Chart of the week: Fast and fair? Understanding the variation in vaccine roll-out speed across the UK

To date, few countries have made more progress in vaccinating their population against Covid-19 than the UK. However, in recent weeks questions have been raised about whether some UK areas are lagging behind in the roll-out.

Certainly, the number of doses administered relative to the size of population does vary – as shown by the dark blue bars in the chart. Across the English regions, as of 23 January, the level in the South West – at equivalent to 12.2 doses per 100 people – was over two-thirds higher than the level in London (7.2). And against this somewhat crude measure of roll-out performance, there also appears to be substantial variation across the four UK nations.

But some degree of variation is to be expected and is not necessarily unwarranted. In particular, with vaccine supplies being prioritised towards those in older age groups, we would expect to see areas with younger populations – such as London and Northern Ireland – lag behind. In lieu of having consistent demographic data on the roll-out across the UK, we have plotted the total doses given relative to the number of people aged 75 and over (see light blue bars).  This demonstrates some of the effect of differences in age across the UK on roll-out so far.

While Wales and Scotland still appear to be behind even after accounting for age, there are other plausible explanations for the disparity. Some areas may have more strictly stuck to the hierarchy for prioritising which groups should get the vaccine first (including vaccinating those in care homes first) rather than ensuring all the vaccine is administered at pace – even if, at times, this means someone from a lower priority group receives it. Differing levels of vaccine hesitancy between regions may also influence speed of roll-out.

However, there have also been suggestions that some of the regional disparity has been caused by, for instance, delays in getting some general practices approved to provide vaccinations. It is also important to note that within the large regions shown in the chart there is considerable local variation.

A founding principle of the NHS was to provide equal opportunity of access for those at equal risk. We therefore need both greater clarity on how the supply of vaccines is being allocated across the UK and more data on the protected characteristics, socio-economic status and occupation of those receiving it. This is needed not just to check fairness now, but also to ensure lessons are learnt when deciding how to prioritise the remainder of the population.