How Britain’s vaccine programme went from world-beater to laggard in less than a year

Only a few months ago, Britain was being lauded as a world leader in a vaccination programme that MPs described as “one of the most stunning scientific achievements in history”.

The jabs juggernaut was averaging more than 600,000 inoculations per day on a seemingly unstoppable journey to protecting the whole population.

In recent weeks, however, the foot has come off the gas and the coronavirus vaccine programme is managing just 200,000 shots per day, despite the urgent need for boosters.

The NHS is blaming the public, saying take-up of boosters is sluggish. GPs are blaming the NHS. Politicians are blaming each other. Boris Johnson is “upset” and has demanded answers from ministers.

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One thing that is indisputable is that the NHS and the Government have stopped doing what they did so well when the rollout was at its peak in the spring.

Back then, an army of volunteers, retired doctors and nurses, service personnel and NHS staff came together with energy, organisation and determination, and quickly became the pride of the nation.

But an army needs generals, and over the summer the leading lights in the vaccination programme have moved on, to be replaced by largely anonymous figures, while the all-important Vaccine Taskforce has been sucked into the “entropy process of Whitehall”, in the words of Dominic Cummings.

“The NHS isn’t focusing on this with the same verve as they did the first time round,” said one Whitehall source who was closely involved with setting up the vaccine programme. “The booster programme has been left to the classic regional NHS bureaucracy.”

The statistics are stark: according to the Government’s own figures, only 1.3 million of the 2.3 million over-80s eligible for a booster have had one. The Covid-19 Actuaries Response Group, which has been tracking the vaccine rollout, says 4.8 million over-50s who are eligible for a booster (having had their second jab at least six months ago) have not had one.

Even NHS England admits that 2.4 million eligible people have not yet been invited to come for their booster.

Perhaps the single most important moment that led to the success of the original rollout was the establishment of the Vaccine Taskforce and the appointment last May of the venture capitalist, and now Dame, Kate Bingham to lead it. A parliamentary committee later described the move as a “masterstroke”.

After riding out claims of cronyism – she is the wife of Jesse Norman, the Tory MP and former transport minister – she seized control of the procurement and delivery of vaccines, recruited the best brains from industry, healthcare and science, and used their entrepreneurial instincts to smash down every barrier to progress, away from the morass of Whitehall.

One of her lieutenants, and an unsung hero of the vaccine rollout, was Emily Lawson, a former troubleshooter for supermarket chain Morrisons who, as NHS England executive lead for the jabs programme, was the woman who made sure doses got into arms as quickly as possible.

Cracking the whip in government was former entrepreneur Nadhim Zahawi, who was recruited from the business department to become vaccines minister, and worked morning, noon and night to iron out any problems in supply and delivery.

Watch: Is the UK's booster jab rollout too slow and will it work?

All three have now moved on to other roles, leaving a huge hole in the vaccines programme.

As Mr Cummings said after leaving Number 10: “Of the 20 people who I saw do most to save thousands of lives, it's striking how many have gone or are leaving or planning to leave.”

The Vaccine Taskforce itself, which originally reported to the Department for Business, Energy and Industrial Strategy, is now overseen by the Department of Health and Social Care, blurring the lines of its independence. Since June, it has been chaired by Sir Richard Sykes, a former chairman of NHS London.

Mr Cummings told a super-committee of MPs examining the Government’s Covid response that: “Since Kate Bingham left, the normal entropy process of Whitehall has got its fingers on the thinking and the operations around this. There hasn’t been the kind of very aggressive approach that some inside government want.”

The committee described the development as “concerning” and Greg Clark, the committee’s co-chairman, suggested it was “the forest creeping back into the clearing”.

Mr Zahawi has been replaced as vaccines minister by Maggie Throup, a former junior whip who has been largely anonymous since taking over the job a month ago.

Amanda Pritchard, who took over from Sir Simon Stevens – now Lord Stevens of Birmingham – as chief executive of NHS England in August, told MPs on Tuesday that “absolutely the crux” of the problem with the booster programme is that people “are not coming forward as quickly when they receive their invitation as we certainly saw for the first jabs”.

There have also been claims that public complacency is partly to blame, with government polling showing the number of people “extremely” or “very” worried about Covid has dropped from 62 per cent in March 2020 to just 20 per cent now.

Yet, the Royal College of General Practitioners said that surgeries that were vaccinating people earlier this year are not giving boosters because they are choosing to clear their backlogs of patient appointments instead, meaning that elderly people currently being invited for their jabs may have to travel further to get them.

Prof Martin Marshall, the chairman of the Royal College, said that “ease of access” was likely to be one of the reasons for the slow uptake.

Meanwhile, the Cabinet Office, which is responsible for public information campaigns, is about to launch a new push to get the public to have a third vaccine, which critics say should have been done before the booster programme started.

There is a growing sense in government that instead of offering excuses for the stalled rollout, those at the sharp end of delivering it need to come up with solutions, in the same way that Dame Kate’s Vaccine Taskforce refused to accept that problems could not be solved.

Novel solutions, such as enticing retired doctors and nurses to come out of retirement again, improving accessibility with community based vaccination surgeries or pop-up clinics, and using more community pharmacies as vaccination centres, have not been forthcoming.

Jonathan Ashworth, the shadow health secretary, said on Tuesday that the current problems stemmed from “complacency”, while Jeremy Hunt, the former health secretary, told Ms Pritchard that “this is going to create a real crisis” if more is not done to get the numbers up.

The alternative, after MPs extended the Coronavirus Act 2020 to next March, could be the imposition of new Covid restrictions, such as vaccine passports, or the reimposition of old ones, such as social distancing.

Case study: Booster rollout has ‘gone badly wrong for the most vulnerable people’

Ceinwen Giles, 46, is immunocompromised following treatment for non-hodgkin lymphoma - but spent months chasing her GP, turning up at vaccination centres and pleading with staff to give her a third jab.

Ms Giles said the process was a “mess” and said it has “gone badly wrong for the most vulnerable people”.

“I think that's the thing that we should be really upset about,” she said.

“These are people who actually could get very ill or end up in hospital because they haven't had this third dose. I just feel someone has taken their eye off the ball.”

After the Government approved third jabs, Ms Giles called her GP to book an appointment but was told they knew nothing about the plans.

Her hospital immunology team said they were unable to help, as they believed the programme was being rolled out through primary care.

The cancer charity director resorted to turning up at a walk-in vaccine clinic, with a letter in hand from her consultant stating she was eligible for the jab and that she was immunocompromised.

But the centre said they had “never heard” of the programme.

“It's just a mess and this has been going on for months now,” she said.

“I’m immunocompromised. I have an 11-year-old daughter who can’t be vaccinated yet because she's not 12. She's in a school where Covid is rife and one of her close friends has just got Covid. It’s really stressful.”

After months of chasing, she eventually secured an appointment at the largest mass vaccination station in Lewisham. However, she said others without the time and ability to make multiple calls would not be so lucky.

“It just seems like since July 19, all of [the attention on vulnerable groups] has fallen away and we don’t matter anymore.”

She said it was “really upsetting, as well as frustrating, that the most vulnerable in society have just been forgotten about”.

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