access …
20
Conclusion
In our assessment, many of the risks that the portfolio approach was intended to mitigate remain. Most notable among these is the risk that future variants of the virus may respond better to one vaccine than another, perhaps a vaccine the UK has not procured. We asked the Taskforce what …
22
Conclusion
The next stage for the rollout of the COVID-19 vaccination programme is to vaccinate 5- to 11-year-olds. NHS England told us it recognised that this would probably be a slower and more challenging rollout given the adaptations necessary to accommodate 42 Public Accounts Committee, Oral evidence: Covid-19: Planning for a …
23
Conclusion
It is in this context that NHS England has started to plan for a reduction in vaccine sites and staffing in 2022. Its strategy responds to the likely drop in the overall scale of the vaccination effort, but it is not yet clear how it will strike the right balance …
24
Conclusion
We also heard from NHS England that it was moving to a position where the NHS and wider public sector estate should be used for vaccination sites wherever possible, in preference to renting private sector sites. Nevertheless, officials confirmed that established private sector sites with good uptake rates in particular …
25
Conclusion
The NAO report highlighted that future staffing was a major risk for the programme as a whole, due to staff burnout and the lack of surplus capacity in the healthcare system more generally.60 This was echoed by evidence provided to the Committee by the Royal College of Nursing and pharmacy …
26
Conclusion
COVID-19 vaccine wastage was considerably below assumptions in 2021. We heard from NHS England and the Taskforce that this was due to system-wide efforts throughout the vaccination supply, distribution and deployment chain to ensure as much vaccine as possible was used.65 Vaccine was treated by all who came into contact …
27
Conclusion
At our evidence session NHS England told us it was expecting wastage levels to increase in 2022, because of the anticipated fall in overall demand.67 This is because, as demand reduces, it becomes harder to guarantee that all doses in a given pack will be used up within the designated …
28
Conclusion
Opportunities to reduce wastage should also be part of NHS considerations about which vaccination sites will remain open in future. A nationwide pharmacy chain, Boots UK, told us that it would support a future model in which particular vaccination sites might be temporarily suspended to prevent ‘low demand, unacceptable wastage …
29
Conclusion
The Taskforce told us that predicting demand for 2022 remained difficult. It said it had consciously taken a cautious approach to procurement, based on the presumption that having too much vaccine would be better than having too little.71 There were opportunities to minimise wastage at all stages of the supply …
31
Conclusion
There are many other parts of the vaccine programme, including GPs and pharmacies, external contractors, volunteer schemes, local authorities and temporary staff, that are central to the delivery of the programme and that need timely confirmation about what funding will be available.77 The Directors of Public Health told us the …
32
Conclusion
Finally, we note that in setting up the vaccine programme the Department provided indemnities to vaccine manufacturers, which gave cover for future claims against producers for any adverse effects of their vaccines. These indemnities may add to the costs of the programme in the long term.80 We heard from one …