Covid Inquiry Module 4, vaccines and therapeutics report: "A success story, yes. But for whom?"
- @cv_cev
- 8 hours ago
- 12 min read
Opinion | 22 April 2026
By Lara Wong, Founder and CEO, Clinically Vulnerable Families
When I set up Clinically Vulnerable Families in August 2020, I had no idea it would eventually lead me to give evidence, under oath, to the largest inquiry in UK history.
I was a science teacher. I was concerned about the risk to families who were being forced back into schools without suitable protection, before any vaccine existed. That was just my starting point.
What followed was over six years of heavy work that I had never expected to do.
THE EARLY DAYS - VACCINE ACCESS
Once vaccines eventually emerged much of my work was around access.
Some people in our group with serious health risks struggled to access vaccines. In some cases, it was because people who hadn't been coded correctly. People with rare conditions weren't always listed in priority groups and needed a sympathetic GP to add them. Later on, a new grouping emerged of 'severely immunosuppressed' people (as different to 'Clinically Extremely Vulnerable' or 'CEV') who often didn't know that they qualified for a third initial vaccine dose. Even when they did know, they were frequently turned away at vaccination centres by staff who hadn't been told that they needed one! To top it off, the computer systems were not designed for 3 doses - and vaccination teams struggled to record them.
I built our group around peer support and rapidly we were drafting guidance and template letters, helping members write to their GPs and consultants, explaining what people were entitled to and how to ask for it.
It really shouldn't have fallen to a volunteer group. But it did.
ANTIVIRALS - ANOTHER STRUGGLE
Next came the antivirals.
The pathway the government set up, at pace, probably sounded easy enough on paper. But in practice it broke down at almost every stage because nobody actually understood how to get the treatments to the patients. GPs were referring people to 119. 119 were referring them to 111. And 111 were referring people back to their GPs in an endless loop.
When the new 'Covid Medicines Delivery Units' or 'CMDUs' were set up - they closed over weekends and bank holidays. The five-day urgent access window rapidly disappeared while someone was making repeated calls to access treatments.
I helped members navigate this by producing flow diagrams, lists of CMDUs phone numbers, and country-specific guidance, so they had something to follow when they needed rapid treatment.
For the most challenging cases - the ones where members had been turned in circles repeatedly, and were often deteriorating - I often helped to contact GPs and hospitals as an advocate. However, in the most difficult cases I found the most effective route was to make representations via their MPs.
NICE STAKEHOLDER
Alongside all of this, a longer piece of work was going on in the background.
Clinically Vulnerable Families ('CVF') had registered as stakeholders in various NICE appraisals ('National Institute for Health and Care Excellence' a public body that provides national health and care guidance and advice) for the protective synthetic antibody treatment - 'Evusheld' (an important alternative to vaccines for those whose immune systems are less effective), and various antiviral treatments.
Our survey of 350 immunosuppressed / immunocompromised households fed into the process. We found that 45% were still strictly shielding. Nearly everyone (93.6%) was experiencing anxiety. Two thirds felt unsafe at work. Over half had lost significant income. Nearly a third had experienced online aggression because they were trying to keep themselves safe.
It is important to remember that this isn't a group of people struggling mentally to recover from the pandemic. It is a group of people for whom Covid remains a serious health threat.
THE PHONE LINE
In parallel, I was talking to AstraZeneca about how people might access Evusheld privately in the UK or abroad, given that NICE seemed unlikely to procure it here. Our members had been travelling as far as the USA at their own expense, some borrowing money to do it, knowing it was their only option.
In October 2022, AstraZeneca contact me to provide a phone number which interested patients could use, with a referral from their UK consultant, to access private treatment in Poland. It was far closer than the US. For some members, it was the first real option they had been given in two years.
Our members bombarded it!!!
The line rapidly crashed under the volume of calls.
Five days later, AstraZeneca contacted me to say that private treatment would be made available in the UK.
For a moment, it felt like something had shifted.
