Vaccine Scarcity: A Policy Choice That Prolongs the Pandemic
March 12, 2021 12:52 PM Subscribe
Major international NGOs from Amnesty International to Human Rights Watch to Oxfam are calling-out a group of governments (EU, UK, US, Switzerland, Canada, Australia, Japan, and others) and major pharmaceutical companies for “prolonging the pandemic” by blocking the waiving of some intellectual property rules at the World Trade Organization to allow wider-spread production of the coronavirus vaccine. The waiver proposal is also backed by 80 other countries and the head of the WTO.
While developing countries are most vocal about the vaccine scarcity problem and the need for the “TRIPS waiver” at the WTO, the shortage of approved vaccines is having detrimental effects on many developed countries as well. Most EU members, for example, are vaccinating at such a slow rate, it will be well into 2022 or even 2023 before they achieve herd immunity of 70% vaccinated.
While developing countries are most vocal about the vaccine scarcity problem and the need for the “TRIPS waiver” at the WTO, the shortage of approved vaccines is having detrimental effects on many developed countries as well. Most EU members, for example, are vaccinating at such a slow rate, it will be well into 2022 or even 2023 before they achieve herd immunity of 70% vaccinated.
we aren't because, why would we, there is money to be made
The true virus is capitalism.
A spark of hope I see out of this is the number of people talking about mutual aid and pointing out how the last year has shown how damaging the pursuit of profit and allowing the invisible hand of the market to also steer the ship can be.
posted by mrzarquon at 1:17 PM on March 12, 2021 [20 favorites]
The true virus is capitalism.
A spark of hope I see out of this is the number of people talking about mutual aid and pointing out how the last year has shown how damaging the pursuit of profit and allowing the invisible hand of the market to also steer the ship can be.
posted by mrzarquon at 1:17 PM on March 12, 2021 [20 favorites]
Maybe we'll see some very abstract Gates Foundation-ish types of efforts but I strongly believe that once we're talking about issues of disease and public health in "the global south", the general mass Western sentiment is somewhere between "eh far away don't give a shit" and "sounds bad - hope someone does something!" (sips mimosa).
Meanwhile, a bunch of new countries added to the list that you can't travel to unless you "got your shots" and will need to mask up, and news reports every year or so of the "dangerous new coronavirus strain taking hold in the US". Sorry but it's all incredibly bleak news that is hitting me hard amidst all the vaccination numbers excitement - good things can happen, but never anything truly or fully good. Problems only can be solved in half-measures, or only for people in rich western countries, or in ways that are friendly to private profit. I wish this were bigger news because it kind of reads to me like an official statement that the virus will not ever be "over", even though we have the means to end it across the globe.
posted by windbox at 1:37 PM on March 12, 2021 [5 favorites]
Meanwhile, a bunch of new countries added to the list that you can't travel to unless you "got your shots" and will need to mask up, and news reports every year or so of the "dangerous new coronavirus strain taking hold in the US". Sorry but it's all incredibly bleak news that is hitting me hard amidst all the vaccination numbers excitement - good things can happen, but never anything truly or fully good. Problems only can be solved in half-measures, or only for people in rich western countries, or in ways that are friendly to private profit. I wish this were bigger news because it kind of reads to me like an official statement that the virus will not ever be "over", even though we have the means to end it across the globe.
posted by windbox at 1:37 PM on March 12, 2021 [5 favorites]
(somewhat tangential: This week's planet money podcast covers a previous project of the Nigerian woman who now heads the WTO. More or less proves that what makes a good entrepreneur is basic competency and access to capital, rather than other forms of fairy dust.)
posted by kaibutsu at 1:47 PM on March 12, 2021 [2 favorites]
posted by kaibutsu at 1:47 PM on March 12, 2021 [2 favorites]
Thanks for posting this, and I hear you about the present issue extending beyond developing countries. Looking at this as an instance of neocolonialism, it feels like a good example of how 'decolonizing the mind' helps everyone. Related links: Abraar Karan (NPR, 5/29/2020), "OPINION: The Ghosts Of Colonialism Are Haunting The World's Response To The Pandemic"; or Mayur M. Desai (Yale School of Public Health, 10/12/2020), "Neocolonialism and Global Health Outcomes: A Troubled History (A Conversation with Rafael Perez-Escamilla)":
MD: Are there readings that you recommend?posted by Wobbuffet at 1:51 PM on March 12, 2021 [11 favorites]
RP-E: There are four reading that I strongly recommend: 1) “A History of Global Health” by Randall Packard, 2) “Colonial Pathologies” by Warwick Anderson, 3) “Panama Fever” by Matthew Parker, 4) “A History of Public Health” by George Rosen, and 5) “Household food insecurity in black-slaves descendant communities in Brazil: has the legacy of slavery truly ended?” [full text online] by Muriel Gubert and Rafael Pérez-Escamilla.
Maybe don't count on the Gates Foundation. Bill and Melinda Gates were the primary drivers behind Oxford going back on their original published plan to donate the rights to its coronavirus vaccine and instead going for an exclusive license with AstraZeneca with no price or profit maximum. There are some complicated manufacturing reasons why this is so (so don't take this as a smoking gun that the Gates Foundation is evil or anything) but, nonetheless, the Gates Foundation's approach to "improving the quality of life" is still built on the idea of enlightened white savior capitalism.
posted by introp at 1:52 PM on March 12, 2021 [21 favorites]
posted by introp at 1:52 PM on March 12, 2021 [21 favorites]
Is there evidence that there actually is high-quality vaccine manufacturing capacity sitting idle due to IP issues?
(As an aside, there was an announcement today that the US and Japan would fund the manufacture of 1bn doses of vaccine in India, for distribution across Asia.)
posted by kickingtheground at 2:02 PM on March 12, 2021 [3 favorites]
(As an aside, there was an announcement today that the US and Japan would fund the manufacture of 1bn doses of vaccine in India, for distribution across Asia.)
posted by kickingtheground at 2:02 PM on March 12, 2021 [3 favorites]
There is not much reason to think that patents are the problem. The Pfizer and Moderna vaccines, for example, have a very complicated supply chain with multiple pinch points where there are only one or two companies in the world with the necessary specialized equipment and expertise. These vaccines are already being produced as fast as tens of billions of dollars will allow. The adenovirus vaccines aren't much easier.
Further, patents are national in scope, and the key patents for many of these vaccines are typically only held in a handful of countries. For example, one of the key lipid nanoparticle inventions is only patented in a handful of industrialized countries.
At the same time, a waiver is unlikely to hurt anything, but let's not pretend that these vaccines could be made by any old biology or chemistry lab and the only thing holding them back is intellectual property.
posted by jedicus at 2:04 PM on March 12, 2021 [45 favorites]
Further, patents are national in scope, and the key patents for many of these vaccines are typically only held in a handful of countries. For example, one of the key lipid nanoparticle inventions is only patented in a handful of industrialized countries.
At the same time, a waiver is unlikely to hurt anything, but let's not pretend that these vaccines could be made by any old biology or chemistry lab and the only thing holding them back is intellectual property.
posted by jedicus at 2:04 PM on March 12, 2021 [45 favorites]
This is the reason to hate Bill Gates, not that you needed another
posted by eustatic at 2:04 PM on March 12, 2021
posted by eustatic at 2:04 PM on March 12, 2021
Is there evidence that there actually is high-quality vaccine manufacturing capacity sitting idle due to IP issues?
Aren't we on the cusp of a major uptick in manufacturing? I think that is why Bill Gates acted when he did, and the WTO is debating this just now.
And if there isn't idle capacity, wouldn't producing such idle capacity through property rights serve to increase costs and profits?
posted by eustatic at 2:07 PM on March 12, 2021
Aren't we on the cusp of a major uptick in manufacturing? I think that is why Bill Gates acted when he did, and the WTO is debating this just now.
