Factories have already ramped up. Additional factories take about 5 years to build.
With a constrained supply (from continual boosting), it is logical that the wealthy countries want to keep it for themselves rather than subsidize other countries. Hopefully they'll stop at 3 doses, as recommended, and then they can roll out to the poorer countries.
I would imagine we'd have the capacity to make as many vaccines as someone will pay for.
Yes the factories have to be ramped up but that can be done quickly enough. If those low to middle income countries were offering big bucks for vaccines, the vaccine makers would have just put more resources on it.
The only reason it might make sense that we should stop boosting because it is taking them away from people who need them more, is if the vaccine makers made more than needed, or built more capacity than needed, simply because they didn't anticipate hesitancy.
It would be great if the US and other wealthy countries wanted to subsidize vaccines for poorer countries.... I mean, I'd vote for that. That just means we have less money, though, not fewer doses of vaccine.
(and just to be clear, I'm not saying we should overdo it if there is no point. I'm just saying the article and the position of the WHO is not logical)
Second, are manufacturers interested in filling that 6 billion gap? They can already afford to build the infrastructure and make more vaccines, but it doesn’t do any good if there is nobody to buy them and no way to get them to patients.
This highlights one issue I've had with calls to secure more vaccine in the US and elsewhere. Countries (notably the US) didn't work through the past year to build out socialized manufacturing capacity for additional dose production - everyone has been making purchasing agreements and everyone knows that everybody is going to need it.
These pushes to outbid other countries might go toward funding additional capacity for the next pandemic, but these corporations didn't have enough warning to know that they were the ones that'd need to make this investment so, for the moment, all of these countries securing additional doses are securing them out of the pockets of other countries.
Hundreds of millions of people would pay 5x the current price to get the vaccine faster. I feel like the policy of governments getting a monopoly on vaccine distribution is stopping companies in competing for speed of vaccine production and building more factories.
I would normally argue this case, but "factories" is sort of hand-wavy here. The factories dumping out the feedstock are all producing enough to meet a higher level of production. The mixing step is the bottle neck, and is a really hard, expensive process to scale up. Demand for the vaccine is likely to dry up in a year or two, and companies don't want to drastically over shoot building out expensive single purpose tooling.
Moderna would probably be happy to license their next vaccine to someone who did invest in a factory. The price would be probably be affordable. I'm not sure it is worth it though, only time will tell if a booster shot is needed.
At some point the economics involves construction of a new facility, which is a pretty significant cost and, perhaps, only makes sense to a company if they expect there to be a persistent need for what they can produce in that facility. So, if company decision makers don't perceive that they can sell more vaccines, for a long time (many years), building a new factory will be off the table.
That is exactly what happened -- governments around the world paid for pre-approval manufacturing and the pharma industry has spent the last 6-8 months ramping up production. That's the reason we have any supplies at the moment.
The truth is just that mass-manufacturing of a brand new vaccine is a hard problem. The fact that we're only a couple months from the very start of vaccinations and the world is already nearing 200 million doses delivered is, frankly, amazing. The only problem is that due to the severity of the crisis we wish we had a magic wand that gave us 10x the supply right this instant.
The good news is that manufacturing continues to ramp up dramatically. It just feels like it's slow because we're all so eager for it to improve. If you look at the month-on-month growth, though, it's clearly ramping up fast: https://covidvax.live/
I think this includes a number of questionable assumptions.
1) The money would go to the manufacturer.
2) The supply limiting factor can be addressed in a reasonable timeline
3) The demand will exist at the time when supply is increased.
4) The price is a limiting factor.
As far as I know, lead times for this drug manufacturing equipment is usually >1 yr and the demand will not be there when it arrives. All of the vaccines currently cost $2-20.
This is better said as "they are not produced fast enough". That will lead you directly to the solution, instead of losing time discussing the price.
It's a very similar thing, the price poor countries pay is not enough to justify investing in extra productive capacity. There is a confounding factor that new capacity takes a long time to arrive, but even when that is taken into account, there are just not enough vaccines and there won't be on the near future.
The cost is in ramping up production, actually after it is ramped up, it's generally cheaper to produce an additional vaccine (Wright's law). With the current pace people in most countries need to wear masks for years to come.
Honestly that is exactly what I would expect China or the US to do. The process of producing the vaccine should be shared with all countries and perhaps enough vaccine samples set aside to help kick other countries kick off producing it. All countries should be trying to develop vaccines and sharing the knowledge but should also reserve production for their own citizens first.
