Abstract Objectives Predicting the future UK Covid-19 epidemic allows other countries to compare their epidemic with one unfolding without public health measures except a vaccine programme. Methods A Dynamic Causal Model (DCM) is used to estimate the model parameters of the epidemic such as vaccine effectiveness and increased transmissibility of alpha and delta variants, the vaccine programme roll-out and changes in contact rates. The model predicts the future trends in infections, long-Covid, hospital admissions and deaths. Results Two dose vaccination given to 66% of the UK population prevents transmission following infection by 44%, serious illness by 86% and death by 93%. Despite this, with no other public health measures used, cases will increase from 37 million to 61 million, hospital admission from 536,000 to 684,000 and deaths from 136,000 to 142,000 over twelve months. Discussion Vaccination alone will not control the epidemic. Relaxation of mitigating public health measures carries several risks – overwhelming the health services, the creation of vaccine resistant variants and the economic cost of huge numbers of acute and chronic cases.
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