And if there isn't idle capacity, wouldn't producing such idle capacity through property rights serve to increase costs and profits?
posted by eustatic at 2:07 PM on March 12, 2021
Getting back to a world with relatively open borders just seems so far away right now. Also, I was certain that the EU was going to be way ahead on vaccination; it has been a real surprise to watch the struggles there.
posted by Dip Flash at 2:21 PM on March 12, 2021 [1 favorite]
posted by Dip Flash at 2:21 PM on March 12, 2021 [1 favorite]
Thuggery, pure and simple.
posted by Sheydem-tants at 2:21 PM on March 12, 2021 [1 favorite]
posted by Sheydem-tants at 2:21 PM on March 12, 2021 [1 favorite]
Too much international bloviation for me to unravel. Can any odd drug factory spin up a Moderna mRNA lab? Listening to actual biotech folks on tv it sounds like it's incredibly specialized and ultra expensive. But I am totally with having an international grrarrr response to not putting all possible resources into getting every single person in the world vaccinated, now, fast. Do these folks not get variants are an extensional danger to even the most privileged? It is going to be real hard to do a major worldwide year long shut down, what if a variant shows up that is not just higher transmissible but whack rich folks in their 30's and 40's?
How to unwind the "is it IP" or "is it too hard to make" reason for vaccine shortages?
posted by sammyo at 2:39 PM on March 12, 2021 [4 favorites]
How to unwind the "is it IP" or "is it too hard to make" reason for vaccine shortages?
posted by sammyo at 2:39 PM on March 12, 2021 [4 favorites]
while only a select few rich ones get vaccinated
The first two highly effective vaccines have stringent cold chain distribution requirements, and that's a major reason why their distribution has been mostly limited to rich countries. Even in those countries there are areas where it's difficult to distribute the vaccines because of the cold chain issues. It's a real problem, not just vaccine nationalism.
The other early vaccines were either developed and distributed in two other large countries (China and Russia) or are of debatable efficacy and safety (Oxford/AZ).
And has been noted previously on MetaFilter, many less wealthy nations do not seem to have been as hard hit by the virus, some because they did a very good job of controlling it (e.g. Vietnam) and some probably because their populations are low in some of the biggest risk factors (e.g. obesity). The 25 worst hit countries in terms of total deaths per capita are almost all OECD members and the next 25 are similar.
This is not a situation where all countries have been equally harmed and are equally capable of making efficient use of the vaccines. That said, rich countries should absolutely be doing more in terms of both interim aid and equitable vaccine supply.
posted by jedicus at 2:44 PM on March 12, 2021 [5 favorites]
The first two highly effective vaccines have stringent cold chain distribution requirements, and that's a major reason why their distribution has been mostly limited to rich countries. Even in those countries there are areas where it's difficult to distribute the vaccines because of the cold chain issues. It's a real problem, not just vaccine nationalism.
The other early vaccines were either developed and distributed in two other large countries (China and Russia) or are of debatable efficacy and safety (Oxford/AZ).
And has been noted previously on MetaFilter, many less wealthy nations do not seem to have been as hard hit by the virus, some because they did a very good job of controlling it (e.g. Vietnam) and some probably because their populations are low in some of the biggest risk factors (e.g. obesity). The 25 worst hit countries in terms of total deaths per capita are almost all OECD members and the next 25 are similar.
This is not a situation where all countries have been equally harmed and are equally capable of making efficient use of the vaccines. That said, rich countries should absolutely be doing more in terms of both interim aid and equitable vaccine supply.
posted by jedicus at 2:44 PM on March 12, 2021 [5 favorites]
The Pfizer and Moderna vaccines, for example, have a very complicated supply chain with multiple pinch points where there are only one or two companies in the world with the necessary specialized equipment and expertise.
The government has had an entire year, 12 months, to eliminate these so-called "pinch points". They have spent over $3,000 billion on pandemic mitigation. You don't think they could have spent a few billion on new production plants? It's a tiny drop in the bucket.
posted by JackFlash at 2:47 PM on March 12, 2021 [4 favorites]
The government has had an entire year, 12 months, to eliminate these so-called "pinch points". They have spent over $3,000 billion on pandemic mitigation. You don't think they could have spent a few billion on new production plants? It's a tiny drop in the bucket.
posted by JackFlash at 2:47 PM on March 12, 2021 [4 favorites]
The posts by Derek Lowe that jedicus links above are some of the most informative on this that I've seen (as has been his vaccine coverage in general). He thinks the main bottleneck and pain point for the mRNA vaccines is the machines that mix them with the lipids into nanoparticles.
That all makes sense, and I can grant that the people who know how to build and tune those machines could be so busy building them, to scale Moderna and Phizer's production, that they don't have time for anything else.
What I simply cannot imagine is that these companies don't have large amounts of internal documentation about that process, the theory of the machines, how to test the quality of the result, etc, etc. Of course they do, that's some of their core IP that they've been developing for decades as part of this mRNA vaccine technology. This information could be released, and maybe other countries would fail, or succeed in building that part of it. We don't know, and can't know, because the companies are going to fight tooth and nail to protect their now-golden egg.
posted by joeyh at 2:50 PM on March 12, 2021 [5 favorites]
That all makes sense, and I can grant that the people who know how to build and tune those machines could be so busy building them, to scale Moderna and Phizer's production, that they don't have time for anything else.
What I simply cannot imagine is that these companies don't have large amounts of internal documentation about that process, the theory of the machines, how to test the quality of the result, etc, etc. Of course they do, that's some of their core IP that they've been developing for decades as part of this mRNA vaccine technology. This information could be released, and maybe other countries would fail, or succeed in building that part of it. We don't know, and can't know, because the companies are going to fight tooth and nail to protect their now-golden egg.
posted by joeyh at 2:50 PM on March 12, 2021 [5 favorites]
though I'd be shocked by any other outcome
For HIV at least there is patent pool that licenses patents to any manufacturer who wants them, as long as they sell only to a list of less developed countries. IIUC it's mostly Indian companies that do the manufacturing, and they are very good at it. This has had the effect of drastically lowering prices--essentially making some generic--and (especially with other aid, both government and NGO) making them accessible there. It's not perfect, but there is a model to follow. Even without waiting for the end of capitalism.
I think the part of the difference here is that Moderna (especially) thinks not just the sequence but the lipid formulation and some other stabilizing tricks are competitive advantages, so opening it up is giving up not just this vaccine to part of the world but all there (probably unrealizable) dreams of being a platform technology for a whole class of sales.
If ever there was a case to seize IP under eminent domain, this is it though. Maybe the threat would get them to become creative in licensing, but if not toss Moderna shareholders a few billion and move on.
Can any odd drug factory spin up a Moderna mRNA lab?
Definitely not.
It'd take a long time to get anyone up and running for these, if you're starting from scratch. You need both the physical facilities and proper personnel, and qualification and validation runs. Like two years probably, though maybe half that if you go all out, get priority inspections and accept lost batches.
I know of a drug that gets a specific lipisomal formulation that went off patent over 10 years ago. The company assumed it would lose all sales, because they didn't compete with generics anyplace else--but it's so specialized that no one has bothered. And that's just delivery, the payload part in that example is way simpler than the mRNA vaccine. Obviously people would jump in given the much higher need here, but it's non-trivial.
Adenovirus is less novel and correspondingly faster to get going, though the Merck/J&J production deal I saw estimated up to six months for Merck to be doing the vaccine at capacity.
