UK Becomes First Country in the World to Approve Covid Vaccine; Jabs Begin 8 December

At 6:31am on 8 December 2020, Matron May Parsons administered a dose of the Pfizer-BioNTech vaccine to Margaret Keenan — known as Maggie — at University Hospital Coventry. Keenan, who would turn 91 the following week, looked at the camera and smiled. "I feel so privileged to be the first person vaccinated against Covid-19," she said. "It's the best early birthday present I could wish for because it means I can finally look forward to spending time with my family and friends in the New Year after being on my own for most of the year." In that moment, the UK's vaccination drive — and with it, the beginning of the global effort to emerge from the worst pandemic in a century — had begun.

The approval, granted by the Medicines and Healthcare products Regulatory Agency six days earlier, came after a rolling review process that allowed the regulator to assess safety and efficacy data as it was generated by the Pfizer-BioNTech trial, rather than waiting for a completed submission. The approach, controversial among some scientists who argued it created shortcuts in a normally rigorous process, was defended by the MHRA as consistent with its standards — simply faster, because the pandemic justified urgency.

"Today is a historic moment. We can now start vaccinating the most vulnerable in our society." — Matt Hancock, Secretary of State for Health, 8 December 2020

How the vaccine was developed

The Pfizer-BioNTech vaccine used messenger RNA (mRNA) technology — a method that had been in development for decades but had never previously resulted in an approved vaccine. Rather than introducing a weakened or inactivated virus, the mRNA vaccine delivered genetic instructions that caused cells to produce the spike protein found on the surface of the SARS-CoV-2 virus. The immune system then learned to recognise and attack this protein, providing protection against infection. The approach allowed the vaccine to be designed within days of the virus's genetic sequence being published in January 2020.

Phase III trial results, published in the New England Journal of Medicine, showed 95% efficacy in preventing symptomatic Covid-19 in participants with no prior evidence of infection. The trial involved 43,448 participants across six countries. Safety data showed that side effects were generally mild and short-lived — sore arm, fatigue, headache — with no serious safety concerns identified in the trial population.

The rollout

The initial rollout prioritised care home residents, care home workers, all adults over 80, and frontline NHS workers — groups identified by the Joint Committee on Vaccination and Immunisation as most at risk from severe disease or most likely to transmit the virus. The logistics were formidable: the Pfizer vaccine required storage at minus 70 degrees Celsius, limiting its initial deployment to large hospital hubs with the necessary cold chain infrastructure.

As the AstraZeneca-Oxford vaccine — which required only standard refrigeration — received its own MHRA approval on 30 December 2020, the rollout expanded dramatically. By the end of January 2021, the UK had vaccinated more people per capita than any other country in the world except Israel. The speed of the rollout — built around repurposed sports stadiums, conference centres and drive-through sites alongside GP surgeries — was widely credited to NHS England's logistical capacity and a volunteer army of over 80,000 people who helped staff vaccination centres.

Impact and legacy

By the time the most acute phase of the pandemic ended, the UK vaccination programme had administered over 150 million doses. Studies estimated that the vaccine programme had prevented around 130,000 deaths and 900,000 hospitalisations in England alone by mid-2021. The success of mRNA technology in addressing Covid-19 accelerated research into mRNA-based vaccines for influenza, HIV, cancer and a range of other diseases that scientists had long believed the technology could help address. The pandemic, for all its catastrophic cost, had compressed decades of medical progress into a single year.