This session will bring together public health care leaders in COVID-10 vaccine delivery from both the U.S. and the UK to discuss and compare operational implications of the COVID-19 vaccine rollout in their countries, and how those programs ultimately affected hospitalization utilization and mortality rates for members of their communities. Chris Pallot, who was the Programme Director for COVID-19 vaccination in Northamptonshire, England will present background for and utilization data on his team's national award-winning vaccine program, highlighting how the program was designed for success and how outcomes have been measured. Chris will be joined by Dr. Michelle Fiscus, who led the COVID-19 vaccine rollout program in Tennessee. Early in the response, both vaccine rollout programs were lauded as among the most scientifically sound and equitable in their countries. Early successes do not always result in long-term success, and we will discuss changes and barriers that emerged from both direct and indirect influences over time and how that impacted vaccination efforts, such as partisan politics in the U.S. and mistrust of the vaccine within some demographics. Hear comparative information that will help you understand, compare, and contrast methods employed for outreach into the community and varying levels of effectiveness for these methods. The session is intended to highlight the operational and decision-making processes that went into developing the fastest vaccine rollout in health care history that has helped to deal with such an unprecedented disruptor to our health care systems. A key component of this is how the implementation and success (or failure) of a program is correlated to identifying and incorporating the unique needs of the community being served and subject to local politics, biases, and beliefs. The session will have brief presentations from both leaders, followed by a moderated Q&A opportunity for audience participation.