The thing is it takes a while to get capacity up no mater when you start, so no reason not to start now.
posted by mark k at 2:54 PM on March 12, 2021 [9 favorites]
For HIV at least there is patent pool that licenses patents to any manufacturer who wants them, as long as they sell only to a list of less developed countries. IIUC it's mostly Indian companies that do the manufacturing, and they are very good at it. This has had the effect of drastically lowering prices--essentially making some generic--and (especially with other aid, both government and NGO) making them accessible there. It's not perfect, but there is a model to follow. Even without waiting for the end of capitalism.
I think the part of the difference here is that Moderna (especially) thinks not just the sequence but the lipid formulation and some other stabilizing tricks are competitive advantages, so opening it up is giving up not just this vaccine to part of the world but all there (probably unrealizable) dreams of being a platform technology for a whole class of sales.
If ever there was a case to seize IP under eminent domain, this is it though. Maybe the threat would get them to become creative in licensing, but if not toss Moderna shareholders a few billion and move on.
Can any odd drug factory spin up a Moderna mRNA lab?
Definitely not.
It'd take a long time to get anyone up and running for these, if you're starting from scratch. You need both the physical facilities and proper personnel, and qualification and validation runs. Like two years probably, though maybe half that if you go all out, get priority inspections and accept lost batches.
I know of a drug that gets a specific lipisomal formulation that went off patent over 10 years ago. The company assumed it would lose all sales, because they didn't compete with generics anyplace else--but it's so specialized that no one has bothered. And that's just delivery, the payload part in that example is way simpler than the mRNA vaccine. Obviously people would jump in given the much higher need here, but it's non-trivial.
Adenovirus is less novel and correspondingly faster to get going, though the Merck/J&J production deal I saw estimated up to six months for Merck to be doing the vaccine at capacity.
The thing is it takes a while to get capacity up no mater when you start, so no reason not to start now.
posted by mark k at 2:54 PM on March 12, 2021 [9 favorites]
This is why we have health officials where I live telling folks to not wait around to get the vaccine of their choice; we can't be sure the supply chain won't get interrupted and you might end up waiting a long time for no good reason.
Here in Kingston, my healthcare clinic got the green light to do a pilot vaccination clinic with the Moderna vaccine for our 80+ & up patients. I am currently getting software training to assist with the clerical end of this. So far, all the patients we've contacted are very excited to get the vaccine but there have been a few folks who are complaining that we don't have clearance for the Pfizer one. (Which you can get here in Ontario, but at the larger public health-designated sites, not our small clinic.)
posted by Kitteh at 3:09 PM on March 12, 2021
Here in Kingston, my healthcare clinic got the green light to do a pilot vaccination clinic with the Moderna vaccine for our 80+ & up patients. I am currently getting software training to assist with the clerical end of this. So far, all the patients we've contacted are very excited to get the vaccine but there have been a few folks who are complaining that we don't have clearance for the Pfizer one. (Which you can get here in Ontario, but at the larger public health-designated sites, not our small clinic.)
posted by Kitteh at 3:09 PM on March 12, 2021
What I simply cannot imagine is that these companies don't have large amounts of internal documentation about that process, the theory of the machines, how to test the quality of the result, etc, etc. Of course they do, that's some of their core IP that they've been developing for decades as part of this mRNA vaccine technology.
My best guess is that there are probably a couple dozen scientists and engineers, tops, in the world that know all the nitty-gritty of the mRNA encapsulation process from end to end, and they're working full bore on scaling up the production capacity that's already present. The machines that perform the encapsulation are incredibly specialized and they're not just any other machine—they're most likely custom-made microfluidic mixers which have to be machined fairly precisely to tight tolerances, and there aren't too many shops that can do that right now that, again, aren't already working on scaling up existing capacity. So my guess is that while there's a lot of documentation (which is just one form of institutional knowledge) already out there but kept under wraps, it's useless without actual experts in the loop to make a whole bunch of judgment calls at many steps in what is still a relatively cobbled-together process.
posted by un petit cadeau at 3:11 PM on March 12, 2021 [10 favorites]
My best guess is that there are probably a couple dozen scientists and engineers, tops, in the world that know all the nitty-gritty of the mRNA encapsulation process from end to end, and they're working full bore on scaling up the production capacity that's already present. The machines that perform the encapsulation are incredibly specialized and they're not just any other machine—they're most likely custom-made microfluidic mixers which have to be machined fairly precisely to tight tolerances, and there aren't too many shops that can do that right now that, again, aren't already working on scaling up existing capacity. So my guess is that while there's a lot of documentation (which is just one form of institutional knowledge) already out there but kept under wraps, it's useless without actual experts in the loop to make a whole bunch of judgment calls at many steps in what is still a relatively cobbled-together process.
posted by un petit cadeau at 3:11 PM on March 12, 2021 [10 favorites]
The government has had an entire year, 12 months, to eliminate these so-called "pinch points".
Not unless they wanted to build that for every single kind of vaccine. We didn't know which vaccines would actually work until ~6 months ago, and we didn't know for certain until about 4 months ago.
Also, companies did start building new facilities. Baxter, for example, announced in November 2020 that it would expand its Bloomington fill/finish facility. It won't actually be up and running in production until sometime in 2022.
And that's the problem. In 2021 the existing vaccines (Pfizer, Moderna, J&J, Novavax*, plus the Chinese and Russian vaccines) will have reached billions of doses. 2 billion from Pfizer, 700 million from Moderna, 1.1 billion from Novavax, 100 million+ from J&J, plus hundreds of millions of doses of the Chinese and Russian vaccines. By the time new production facilities come online, the job will basically be done already.
* Novavax is not yet approved but it's almost certain to be based on yesterday's UK Phase 3 results.
posted by jedicus at 3:12 PM on March 12, 2021 [6 favorites]
Not unless they wanted to build that for every single kind of vaccine. We didn't know which vaccines would actually work until ~6 months ago, and we didn't know for certain until about 4 months ago.
Also, companies did start building new facilities. Baxter, for example, announced in November 2020 that it would expand its Bloomington fill/finish facility. It won't actually be up and running in production until sometime in 2022.
And that's the problem. In 2021 the existing vaccines (Pfizer, Moderna, J&J, Novavax*, plus the Chinese and Russian vaccines) will have reached billions of doses. 2 billion from Pfizer, 700 million from Moderna, 1.1 billion from Novavax, 100 million+ from J&J, plus hundreds of millions of doses of the Chinese and Russian vaccines. By the time new production facilities come online, the job will basically be done already.
* Novavax is not yet approved but it's almost certain to be based on yesterday's UK Phase 3 results.
posted by jedicus at 3:12 PM on March 12, 2021 [6 favorites]
Sinopharm and Sinovac are using traditional methods. Not as effective, so it is said, but is it good enough? There are also some trust issues.
posted by BWA at 3:26 PM on March 12, 2021 [1 favorite]
posted by BWA at 3:26 PM on March 12, 2021 [1 favorite]
Not unless they wanted to build that for every single kind of vaccine. We didn't know which vaccines would actually work until ~6 months ago, and we didn't know for certain until about 4 months ago.
And why not build for every kind of vaccine? They had literally unlimited amounts of money. All they needed was the will to do so. They knew the vaccine formulations when they started phase 3 trials back in July. They could have started mass production right then. So what if they might have had to throw away a billion dollars of a failed vaccine. Turns out none of the first three failed. They gave up that time for nothing.
4000 people were dying a day, just in the US. These weak excuses are just bullshit.
posted by JackFlash at 3:27 PM on March 12, 2021 [4 favorites]
And why not build for every kind of vaccine? They had literally unlimited amounts of money. All they needed was the will to do so. They knew the vaccine formulations when they started phase 3 trials back in July. They could have started mass production right then. So what if they might have had to throw away a billion dollars of a failed vaccine. Turns out none of the first three failed. They gave up that time for nothing.
