A new study from University College Cork has examined Ireland’s experience of implementing the COVID-19 vaccination programme, identifying lessons that could help strengthen both routine immunisation and preparedness for future pandemics. Published in Elsevier Vaccine, the qualitative study explored the experiences of 16 stakeholders involved in COVID-19 vaccine implementation at national, regional and local levels. Using implementation science, researchers examined the factors that helped or hindered the rapid delivery of COVID-19 vaccines across Ireland.

The findings demonstrate that having vaccines available is only one part of delivering a successful vaccination programme. Implementation depended on the ability to rapidly mobilise people, resources and infrastructure, adapt delivery models, coordinate across organisations and communicate effectively in an environment of rapidly evolving evidence.

The COVID-19 vaccination programme relied on healthcare professionals across multiple settings, including general practice, pharmacies, hospitals, mobile vaccination and mass vaccination centres. However, the study also highlights the contribution of non-healthcare sectors and wider community partnerships. Participants described substantial support from the Irish Defence Forces, demonstrating how organisations outside the traditional healthcare workforce can provide valuable operational and logistical capacity during a public health emergency.

The study also highlighted the importance of engaging both healthcare professionals and the public. Clear, accessible and culturally and linguistically appropriate communication was important for supporting vaccine confidence, complacency and uptake, particularly amid misinformation, uncertainty and rapidly changing evidence.

These lessons are relevant beyond pandemic vaccination. Routine immunisation programmes also require sustained workforce capacity, reliable infrastructure, effective communication, coordinated systems and accessible vaccination services. Strengthening these foundations during routine delivery may ensure that systems are better positioned to rapidly scale up when a public health emergency occurs.

The study detailed some challenges, including:

• Changing evidence and guidance;
• Limited time and staffing at the beginning of the pandemic;
• Time-consuming legislation changes to allow pharmacists to vaccinate; and
• The complexity of implementing vaccination at unprecedented speed.

At the same time, (i) strong leadership, (ii) motivated staff, (iii) established relationships, (iv) introduction of the national electronic vaccine record, (v) use of multiple vaccine delivery models, and (vi) the ability to be agile and adaptive, facilitated implementation.

The researchers at University College Cork, said: “COVID-19 demonstrated that pandemic preparedness cannot begin when the next pandemic arrives. We need to strengthen our routine vaccination systems now, while also building the additional capacity, partnerships and trust needed to respond rapidly when a pandemic occurs.”

The researchers argued that lessons from COVID-19 should be translated into sustained investment in routine immunisation and pandemic preparedness, using routine programmes as the foundation for a scalable emergency response.

This could include maintaining a multidisciplinary pandemic vaccination preparedness group or committee that can be rapidly activated when needed. The committee could have clearly defined roles, responsibilities and escalation pathways across health, government, community and relevant non-healthcare sectors. Rather than attempting to maintain all emergency partnerships and surge capacity between pandemics, key arrangements could be documented, periodically reviewed and tested through simulation exercises.

The COVID-19 experience also demonstrated the value of flexible vaccination delivery models that can be scaled or adapted according to need — embedding this flexibility within routine immunisation alongside strong workforce capacity, digital systems, communication channels and community engagement. This could enable existing services to expand rapidly during an emergency and reduce the need to develop new systems from scratch. This approach would allow Ireland to maintain preparedness between pandemics while avoiding the need to recreate governance structures, partnerships and operational plans when the next emergency occurs.

Ultimately, the study provides an opportunity to move from simply learning from the COVID-19 response to building stronger vaccination systems for the future — systems that can deliver routine immunisation effectively today while being ready to scale rapidly tomorrow.

We cannot predict when the next pandemic will occur. But we can prepare for it by strengthening vaccination systems now.

The study, “Barriers and facilitators to COVID-19 vaccination programme implementation in Ireland: a qualitative study of implementation stakeholders using CFIR,” was published in Elsevier Vaccine and is available at sciencedirect.com.