Dr Gareth Millward from the University of Warwick's Centre for the History of Medicine comments on the unique challenge of managing Britain's largest ever vaccination programme and how it compares to previous public health roll outs in the UK.

He said: "There is much about the current COVID-19 vaccination drive that is unique. The scale of vaccination among the adult population is unprecedented. But Britain has had had to roll out new vaccines before.

"The polio vaccine in the 1950s was also unveiled with much media fanfare. The British government organised a grand press conference to announce its arrival. Competing vaccines soon emerged which forced the government to make choices about which to buy and how to distribute it. The British government favoured a British-made vaccine for nationalistic as well as epidemiological purposes, though found itself embarrassed when the local pharmaceutical firms were unable to produce and distribute doses quickly enough to those who had put themselves on the waiting list.

"Polio was a turning point in British vaccination policy. The ‘Joint Committee on Poliomyelitis Vaccination’ evolved into the ‘Joint Committee on Vaccination and Immunisation’ currently advising the government on which groups to prioritise in the current crisis. Indeed, the JCPV also had priority lists, focusing first on young children, then teenagers, then young adults and then everybody under the age of 40. A reverse of what we are seeing today, but no less a logistical headache for medical experts and administrators. Authorities also struggled to convince young adults to take the risks of the disease seriously – leading one enterprising medical officer in Bristol to organise an ‘Injections-while-you-dance’ night at the local dance hall.

"Since the 1950s, Britain has developed and adopted a range of technologies and practices to greatly increase uptake. Authorities can more easily follow up with parents to ensure their children get offered the correct immunisations at the correct time. Multidose vaccines reduce the number of appointments necessary (and reduce the number of times children have to go through what can be an unpleasant procedure). Public health authorities are more aware that populations that do not have English as a first language or move home regularly might get ‘lost’ in the system and therefore need special attention and communication about the benefits of vaccination.

"But many of these systems are built to reach children. COVID-19 presents a unique challenge not seen outside of specific epidemics such as smallpox. Like with smallpox, the vaccine needs to reach everyone, and as quickly as possible. The government will have to deal with this, as well as the inevitable public relations problems that will come if there are interruptions to supply (problems which might not be entirely of their own making)."

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You can read more from Dr Gareth Millward on this topic on the Warwick Knowledge Centre.

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