4000 people were dying a day, just in the US. These weak excuses are just bullshit.
posted by JackFlash at 3:27 PM on March 12, 2021 [4 favorites]
And why not build for every kind of vaccine?
Because there were dozens of potentially viable vaccine candidates and there is, actually, a limit to the amount of money, and even more importantly there is a limit to the number of people and companies who can build these kinds of facilities and the machines that go in them.
They knew the vaccine formulations when they started phase 3 trials back in July. They could have started mass production right then.
Pfizer put $2 billion into its vaccine in spring 2020 and was ramping up toward mass production as fast as it could. Stable mRNA is extremely difficult to make, as are the lipid nanoparticles. Knowing the formulation isn't enough. You have to develop a scalable process. Even with billions of dollars of its own money, a company-wide commitment to the product, and guaranteed contracts with multiple governments, Pfizer still fell 50% short of its 2020 production goal.
You can't build the facility before you know what should go in it, and there's no reason to think that more money would have made the fastest successful vaccines go any faster. This is "9 women can make a baby in 1 month" thinking.
posted by jedicus at 3:37 PM on March 12, 2021 [28 favorites]
Because there were dozens of potentially viable vaccine candidates and there is, actually, a limit to the amount of money, and even more importantly there is a limit to the number of people and companies who can build these kinds of facilities and the machines that go in them.
They knew the vaccine formulations when they started phase 3 trials back in July. They could have started mass production right then.
Pfizer put $2 billion into its vaccine in spring 2020 and was ramping up toward mass production as fast as it could. Stable mRNA is extremely difficult to make, as are the lipid nanoparticles. Knowing the formulation isn't enough. You have to develop a scalable process. Even with billions of dollars of its own money, a company-wide commitment to the product, and guaranteed contracts with multiple governments, Pfizer still fell 50% short of its 2020 production goal.
You can't build the facility before you know what should go in it, and there's no reason to think that more money would have made the fastest successful vaccines go any faster. This is "9 women can make a baby in 1 month" thinking.
posted by jedicus at 3:37 PM on March 12, 2021 [28 favorites]
Also, companies did start building new facilities
Just as an aside, this appears to be something Derek Lowe's employer profited from. I don't doubt he's speaking earnestly about how the production process works and has a great background and track record. I do think it's common for a technical insider's point of view to be conditioned by familiar constraints and to help advertise the scarcity/costs of materials.
posted by Wobbuffet at 3:45 PM on March 12, 2021 [1 favorite]
Just as an aside, this appears to be something Derek Lowe's employer profited from. I don't doubt he's speaking earnestly about how the production process works and has a great background and track record. I do think it's common for a technical insider's point of view to be conditioned by familiar constraints and to help advertise the scarcity/costs of materials.
posted by Wobbuffet at 3:45 PM on March 12, 2021 [1 favorite]
Because there were dozens of potentially viable vaccine candidates and there is, actually, a limit to the amount of money, and even more importantly there is a limit to the number of people and companies who can build these kinds of facilities and the machines that go in them.
In July there were just two vaccines in phase 3. And no, there was no limit on money. The government was willing to spend trillions of dollars for the coronavirus.
And no, there wasn't a limit on the number of people and companies who can build these facilities. You take people into the existing factories and train them on the spot. They had months to do this. You use the Defense Production Act, you walk in and you tell the Moderna and Pfizer folks what you want them to do.
These are terrible excuses.
posted by JackFlash at 3:49 PM on March 12, 2021 [1 favorite]
In July there were just two vaccines in phase 3. And no, there was no limit on money. The government was willing to spend trillions of dollars for the coronavirus.
And no, there wasn't a limit on the number of people and companies who can build these facilities. You take people into the existing factories and train them on the spot. They had months to do this. You use the Defense Production Act, you walk in and you tell the Moderna and Pfizer folks what you want them to do.
These are terrible excuses.
posted by JackFlash at 3:49 PM on March 12, 2021 [1 favorite]
What I don't get is why the phase III cycle was not modified. They had demostraitably safe vaccines with positive phase II results. The whole friggn world was shut down. Why not go wide on the most positive few, do phase III with massive numbers. I know I'm not the only one to think of this as I remember a paper from Harvard reviewing the rational and outlining a "go wide early" approach (but I can't find the link, grr). The dangers were cost of non-efficacy and more administration tracking, but the whole world was SHUT DOWN.
(yes a big reason was a dysfunctional and hampered CDC and the rest by the very broken gov, but why not more proposals for extreme approaches?)
posted by sammyo at 4:35 PM on March 12, 2021
(yes a big reason was a dysfunctional and hampered CDC and the rest by the very broken gov, but why not more proposals for extreme approaches?)
posted by sammyo at 4:35 PM on March 12, 2021
In July there were just two vaccines in phase 3.
Ah suddenly now it's July and only the Phase 3 vaccines and not 12 months ago for every vaccine. But as I showed, they were already spending as much money and throwing as many sufficiently trained people at the problem as possible. Why do you think throwing more money and unqualified people at the problem would have helped?
And no, there wasn't a limit on the number of people and companies who can build these facilities. You take people into the existing factories and train them on the spot. They had months to do this.
Again, just as a small example, Baxter started building a new facility in November of 2020 for which it is hiring 100 people. It will take at least 13 months before it is ready to produce anything. So let's suppose all those factories you want had been started back in July 2020 (you know, during the summer peak). Congratulations, they're ready to start production in August 2021 at best. It would make literally zero difference to the current situation, and it would make no difference at all to the vaccination effort in the US and at least a few other countries, which will be effectively complete by then.
Let me put this another way: why is it that every developed country in the world simultaneously failed to take this massive scale up approach that you think would have been so easy? I'll give you the US and the UK, since they were/are run by total incompetents. But China, Russia, the EU, Switzerland, South Korea, Japan? They've all got resources and biotech companies. Maybe, just fucking maybe, things are actually going about as fast as it's possible for them to have gone.
The problem was not how fast vaccines were put together. The problem was how the pandemic was mishandled politically in so many rich countries from the beginning, especially insufficient lockdowns, insufficient distancing, and insufficient production and adoption of masks.
posted by jedicus at 4:53 PM on March 12, 2021 [23 favorites]
Ah suddenly now it's July and only the Phase 3 vaccines and not 12 months ago for every vaccine. But as I showed, they were already spending as much money and throwing as many sufficiently trained people at the problem as possible. Why do you think throwing more money and unqualified people at the problem would have helped?
And no, there wasn't a limit on the number of people and companies who can build these facilities. You take people into the existing factories and train them on the spot. They had months to do this.
Again, just as a small example, Baxter started building a new facility in November of 2020 for which it is hiring 100 people. It will take at least 13 months before it is ready to produce anything. So let's suppose all those factories you want had been started back in July 2020 (you know, during the summer peak). Congratulations, they're ready to start production in August 2021 at best. It would make literally zero difference to the current situation, and it would make no difference at all to the vaccination effort in the US and at least a few other countries, which will be effectively complete by then.
Let me put this another way: why is it that every developed country in the world simultaneously failed to take this massive scale up approach that you think would have been so easy? I'll give you the US and the UK, since they were/are run by total incompetents. But China, Russia, the EU, Switzerland, South Korea, Japan? They've all got resources and biotech companies. Maybe, just fucking maybe, things are actually going about as fast as it's possible for them to have gone.
The problem was not how fast vaccines were put together. The problem was how the pandemic was mishandled politically in so many rich countries from the beginning, especially insufficient lockdowns, insufficient distancing, and insufficient production and adoption of masks.
posted by jedicus at 4:53 PM on March 12, 2021 [23 favorites]
So let's suppose all those factories you want had been started back in July 2020 (you know, during the summer peak). Congratulations, they're ready to start production in August 2021 at best.