TOO LITTLE, TOO LATE
By the time private access was possible, NICE had already decided against procurement. Evusheld was showing signs of becoming less effective against newer variants. Yet people in the USA and Europe had been receiving it for the best part of a year. Those now considering paying for it privately in the UK - at around £1,500 per dose, without the considerable NHS discount - were left with the only option of a drug whose effectiveness was already declined.
The UK was the only Western country not to protect its immunocompromised population with long-acting synthetic antibodies.
It is hard to write about this part dispassionately. The decision had real and serious consequences. Many people I know, people I spoke to every week, were left with nothing. Lives were massively restricted and undoubtedly lost as a consequence.
CHILDREN'S VACCINES
There was a similar pattern with children.
Families were desperate to return their children to school safely. The UK's vaccine offer to children was too slow, too limited, and too short. Markedly out of step with comparable countries including the United States, Canada, and Europe. Some families simply could not wait for this important protection.
I encouraged members to share information about accessing children's vaccines abroad. Germany, mostly. Some travelled multiple times to fully vaccinate their children.
I have repeatedly asked the UK government to allow children under 12 to access private Covid vaccines in this country. That has still not happened. Healthy children aged under 5 on 1 September 2022 have never been offered a Covid vaccine in the UK at all - and as of autumn 2025 that also includes all Clinically Vulnerable children who are not immunocompromised.
Vulnerable families have frequently been left to manage risks alone, often without the tools they need.
BEING ASKED TO GIVE EVIDENCE
Because of all of this, the Inquiry asked Clinically Vulnerable Families for a written witness statement. It was to 138 exhibits, over 200 paragraphs, and 122 pages. Then the Inquiry asked me to give oral evidence.
Now writing a statement is one thing. Being questioned, under oath, on a live stream is quite another. Then I was told I would be questioned by Mr Hugo Keith KC - Lead Counsel to the Inquiry, the same barrister who, in Module 2, had Boris Johnson on the ropes!
So I prepared. I re-read everything more than once and tried to anticipate every angle. I thought about what our members would want me to say, and I worried because I did not want to let anyone down.
In the event, Mr Keith did not treat me harshly. He was as thorough as the time allowed, and fair. He let me tell much of our story, or in his words "put meat on the bones" of our witness statement.
MY EVIDENCE, AND WHAT FOLLOWED
Many of our issues were followed up and confirmed, in the days and weeks that followed, by the people who were involved in the response. Dame Kate Bingham. Dr. Clive Dix. Sir Sajid Javid. The Inquiry now has it on the record, from people who were in the room at the time, that antivirals and prophylactic development were deprioritised compared to the vaccine response.
That the Treasury resisted funding prophylaxis (Evusheld). Cost, in the end, was the deciding factor.
It is strange to describe that as vindication. To me, it felt more like a quiet and deeply sad confirmation.
WHERE THIS LEAVES US
What I wanted to be heard in the witness box, more than anything else, was that these are not historical problems. People are still struggling to access antivirals. There is still no prophylactic on the NHS - and none available privately in the UK either. And what wasn't confirmed at the time, that the vast majority of Clinically Vulnerable people lost their vaccine eligibility in Autumn 2025. Many children were never offered a vaccine at all. Unfortunately, decisions made after the Inquiry's evidence window had closed, and therefore outside its remit to rule on. That is why this work must continue. The Inquiry can confirm what went wrong. But for policies made after the scope closed, and for implementation still to come, the pressure must still come from us.
WHAT THE MODULE 4 REPORT FOUND
On Thursday 16 April 2026, Baroness Hallett published her report. It concludes that the vaccine and therapeutics programmes were "two of the success stories of the pandemic" - and for many people, that is true. Hundreds of thousands of lives were saved. But within the report is a finding that matters enormously to CVF, and to every one of our members whose lives were shaped by the fact that the programme's success did not reach them.
What follows is what the report means for the people in Clinically Vulnerable households that CVF represents - the wins, and the work that still needs doing.
✓ PROTECTING IMMUNOCOMPROMISED PEOPLE: RECOMMENDED "MUST BE A PRIORITY"
This is the finding that matters most to our members - the ones for whom the vaccine programme offered the least.
