Background This study explored the challenges, and actions leaders took to manage them, in delivering the COVID-19 vaccine in vaccination centres in England.

Methods Following informed consent, 20 semi-structured interviews were conducted with 22 senior leaders working within vaccination centres, mostly clinical and operational leads, using Microsoft Teams. Transcripts were analysed thematically using ‘template analysis’.

Results Some of the challenges leaders faced included leading dynamic and transient teams, interpreting and sharing communications received through national and regional and system vaccination operations centres. The simpler nature of the service allowed for leaders to delegate and reduce hierarchies among staff to support a more cohesive work environment that encouraged staff, often working through bank or agency, to return. Many leaders felt communication skills as well as the attributes of resilience and adaptability were particularly important to lead in these novel settings.

Conclusion Illustrating the types of challenges faced by leaders in vaccination centres and how they handled them can help others in similar leadership positions in vaccine centres or other novel settings. As healthcare teams are increasingly dynamic and transient due to more flexible working patterns the need for leaders to apply these skills becomes ever more important.