So where do you get this bullshit. Moderna had never produced a single vaccine in volume before this year, just clinical trials. They were given money by the government in July to build production facilities. By the end of the year they were shipping millions of doses.
Moderna built their production facilities in less than 6 months. Parallel facilities could have be built just as fast. All it takes is money and the will to do so.
posted by JackFlash at 5:20 PM on March 12, 2021
So where do you get this bullshit. Moderna had never produced a single vaccine in volume before this year, just clinical trials. They were given money by the government in July to build production facilities. By the end of the year they were shipping millions of doses.
Moderna built their production facilities in less than 6 months. Parallel facilities could have be built just as fast. All it takes is money and the will to do so.
posted by JackFlash at 5:20 PM on March 12, 2021
All it takes is money and the will to do so.
Same can be said about my mission to get married to every living Best Actress Oscar winner.
However, not sure it's going to work out for me.
posted by sideshow at 5:44 PM on March 12, 2021 [6 favorites]
Same can be said about my mission to get married to every living Best Actress Oscar winner.
However, not sure it's going to work out for me.
posted by sideshow at 5:44 PM on March 12, 2021 [6 favorites]
Looking at the WHO director's statement supporting the patent waiver, I found this point interesting--though not by itself:
posted by Wobbuffet at 6:30 PM on March 12, 2021 [1 favorite]
First, we need sustainable vaccine manufacturing and production across the globe ... Some companies, like AstraZeneca, have shared their licences so that vaccines can be manufactured at multiple sites. Others, like Pfizer and Sanofi, have made agreements to transfer technology, such as the finishing of vaccine vials ... These are significant steps but we cannot rest until everyone has access, and we need to ensure sustainable vaccine supply chains for the long termWhat struck me was a connection with what two virology/immunology researchers in South Africa said about the situation there--i.e. in one of the two countries that initiated the proposal for the waiver:
Aspen is scheduled to start producing the Johnson & Johnson COVID-19 vaccine in March or April of 2021 at these facilities. It will be filling and packaging vials with vaccine product manufactured in bulk outside of South Africa.Finishing vials may not be the best example, but I take it production capabilities of some kind will eventually ramp up in or nearer to low-income countries, if for no other reason than to cope with distribution issues mentioned above. And people seem concerned about weird situations like the possibility of no deal for local use--or not being able to make full use of whatever tech transfer does happen. Put another way, what do so many countries (mapped here) actually want from a waiver that makes the Cato Institute oppose it?
Most of the vials will be shipped back to Johnson & Johnson for international distribution. A recent announcement indicates that 9 million doses will remain in South Africa for local use. The original packaging deal between Aspen and Johnson & Johnson was announced more than two months prior. There had been no mention of a procurement deal for South Africa until pressure began to mount recently on all parties.
posted by Wobbuffet at 6:30 PM on March 12, 2021 [1 favorite]
Moderna built their production facilities in less than 6 months.
This is not true.
They are relying on contract manufacturers like Lonza, who have extensive preexisting specialized manufacturing capacity.
posted by aramaic at 7:07 PM on March 12, 2021 [9 favorites]
This is not true.
They are relying on contract manufacturers like Lonza, who have extensive preexisting specialized manufacturing capacity.
posted by aramaic at 7:07 PM on March 12, 2021 [9 favorites]
For folks who are interested, this is a halfway decent article from C&EN on the manufacturing side of things, although it is (perhaps inevitably) a bit brief.
posted by aramaic at 7:09 PM on March 12, 2021 [1 favorite]
posted by aramaic at 7:09 PM on March 12, 2021 [1 favorite]
I do not understand the snarling fury from some folks here who clearly have less domain expertise than others. As was pointed out above, multiple developed countries (whose leaders' names don't rhyme with "dump") are moving at similar paces on vaccine development, production, and distribution. We can all be disappointed and wish things were moving faster, but naive fantasies don't bring us any closer to ending this pandemic.
posted by PhineasGage at 7:48 PM on March 12, 2021 [17 favorites]
posted by PhineasGage at 7:48 PM on March 12, 2021 [17 favorites]
They are relying on contract manufacturers like Lonza, who have extensive preexisting specialized manufacturing capacity.
Oh, wait. I thought these manufacturing processes were so delicate and nobody knows how to make them. So it turns out you can just call up a bunch of contract manufacturer to do each step. Apparently it took them less than 6 months to ramp up. Why not get lots of contract manufacturers involved?
It's all about their precious intellectual property and trade secrets. So tens of thousands have to die.
posted by JackFlash at 8:40 PM on March 12, 2021 [1 favorite]
Oh, wait. I thought these manufacturing processes were so delicate and nobody knows how to make them. So it turns out you can just call up a bunch of contract manufacturer to do each step. Apparently it took them less than 6 months to ramp up. Why not get lots of contract manufacturers involved?
It's all about their precious intellectual property and trade secrets. So tens of thousands have to die.
posted by JackFlash at 8:40 PM on March 12, 2021 [1 favorite]
Moderna contracted a CMO (Contract Manufacturing Organization) to produce those vaccines. There are bunches of CMOs (and CDMOs, Contract Development and Manufacturing Organizations) that can take some medicine and turn in into a form (pill, injection, patch, etc)
There's nothing wrong with a development company contracting out to a manufacturing company. This is a common practice, it's totally on the up-up.
But, not all CMOs can handle weird new drugs immediately. Also, not all CMOs can handle the formulation of injectable forms. And, not all CMOs can handle preventative vaccines.
So, Moderna is relying on their CMO partner to produce vaccines ASAP. And they have a good CMO! But it absolutely takes time to build new capacity, and it makes news in the CDMO world when a company brings a new plant w/substantial capacity online.
Johnson & Johnson is one of the largest drug companies in the world. They're not trying to be third-place in the "good vaccine" race, but they are, and it's not for lack of trying.
posted by nicething at 8:50 PM on March 12, 2021 [7 favorites]
There's nothing wrong with a development company contracting out to a manufacturing company. This is a common practice, it's totally on the up-up.
But, not all CMOs can handle weird new drugs immediately. Also, not all CMOs can handle the formulation of injectable forms. And, not all CMOs can handle preventative vaccines.
So, Moderna is relying on their CMO partner to produce vaccines ASAP. And they have a good CMO! But it absolutely takes time to build new capacity, and it makes news in the CDMO world when a company brings a new plant w/substantial capacity online.
Johnson & Johnson is one of the largest drug companies in the world. They're not trying to be third-place in the "good vaccine" race, but they are, and it's not for lack of trying.
posted by nicething at 8:50 PM on March 12, 2021 [7 favorites]
Moderna built their production facilities in less than 6 months. Parallel facilities could have be built just as fast. All it takes is money and the will to do so.
We often faced this attitude when I worked in scale up development groups. The "I want a baby in a month so you just need to get nine women on it" approach to planning.
I realize people--managers, consultants, consumers, politicians--want everything to be achievable when they want it, if they just want it badly enough. And then they don't want to hear explanations, because that would require understanding details and learning something, which is a lot of work to have to admit they were wrong. Easier to stick to their first instinct and repeat the same questions incredulously.
Bottlenecks can appear at any point. Raw materials, constructions components, personnel, whatever. So, for example, if the planet has never bought more than two custom-coated custom reactors of a certain size and tolerance in a year, you'll probably find there's simply no way to get your hands on ten of them, only twice as big, in six months.
posted by mark k at 10:07 PM on March 12, 2021 [17 favorites]
We often faced this attitude when I worked in scale up development groups. The "I want a baby in a month so you just need to get nine women on it" approach to planning.
I realize people--managers, consultants, consumers, politicians--want everything to be achievable when they want it, if they just want it badly enough. And then they don't want to hear explanations, because that would require understanding details and learning something, which is a lot of work to have to admit they were wrong. Easier to stick to their first instinct and repeat the same questions incredulously.
