The steps needed for a successful Covid vaccine rollout


The Pfizer/BioNTech vaccine has been judged safe for use in the UK by the Medicines and Healthcare products Regulatory Agency (MHRA), but what must be done to ensure that the rollout is a success? Dr Anthony Hill MBA, Programme Leader for our Public Health Online Courses, is a specialist with more than 30 years’ experience. He gives his insights on the crucial steps that must be taken.

Even in a relatively small country like Wales, a vaccine programme on this scale to be conducted with the necessary speed is a vast administrative and logical undertaking.

There are several key steps to ensuring success, all of which have been influenced by vaccination projects conducted around the globe ever since the first vaccine was born.


Above all else, it must be established just how the vaccine will be transported, stored and distributed to the people of Wales.

Robust and innovative health infrastructure is required here, incorporating meticulous internal communications, precision supply chain management, sufficient and sustainable financing and ultimately, high-quality dispensing facilities and procedures.

Encouragingly, the welsh government has been engaged in a four-naition approach to the vaccine since May and health and social care sectors have been planning in earnest for its deployment.

One of the more troublesome hallmarks of the new vaccine is its need for storage at very low temperatures of between -75C +/- 15C.

Two specialist sites have been identified as appropriate delivery sites for the vaccine and local health boards will collect the vaccines directly from those sites.

Multiple Wales-wide simulation exercises have already taken place to test distribution and storage arrangements, widening the parameters each time to create more and more demands upon the system. It has been reported by the Welsh Government that cold chain maintenance was maintained throughout.

Initially, hospital sites will be prioritised for distribution, followed by community settings, and the Welsh Immunisation System will create appointments and automatically schedule second doses, send appointment letters and record vaccinations for every vaccine given.

As for the second vaccine on the horizon, if approved the Oxford AstraZeneca vaccine should be available early January. The UK Government has pre-ordered 100 million doses, and unlike the Pfizer/BioNTech vaccine it does not require such extremes of temperature to keep it stable. If the rollout can cope with the stringent requirements placed on it by the first vaccine, anything that follows should be a little more straightforward in comparison.

Strong political will and strength of leadership

A lack of political will and weak leadership destroys public confidence in vaccination programmes. It has happened before and the moment the public senses a lack of assurance in their leaders, compliance rates fall off a cliff.

We have already seen a precursor to this play out in the US, where anti-maskers and anti-vaxxers have aligned themselves in opposition to the Covid response strategies thanks to misinformation and confusing rhetoric courtesy of the outgoing administration.

As a result US death rates are rising exponentially and a recent poll reported that just 58% of US adults would be willing to be vaccinated.

In Wales, we know there is a strong appetite for a vaccine, and so to maintain this it is imperative that senior Welsh Government officials and public health chiefs lead with conviction.

Comms are key

None of the above can be achieved without the bulletproof communication strategies. Political and healthcare leaders must deliver common and consistent messaging from the very top.

At all moments – a press conference, a press release, web and social media content, debates in the Senedd chamber, and appearances on radio shows, training and recruitment events, supply chain memos, medical consultations – everyone needs to be dealing with the same facts and working with the same scripts. This is vital to maintain public belief and trust.


Audience identification and engagement is another crucial strand to a successful vaccination campaign and one that also falls under the umbrella of “comms”.

In a “normal” vaccination programme, a complex, years-long project to assess the needs of different populations and the development of customised plans would be undertaken. Internal and external communication teams would be assigned to win the hearts and minds of everyone involved, from programme operatives to vaccines recipients.

With Covid, we don’t have the luxury of time, and thanks to the speed at which vaccines are being delivered, at this point it is simply a case of getting the vaccine into as many of the general population as possible, and fast.

To date, the four-nation approach has skirted around audience segmentation (for now) and instead devised a priority groups list, based principally on age, medical need and health-social care worker status. It is an approach that makes complete sense.

Following this, secondary outreach programmes must be done to fully engage hard-to-reach audience groups, for example BAME communities as well as other communities where interaction with public services and consumption of news media and information channels are traditionally low.

There are no laws which could force any British citizen to be vaccinated against their will and there is no intention to do so. For now, the hope is that those who do not wish to receive a Covid vaccine are far outnumbered by those who do, thereby achieving herd immunity, halting the spread of the virus, protecting communities, nations and, ultimately, humanity.