Summarize this content to 100 words Samantha Vanderslott, associate professor and career development fellowPandemic Sciences Institute, University of OxfordWe must learn from the successes and failures of the covid-19 vaccination programme if we are to prepare for the next pandemic, writes Samantha VanderslottVaccination has been so successful in protecting whole populations from disease that it is now an often-repeated phrase that vaccines are victims of their own success. As vaccination rates rise, vaccine-preventable diseases become less common within society, creating the illusion that vaccination against these diseases is no longer necessary. This means that the more successful vaccines are, the harder health authorities must work to make their value apparent. During the covid-19 pandemic the need to vaccinate against SARS-CoV-2 was paramount, but uptake was nevertheless a challenge. It would be wrong, however, to view vaccination failures as being only the fault of those who do not want to vaccinate. Government failings should also be considered.These failings have been highlighted by the ongoing UK covid inquiry. Module four, which focused on vaccines and treatments, concluded in January 2025.1 The inquiry emphasised that the covid-19 vaccination is a success story from the pandemic, judged on the development of safe and effective vaccines that prevented severe disease and mortality, as well as their successful procurement and distribution. However, the inquiry also reflected critically on what went wrong in the government response and what could be improved to plan and prepare for the future.The development and introduction of new vaccines during a pandemic faces challenges beyond those of routine vaccination schedules. The immediate and visible threat of a novel disease evokes feelings of hope and fear, which are heightened by the uncertainty surrounding a newly developed biomedical intervention. Political and moral agendas, and the rise of persuasive disinformation and misinformation, complicate the situation. During the pandemic we saw the politicisation of vaccines by governments in the media, where positions on vaccination were used to advance political agendas. Also, disinformation and misinformation proliferated, including via rumours and conspiracy theories.The inquiry brought into focus two questions specific to rolling out a vaccination programme during a pandemic. The first is, what happens when people are injured by vaccination? The second, what can be done when people are not willing to be vaccinated? Other challenges, such as vaccine manufacturing capacity, have also been examined, but these two questions have received the most attention.Despite saving the lives of millions,2 vaccination has caused injury or (in very rare cases) death in a small number of people.3 These individuals have been appallingly let down by a government system that should have helped them. The wife of a man who was left disabled after receiving a covid-19 vaccine said that “The scheme is inadequate and inefficient—offers too little, too late, and to too few.”4This situation was entirely foreseeable. In 2020, together with other researchers, I called for a bespoke compensation scheme to be created for possible adverse effects caused by covid-19 vaccines. This is a much needed legal safeguard and resource to ensure the public acceptability of vaccines.5 After the pandemic, the previous health secretary Victoria Atkins stated she was looking at reform of the vaccine damage payment scheme, but a solid commitment is still lacking and there has been no further action.6Reluctance to be vaccinated was not new to the pandemic, but the inequalities in uptake among certain groups, along with weak outreach and engagement, were starkly highlighted. People from ethnic minority groups were less likely to be vaccinated than white British people.7 exposing persistent inequalities in public health engagement and services.Another overlooked issue was vaccine confidence in healthcare workers, who are often patients’ most highly trusted source of information on vaccines,89 but who may themselves be susceptible to vaccine hesitancy. Since the pandemic, there have been indications of rising hesitancy among healthcare workers, as well as a clear pushback against mandated vaccination—a policy that was intended as a requirement for employment but later scrapped.10For ethnic minority groups, concerns about underlying factors influencing vaccination have been identified, notably a legacy of mistrust and ongoing discrimination.11 For healthcare workers, a lack of confidence in the healthcare system, pharmaceutical companies, and experts has dampened vaccine support from those who have an influential role.10 These worries have not gone away and have likely contributed to hesitancy around other vaccines, including those that are long established.12An openness to acknowledge the success and failure of vaccination is essential for dealing with future pandemics. The focus of the UK covid inquiry has been the problems rather than the solutions arising from the pandemic. We must adequately prepare by responding to shortcomings.Firstly, we need to overhaul our compensation scheme for those who might suffer rare vaccine adverse events. It is only fair that anyone inadvertently harmed by vaccination is compensated and this is needed for continued trust in vaccine safety as well as the related legal safeguards. Secondly, longlasting public engagement strategies are needed to rebuild vaccine confidence beyond the pandemic, particularly with ethnic minority communities and healthcare workers. Building on effective communication and engagement practices, such as the promotion of vaccination via community leaders, will be crucial to build trust and sources of credible information going forward.FootnotesProvenance and peer review: commissioned, not externally peer reviewed.Competing interests: SV declares no competing interests.
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Confronting the shortcomings of covid-19 vaccination will help us in future pandemics