Baroness Hallett acknowledges that many of those who were not protected by the vaccine during the pandemic felt left behind. She quotes me directly, from my oral evidence:
"[Evusheld would have given severely immunosuppressed people] the freedoms that other people received through their own vaccination, and the consequence of not protecting this group was phenomenal in terms of their mental health, in terms of their social connections, in terms of their general ability to re-engage with the rest of the world." Lara Wong, Founder of Clinically Vulnerable Families
And then, she states:
"Evusheld may or may not have been the answer, but the Inquiry accepts without reservation that the need to provide protection to the immunocompromised, including through prophylactic drugs, must be a priority when preparing for the next pandemic." Module 4 report
"Without reservation" is not used lightly. For the members of our group who have spent six years waiting and shielding - this paragraph matters. It is a principle Clinically Vulnerable Families was founded to argue for, and I am pleased that is now stated as a finding of the Inquiry.
The oral evidence was unambiguous - from Dame Kate Bingham who described the two-tier strategy as "manifestly wrong, both ethically and morally", from Dr. Clive Dix who said the real reason Evusheld was not procured was "cost", and Sir Sajid Javid who described a "big battle" with the Treasury over funding.
Due to CVF’s work in the Inquiry, the need to protect immunocompromised people is now clearly established as a formal finding of the UK Covid Inquiry. The next job for us all is to make sure it is acted on!
✓ SAFE VACCINE DELIVERY ENVIRONMENTS: RECOMMENDED
The report is clear that future systems of vaccine delivery must "pay close attention to the specific needs of the clinically vulnerable, to ensure that they are able to access the vaccine in a safe environment."
This is another important win. Vulnerable people broke their shielding only to take risks in Covid vaccination centres because they were hosted in busy, poorly ventilated spaces where masks were inconsistently worn. Our members shared their stories to the Inquiry though us, and the need for safe environments is an important finding. This recommendation follows the same safety principles identified in healthcare during Module 3.
✓ CLEAR MESSAGING ON ANTIVIRAL ELIGIBILITY: RECOMMENDED
The report states that in any future pandemic, "messaging in relation to eligibility for therapeutics and antivirals and the extent to which this might differ from other criteria or lists should be clear and easily understandable."
This is not the overhaul of the antivirals pathway our members need, but it does acknowledge something we have been raising for years - that the eligibility lists for vaccines, boosters and antivirals were different, confusing, and frequently changed. People who were entitled to treatment did not know they were entitled, and even clinicians frequently did not know. The Inquiry heard that, and said it should not happen again.
✓ DIVERSE VACCINE AND THERAPEUTICS PORTFOLIO: RECOMMENDED
The report concludes that the UK government must ensure its future pandemic strategy is "sufficiently diverse - including in terms of vaccines and therapeutics - to meet a range of threats, including those that are unknown" and that "It is critical that work on the development of therapeutics continues." It also calls for continued investment in life sciences.
For Clinically Vulnerable people this matters because a diverse vaccines and therapeutics toolkit is not just to do with scientific preparedness - it is important to anticipate the needs of those with different risks.
✓ LINKED HEALTHCARE RECORDS FOR SAFETY MONITORING: RECOMMENDED
Recommendation 4 of the report calls for the MHRA to be granted "specific and proportionate access to comprehensive and comparable data from across the four nations of the UK, including linked primary and secondary healthcare data records", with strong safeguards for patient confidentiality overseen by the Information Commissioner's Office.
CVF's members have lived for years with the consequences of fragmented healthcare data. Many people were missed off priority lists because their codes were not linked. Some people's eligibility for antivirals was effectively invisible because their GP and specialist care records weren't connected. Disappointingly, Professor Sir Chris Whitty told the Inquiry that the UK has actually "slipped backwards" on linking data together since the pandemic.
Better linkage - with proper safeguards - is an important foundation for almost everything else. It is how eligibility gets flagged. It is how safety signals are identified. It is how the next prophylactic will reach the right patients. We welcome this recommendation.