Bottlenecks can appear at any point. Raw materials, constructions components, personnel, whatever. So, for example, if the planet has never bought more than two custom-coated custom reactors of a certain size and tolerance in a year, you'll probably find there's simply no way to get your hands on ten of them, only twice as big, in six months.
posted by mark k at 10:07 PM on March 12, 2021 [17 favorites]
Why not get lots of contract manufacturers involved?
You have literally zero concept of what’s involved. Whatever you think you understand is hilariously wrong. Do you honestly think that these capabilities grow on trees? They’ve booked all of the competent CMOs; these abilities don’t just pop up overnight, there isn’t wasted capacity here.
... Jesus Christ, why don’t we have fusion power yet? You just ram some atoms together, how hard could it be? Obviously a Rothschild conspiracy.
posted by aramaic at 10:18 PM on March 12, 2021 [15 favorites]
You have literally zero concept of what’s involved. Whatever you think you understand is hilariously wrong. Do you honestly think that these capabilities grow on trees? They’ve booked all of the competent CMOs; these abilities don’t just pop up overnight, there isn’t wasted capacity here.
... Jesus Christ, why don’t we have fusion power yet? You just ram some atoms together, how hard could it be? Obviously a Rothschild conspiracy.
posted by aramaic at 10:18 PM on March 12, 2021 [15 favorites]
Mod note: JackFlash, you seem to be lashing out angrily over issues that you have an imperfect understanding of, and it's turning this into a less useful thread. Please refresh yourself on the guidelines, and take a break here for now.
posted by taz (staff) at 11:34 PM on March 12, 2021 [8 favorites]
posted by taz (staff) at 11:34 PM on March 12, 2021 [8 favorites]
So let's hear it, what is the reason for NOT waiving all patents and making the information on production processes for these vaccines freely available for anyone in the world who wants it?
Not saying it would magically ramp up production in less than a year, just waiting for the rationalisation on why property rights should be enforced for this or any medical technology at all. Something something ~innovation~ I imagine.
> why don’t we have fusion power yet?
Because it's probably impossible, unlike this which is already in production. What's the harm in letting everyone know how to do it, even if it took them a decade to get up to speed? Isn't the mRNA method something that could be eventually applied to different pathogens?
> Obviously a Rothschild conspiracy.
No, it's just wankers being wankers, business as usual.
posted by Bangaioh at 5:58 AM on March 13, 2021 [1 favorite]
Not saying it would magically ramp up production in less than a year, just waiting for the rationalisation on why property rights should be enforced for this or any medical technology at all. Something something ~innovation~ I imagine.
> why don’t we have fusion power yet?
Because it's probably impossible, unlike this which is already in production. What's the harm in letting everyone know how to do it, even if it took them a decade to get up to speed? Isn't the mRNA method something that could be eventually applied to different pathogens?
> Obviously a Rothschild conspiracy.
No, it's just wankers being wankers, business as usual.
posted by Bangaioh at 5:58 AM on March 13, 2021 [1 favorite]
we need to ensure sustainable vaccine supply chains for the long term
I think there are two issues here: (1) what can be, or should have been, done to speed up global vaccine availability for the current pandemic; (2) what needs to be done to make sure that vaccine distribution is fast and equitable for the next pandemics.
Regarding the first one, I think people here are right that it wasn't that easy, and I also think the head of the WHO is right when he says that much more can and should be done. (His call to action for individuals: "show also your support by donating to Covax, which in itself sends a powerful message to governments that vaccine equity is the right thing to do.")
The second issue is a different story. Maybe there wasn't time to do things right during the current go around. But for the next pandemic, that isn't going to be an excuse. And a situation where the whole world is well-equipped to respond quickly to new medical production demands is a situation that would benefit all of us regardless of where we live. If many parts of the world -- all of which were formerly colonized, all of which have had their resources stripped away for centuries to feed advancements elsewhere -- are lacking in the specialized machinery, training, and intellectual property necessary to produce vaccines (and meds!), then the parts of the world that do have those resources need to start making them affordably available. And they pretty much need to start doing it now.
posted by trig at 6:05 AM on March 13, 2021 [4 favorites]
I think there are two issues here: (1) what can be, or should have been, done to speed up global vaccine availability for the current pandemic; (2) what needs to be done to make sure that vaccine distribution is fast and equitable for the next pandemics.
Regarding the first one, I think people here are right that it wasn't that easy, and I also think the head of the WHO is right when he says that much more can and should be done. (His call to action for individuals: "show also your support by donating to Covax, which in itself sends a powerful message to governments that vaccine equity is the right thing to do.")
The second issue is a different story. Maybe there wasn't time to do things right during the current go around. But for the next pandemic, that isn't going to be an excuse. And a situation where the whole world is well-equipped to respond quickly to new medical production demands is a situation that would benefit all of us regardless of where we live. If many parts of the world -- all of which were formerly colonized, all of which have had their resources stripped away for centuries to feed advancements elsewhere -- are lacking in the specialized machinery, training, and intellectual property necessary to produce vaccines (and meds!), then the parts of the world that do have those resources need to start making them affordably available. And they pretty much need to start doing it now.
posted by trig at 6:05 AM on March 13, 2021 [4 favorites]
Yeah, this could save a lot of lives, but on the other hand… money!
posted by blue_beetle at 6:56 AM on March 13, 2021
posted by blue_beetle at 6:56 AM on March 13, 2021
To borrow a concept from open source software development, vaccine creation/manufacturing has traditionally been done in the (proprietary) Cathedral, and the suggestion here is that it would be better done (or at least produced) in the (collaborative) Bazaar. What's missing in this debate is a proof--of-concept (á la Linux) that proves that this model is transferable to a different domain.
posted by villard at 7:02 AM on March 13, 2021 [2 favorites]
posted by villard at 7:02 AM on March 13, 2021 [2 favorites]
What's missing in this debate is a proof--of-concept (á la Linux) that proves that this model is transferable to a different domain.
Not really. If anything the pharma world is far more familiar with this, since patents are meaningful in the industry and actually expire while our products are still useful (as opposed to copyright and other IP strategies in software.)
So we know what happens when a drug goes off patent--other manufacturers step in and develop expertise in manufacturing. The commercial price drops almost immediately and the manufacturing price usually comes down dramatically as well. (Usually. Some things are harder than others and some biologics have heavy regulatory burdens, independent of patent protection.)
There's a ton of experience with both simply removing IP, and actively trying to teach someone else how to make your drug (contractors, partners, new facilities). It will bring down the price, but people commenting on the challenges are doing so from experience.
posted by mark k at 7:47 AM on March 13, 2021 [10 favorites]
Not really. If anything the pharma world is far more familiar with this, since patents are meaningful in the industry and actually expire while our products are still useful (as opposed to copyright and other IP strategies in software.)
So we know what happens when a drug goes off patent--other manufacturers step in and develop expertise in manufacturing. The commercial price drops almost immediately and the manufacturing price usually comes down dramatically as well. (Usually. Some things are harder than others and some biologics have heavy regulatory burdens, independent of patent protection.)
There's a ton of experience with both simply removing IP, and actively trying to teach someone else how to make your drug (contractors, partners, new facilities). It will bring down the price, but people commenting on the challenges are doing so from experience.
posted by mark k at 7:47 AM on March 13, 2021 [10 favorites]
I don't see cancelling the discussion just because it makes some uncomfortable.
This is not what is happening.
Oh, wait. The experts here told us this was impossible. The expertise doesn't exist. The facilities don't exist. It can't be done.
Well, it seems that facts are quite different. It can be done. And it should have been done months ago...