Also the 500,000 is not just for July it includes %90 of production for August and September and of course can be used whenever before it expires. Also it is not a single does per patient more like 11 for a 10 day treatment program. So it's enough doses to treat about 15,000 patients per month for three months. The rate of new cases is accelerating and currently stands at 40,000 new cases a day and Dr. Fauci expects it to hit 100,000 per day. So I would not classify it as unnecessary hording.
> Is there any reason not to increase vaccine production rates so we have the capacity to vaccinate the world population faster than every 9 months?
Capital constraints. Most specifically, human capital. mRNA production methods, including for critical precursors, are complicated. There is a limited number of people who can build and monitor the productions systems.
From what I understand, the problem with scaling the Moderna/Pfizer vaccines is that they use a novel process that hasn't been used for producing a vaccine at scale previously. They're having to build out entirely new factories and supply chains. This sort of work normally takes years.
Would throwing more money at the problem ease some bottlenecks in increasing production? maybe? Would it cut months off the time to complete the roll out? Plausibly. However, I don't think it'd make a huge difference to the speed of the roll out over the next six months or so. Some things just take time to ramp up.
I wonder if governments around the world are thinking more about manufacturing and distribution since we have promising early results. Bill Gates & his foundation have been talking about how 7 billion doses vaccines will be produced [1] and distributed equitably [2].
Its mostly in the form of advanced purchases of product and grants. No one is building new factories. This is more about distribution and R&D grants than it is about factories.
> In July, Pfizer got a $1.95 billion deal with the government’s Operation Warp Speed, the multiagency effort to rush a vaccine to market, to deliver 100 million doses of the vaccine. The arrangement is an advance-purchase agreement, meaning that the company won’t get paid until they deliver the vaccines. Pfizer did not accept federal funding to help develop or manufacture the vaccine, unlike front-runners Moderna and AstraZeneca.
> April 16: HHS made up to $483 million in support available for Moderna's candidate vaccine, which began Phase 1 trials on March 16 and received a fast-track designation from FDA. This agreement was expanded on July 26 to include an additional $472 million to support late-stage clinical development, including the expanded Phase 3 study of the company's mRNA vaccine, which began on July 27th.
> May 21: HHS announced up to $1.2 billion in support for AstraZeneca's candidate vaccine, developed in conjunction with the University of Oxford. The agreement is to make available at least 300 million doses of the vaccine for the United States, with the first doses delivered as early as October 2020, if the product successfully receives FDA EUA or licensure. AstraZeneca's large-scale Phase 3 clinical trial began on August 31, 2020.
> October 16: HHS and DoD announced agreements with CVS and Walgreens to provide and administer COVID-19 vaccines to residents of long-term care facilities (LTCF) nationwide with no out-of-pocket costs. Protecting especially vulnerable Americans has been a critical part of the Trump Administration's work to combat COVID-19, and LTCF residents may be part of the prioritized groups for initial COVID-19 vaccination efforts until there are enough doses available for every American who wishes to be vaccinated. The Pharmacy Partnership for Long-Term Care Program provides complete management of the COVID-19 vaccination process. This means LTCF residents and staff across the country will be able to safely and efficiently get vaccinated once vaccines are available and recommended for them, if they have not been previously vaccinated. It will also minimize the burden on LTCF sites and jurisdictional health departments of vaccine handling, administration, and fulfilling reporting requirements.
> November 12: HHS and DoD announced partnerships with large chain pharmacies and networks that represent independent pharmacies and regional chains. Through the partnership with pharmacy chains, this program covers approximately 60 percent of pharmacies throughout the 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Through the partnerships with network administrators, independent pharmacies and regional chains will also be part of the federal pharmacy program, further increasing access to vaccine across the country—particularly in traditionally underserved areas.
More money per dose might have increased the efforts of the vaccine producers to speed up production and given them more financial means to do so. However, this still would not have been the optimal solution.
This is a case, where governments should have directly funded the build-up of production capacity. We need production capacities at a level which is economically infeasibly from a vendors perspective. Internationally, we need to produce like 14 billion doses per year. This would mean that whole humanity could be vaccinated within a year. Which is what we need, if we want to erradicate Sars-cov-2. But if we manage to do that, most of those new plants would become redundant and thats exactly why the government needs to pay for them.
I agree with your sentiment.
Also, why not let other manufacturers produce vacciness aswell? Getting the vacinnes produced rapidly and in enough numbers seem to be the number one priority in this.
With a constrained supply (from continual boosting), it is logical that the wealthy countries want to keep it for themselves rather than subsidize other countries. Hopefully they'll stop at 3 doses, as recommended, and then they can roll out to the poorer countries.
https://www.cnn.com/2022/01/04/health/andrew-pollard-booster...
https://www.barrons.com/articles/a-plan-to-break-the-vaccine...
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