✓ THE ANTIVIRALS PATHWAY IN PRACTICE: ACKNOWLEDGED
The report sets out what CVF had told the inquiry on behalf of our members. Baroness Hallett recognised the challenges in accessing these urgent treatments "either because patients were not referred locally or because they had missed the treatment window, as well as an inability to access testing."
NHS England took some steps to inform people including letters, text messages, and additional clinician guidance. By June 2023, the delivery units had provided around 115,000 community-based treatments, including roughly 73,000 oral antivirals. But as the report irecognises, "the extent to which the actions resolved issues for individual patients is unclear."
Many doses that were purchased were never used. The Treasury's own closing submission revealed that nearly 5 million doses of antivirals were ultimately binned - not because there was no need, but because the system could not deliver them to the people they were bought for.
Eligible patients are still, today, being turned away at the clinical decision point for not being "ill enough" - for a treatment designed to be given early, before symptoms escalate. Access remains challenging on bank holidays. CVF will continue to press for a system that flags eligibility in advance, both digitally and perhaps on a physical card, and delivers antivirals rapidly on a positive test.
◉ CHILDREN'S VACCINES: NOT GOOD ENOUGH
The report's findings on children's vaccines are less positive than we had hoped. The UK's rollout to children was too slow, too limited, and too short. It was markedly out of step with comparable countries. Children aged 12-15 were offered vaccines eight months after the first adult; children aged 5-11 over a year after. Children under 5 without health conditions have never been offered a Covid vaccine in this country at all.
We helped members share information about accessing children's vaccines abroad. Some travelled to the USA and Germany to access vaccines. Clinically vulnerable and healthy children under 12 years old still have no route to a Covid vaccine, on the NHS or privately in the UK. CVF continues to argue that our families should have a choice.
◉ VACCINE CONFIDENCE: IDENTIFIED, BUT NO PLAN
The report makes an important observation: "Vaccine confidence generally must be encouraged and supported and this decline reversed." Recent figures show vaccination rates falling across Europe and a resurgence in preventable childhood diseases - measles, whooping cough.
This is a vital point. But the report does not set out how this is to be done. Rebuilding confidence will take sustained effort, and a plan.
→ OUR ARGUMENT CONTINUES - INTO MODULES 8 AND 10
Module 4 focused on the development and rollout of vaccines and therapeutics. The question of whether Clinically Vulnerable people should be recognised in law as having distinct needs - a protected characteristic - is not something Module 4 was likely to address, and it did not. That argument has continued to develop through our later modules.
The Equality Act 2010 does not protect people on the basis of clinical vulnerability. The pandemic exposed that gap catastrophically. Protections were switched on and switched off at the discretion of ministers, without a statutory footing for our members to fall back on. That is still not fixed.
There will always be another epidemic or pandemic. The millions of people in the UK with cancer, asthma, diabetes, heart disease, or weakened immune systems deserve to have their safety guaranteed in law - not offered up as a temporary measure, and not withdrawn at the first opportunity.
Work remains to be done. A report that calls the vaccine and therapeutics programmes "two of the success stories of the pandemic" tells only part of the story. For the families who flew to the USA to vaccinate their children. For the people who have been told to ring 119 and 111 and their GP, and still could not access the antiviral they were entitled to. For the immunocompromised who have been shielding since 2020, with nothing to protect them. For the millions of Clinically Vulnerable who have been quietly removed from the vaccine eligibility list. A success story, yes. But for whom?
And yet - we mark this report as a real victory. Next comes the work of turning a paragraph in a report into protection for people's lives.
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Lara Wong is Founder and CEO of Clinically Vulnerable Families. CVF was granted Core Participant status in Module 4 of the UK Covid-19 Inquiry, represented by Adam Wagner KC, Daniella Waddoup and Hayley Douglas of Doughty Street Chambers, instructed by Kim Harrison and Shane Smith of Slater and Gordon. UK Covid-19 Inquiry 'Vaccines and Therapeutics' module.