If you read the text of the article you posted you'll see that this did start moving on this months ago - before they'd even finished final-stage trials. It just takes time, and there aren't any other resources not being pursued that magically could be had at the snap of some fingers - which is what everyone has been telling you.
posted by Dysk at 8:35 AM on March 13, 2021 [6 favorites]
This is not what is happening.
Oh, wait. The experts here told us this was impossible. The expertise doesn't exist. The facilities don't exist. It can't be done.
Well, it seems that facts are quite different. It can be done. And it should have been done months ago...
If you read the text of the article you posted you'll see that this did start moving on this months ago - before they'd even finished final-stage trials. It just takes time, and there aren't any other resources not being pursued that magically could be had at the snap of some fingers - which is what everyone has been telling you.
posted by Dysk at 8:35 AM on March 13, 2021 [6 favorites]
(And also from the same article: "Right now, the scarcest ingredients are the lipids used to deliver the vaccine’s RNA. These are produced by a handful of companies and the shortage is compounded by the fact that vaccine-makers use a similar technology and rely on the same suppliers."
This does not exactly imply that more could be done by bringing more pharma partners in. This sounds like a further-back-up-the-supply-chain issue.)
posted by Dysk at 8:38 AM on March 13, 2021 [3 favorites]
This does not exactly imply that more could be done by bringing more pharma partners in. This sounds like a further-back-up-the-supply-chain issue.)
posted by Dysk at 8:38 AM on March 13, 2021 [3 favorites]
The other early vaccines were either developed and distributed in two other large countries (China and Russia) or are of debatable efficacy and safety (Oxford/AZ).
Are there any results on the Russian vaccine from agencies independent of the Russian government? Russia has an advanced biotech industry, though it also is a massively corrupt autocracy, and while it claims Sputnik V to have a >90% efficacy, that’s the sort of claim that could do with independent verification.
Also, IIRC, one of the Chinese vaccines, once tried abroad (in Brazil, I think) turned out to have an efficacy under 60% (the magic number used as a cutoff), and ended up being jettisoned by the rest of the world. Perhaps autocratic systems aren’t the best at producing results that stand up outside of their apparatus of control?
posted by acb at 8:46 AM on March 13, 2021 [1 favorite]
Are there any results on the Russian vaccine from agencies independent of the Russian government? Russia has an advanced biotech industry, though it also is a massively corrupt autocracy, and while it claims Sputnik V to have a >90% efficacy, that’s the sort of claim that could do with independent verification.
Also, IIRC, one of the Chinese vaccines, once tried abroad (in Brazil, I think) turned out to have an efficacy under 60% (the magic number used as a cutoff), and ended up being jettisoned by the rest of the world. Perhaps autocratic systems aren’t the best at producing results that stand up outside of their apparatus of control?
posted by acb at 8:46 AM on March 13, 2021 [1 favorite]
Some of those plants that Biontech is planning to use are only available because some of the other proposed vaccines haven’t panned out yet. For example, the Sanofi plant in Frankfurt will be used to condition and fill the vaccine produced nearby in Mainz/Idar Oberstein/Marburg. The plant was originally supposed to be used for Sanofi’s own vaccine, but that’s been delayed.
Their Marburg plant has now started production, but it takes about 4 weeks for the vaccine to be available. (There’s a lot of testing that needs to be done, particularly for the first batches.) I live in Hessen, so the local media and government has been keeping us informed of what’s going on there. There seemed to be a total lead in time of over 6 months - and that was with high priority for all the approval processes that are necessary for pharma plants.
I’d also note that Mainz, Idar Oberstein and Marburg are pretty close together, so that you can send people from one to the other easily to help with the unavoidable start-up issues.
posted by scorbet at 9:09 AM on March 13, 2021 [5 favorites]
Their Marburg plant has now started production, but it takes about 4 weeks for the vaccine to be available. (There’s a lot of testing that needs to be done, particularly for the first batches.) I live in Hessen, so the local media and government has been keeping us informed of what’s going on there. There seemed to be a total lead in time of over 6 months - and that was with high priority for all the approval processes that are necessary for pharma plants.
I’d also note that Mainz, Idar Oberstein and Marburg are pretty close together, so that you can send people from one to the other easily to help with the unavoidable start-up issues.
posted by scorbet at 9:09 AM on March 13, 2021 [5 favorites]
Oh, wait. The experts here told us this was impossible. The expertise doesn't exist. The facilities don't exist. It can't be done.
Literally no one said that? People are saying it requires time to build capacity and bring things online; that there's a ramp up period. We've been ramping up and are continuing to do so. There is actually a different stock of expertise and different availability of facilities than there was a year ago. It's like, things change over time!
Your silly idea that you could simultaneously prepare for all the capacity for all possible vaccines is belied by the article you think clinches your point. Merck is getting into manufacturing rivals' vaccines precisely because it's own trials failed so it's freed up capacity. Novartis is using an advanced facility for the Moderna vaccine; that means it can't be used for other things. That's how it works. It's not just "money and will," even if Silicon Valley VCs and billionaires with inflated egos and little knowledge prefer to think that it is.
During this pandemic, people with lupus lost access to hydroxychloroquine because the manufacture couldn't keep up in with the demand. We suffered a worldwide compressed CO2 gas shortage. We had bottlenecks in hand sanitizers, masks and fucking toilet paper. But you think putting the money in a big pile and willing it to transmorgify into liposomal formulations of mRNA would have worked.
In other words, the months of delay were the lawyers arguing over intellectual property rights, not any technical difficulties.
It's clear you, personally, can only think of only one thing people discuss in negotiations. The period during negotiations need to tackle all things, though.
posted by mark k at 9:21 AM on March 13, 2021 [14 favorites]
Literally no one said that? People are saying it requires time to build capacity and bring things online; that there's a ramp up period. We've been ramping up and are continuing to do so. There is actually a different stock of expertise and different availability of facilities than there was a year ago. It's like, things change over time!
Your silly idea that you could simultaneously prepare for all the capacity for all possible vaccines is belied by the article you think clinches your point. Merck is getting into manufacturing rivals' vaccines precisely because it's own trials failed so it's freed up capacity. Novartis is using an advanced facility for the Moderna vaccine; that means it can't be used for other things. That's how it works. It's not just "money and will," even if Silicon Valley VCs and billionaires with inflated egos and little knowledge prefer to think that it is.
During this pandemic, people with lupus lost access to hydroxychloroquine because the manufacture couldn't keep up in with the demand. We suffered a worldwide compressed CO2 gas shortage. We had bottlenecks in hand sanitizers, masks and fucking toilet paper. But you think putting the money in a big pile and willing it to transmorgify into liposomal formulations of mRNA would have worked.
In other words, the months of delay were the lawyers arguing over intellectual property rights, not any technical difficulties.
It's clear you, personally, can only think of only one thing people discuss in negotiations. The period during negotiations need to tackle all things, though.
posted by mark k at 9:21 AM on March 13, 2021 [14 favorites]
Meanwhile: Pfizer has been accused of “bullying” Latin American governments in Covid vaccine negotiations and has asked some countries to put up sovereign assets, such as embassy buildings and military bases, as a guarantee against the cost of any future legal cases,
posted by adamvasco at 5:41 PM on March 13, 2021
posted by adamvasco at 5:41 PM on March 13, 2021
I do not understand the snarling fury from some folks here who clearly have less domain expertise than others.
To be fair, domain expertise often acts as a brake on the rapid ramp-up of snarling fury in response to any crisis.
posted by flabdablet at 12:59 AM on March 14, 2021 [5 favorites]
To be fair, domain expertise often acts as a brake on the rapid ramp-up of snarling fury in response to any crisis.
posted by flabdablet at 12:59 AM on March 14, 2021 [5 favorites]
Let me put this another way: why is it that every developed country in the world simultaneously failed to take this massive scale up approach that you think would have been so easy? I'll give you the US and the UK, since they were/are run by total incompetents. But China, Russia, the EU, Switzerland, South Korea, Japan? They've all got resources and biotech companies. Maybe, just fucking maybe, things are actually going about as fast as it's possible for them to have gone.
The two examples of incompetent leadership in that list are the ones that took the "scale everything up" approach most aggressively.
The UK had almost no domestic vaccine manufacturing capacity in early 2020 (but did have a substantial pharmaceutical industry and researchers) and spent almost £200 / person on building up manufacturing capacity to produce a range of different vaccine candidates.
That includes the facilities making AZ, the fill & finish factory in Wrexham, a factory for Valneva in Scotland, one for Novavax, and deals with CureVac and others.
That's in addition to purely commercial orders with Pfizer/Biontech, Moderna, J&J where they are not investing in factories but just pre-ordering.
The thing is there's really three timescales at work here:
what can be done to scale up production now? (bring in other vaccine manufacturers as contract producers of working vaccines to make sure there's no idle capacity)
what could have been done starting this time last year? Build vaccine production facilities in places that already had specialty biotech industries.
what should be done over time? Create more equitable global production capacity.
On that third point, 1% of the vaccines used in Africa are manufactured there. That's definitely a problem but I don't know that it could have been solved during the pandemic because of the timescales. Surely all the more reason to make sure it does get fixed so this doesn't happen again.
posted by atrazine at 8:24 AM on March 14, 2021 [5 favorites]
The two examples of incompetent leadership in that list are the ones that took the "scale everything up" approach most aggressively.
The UK had almost no domestic vaccine manufacturing capacity in early 2020 (but did have a substantial pharmaceutical industry and researchers) and spent almost £200 / person on building up manufacturing capacity to produce a range of different vaccine candidates.
That includes the facilities making AZ, the fill & finish factory in Wrexham, a factory for Valneva in Scotland, one for Novavax, and deals with CureVac and others.
That's in addition to purely commercial orders with Pfizer/Biontech, Moderna, J&J where they are not investing in factories but just pre-ordering.
The thing is there's really three timescales at work here:
what can be done to scale up production now? (bring in other vaccine manufacturers as contract producers of working vaccines to make sure there's no idle capacity)
what could have been done starting this time last year? Build vaccine production facilities in places that already had specialty biotech industries.
what should be done over time? Create more equitable global production capacity.
On that third point, 1% of the vaccines used in Africa are manufactured there. That's definitely a problem but I don't know that it could have been solved during the pandemic because of the timescales. Surely all the more reason to make sure it does get fixed so this doesn't happen again.
posted by atrazine at 8:24 AM on March 14, 2021 [5 favorites]
Trump fuckery
As Brazil’s death toll from the Covid-19 pandemic nears 275,000, documents reveal that Washington pressured the Brazilian government not to buy Russia’s “malign” Sputnik V vaccine – a decision which may have costed many thousands of lives.
posted by adamvasco at 6:21 PM on March 14, 2021
As Brazil’s death toll from the Covid-19 pandemic nears 275,000, documents reveal that Washington pressured the Brazilian government not to buy Russia’s “malign” Sputnik V vaccine – a decision which may have costed many thousands of lives.
posted by adamvasco at 6:21 PM on March 14, 2021
An interesting deep dive from The New Yorker on the challenges of ramping up vaccine production: "Why COVID-19 Vaccines Aren’t Yet Available to Everyone."
posted by PhineasGage at 8:23 PM on March 14, 2021
posted by PhineasGage at 8:23 PM on March 14, 2021
Pfizer executives explain to investors that people may need a third dose of covid vaccine, in addition to regular yearly boosters. The company will soon begin plans to hike prices given the "significant opportunity for our vaccine".
via
posted by adamvasco at 8:08 AM on March 16, 2021 [1 favorite]
via
posted by adamvasco at 8:08 AM on March 16, 2021 [1 favorite]
Rich countries with 14% of the world’s population have secured 53% of the best vaccines.
The world's richest countries are hoarding vaccines. The wealthiest western nations have wiped their hands of any responsibility to slow a pandemic they helped spread
This is morally indefensible.
posted by adamvasco at 6:33 PM on March 17, 2021
The world's richest countries are hoarding vaccines. The wealthiest western nations have wiped their hands of any responsibility to slow a pandemic they helped spread
This is morally indefensible.
posted by adamvasco at 6:33 PM on March 17, 2021
What a disappointing article, filled with personal aspersions and bald statements with no backing:
"In fact, nine out of 10 people in poor countries may never be vaccinated at all." (source?)
"It’s unlikely that Moderna’s chief executives feel badly about the unvaccinated poor." (simply libelous)
How to get vaccines to all 8 billion in the world on an equitable basis is vitally important. A screed like this adds no light - and not even much heat - to the topic.
posted by PhineasGage at 6:49 PM on March 17, 2021 [3 favorites]
"In fact, nine out of 10 people in poor countries may never be vaccinated at all." (source?)
"It’s unlikely that Moderna’s chief executives feel badly about the unvaccinated poor." (simply libelous)
How to get vaccines to all 8 billion in the world on an equitable basis is vitally important. A screed like this adds no light - and not even much heat - to the topic.
posted by PhineasGage at 6:49 PM on March 17, 2021 [3 favorites]
The world's richest countries are hoarding vaccines.
It's a weird definition of "hoarding" that uses it not to mean sitting on an unused excess, but instead refers to using something as quickly as you can procure it. I get that the US is sitting on some stocks of the AZ that their regulators haven't okayed yet, but that is a one country, for an inherently temporary position. If this is at all representative of this article's relationship to the truth, then I'd take it with a shaker of salt.
The European Union has exported 34m doses to, of all places, Singapore, Saudi Arabia and Hong Kong – countries that have no problem sourcing or paying for vaccines
Also this is tautological. They exported vaccines to countries that aren't struggling to source imports! (Never mind that this would automatically be true of anywhere the vaccines are being exported to). The quote conveniently omits Chile and Malaysia as well, because I guess it doesn't fit the narrative.
There's also all the completely off-topic non-sequiturs: "By November 2020, [Vietnam] had registered just over 1,000 cases. On the other hand, a year into the pandemic, half a million Americans have died from Covid-19, more Americans than died in combat in the first and second world wars and the Vietnam war combined. Yet, even as its country suffered and struggled, the mighty power still found time to bomb Syria."
Wasn't this article supposed to be about vaccines? This is just a tendentious" and Biden and the Democrats are BAD" tacked on to the end of an unrelated article.
Like, vaccine restrictions are bad, pharma profiteering is bad... but Christ alive, so is this article.
posted by Dysk at 1:53 AM on March 18, 2021 [3 favorites]
It's a weird definition of "hoarding" that uses it not to mean sitting on an unused excess, but instead refers to using something as quickly as you can procure it. I get that the US is sitting on some stocks of the AZ that their regulators haven't okayed yet, but that is a one country, for an inherently temporary position. If this is at all representative of this article's relationship to the truth, then I'd take it with a shaker of salt.
The European Union has exported 34m doses to, of all places, Singapore, Saudi Arabia and Hong Kong – countries that have no problem sourcing or paying for vaccines
Also this is tautological. They exported vaccines to countries that aren't struggling to source imports! (Never mind that this would automatically be true of anywhere the vaccines are being exported to). The quote conveniently omits Chile and Malaysia as well, because I guess it doesn't fit the narrative.
There's also all the completely off-topic non-sequiturs: "By November 2020, [Vietnam] had registered just over 1,000 cases. On the other hand, a year into the pandemic, half a million Americans have died from Covid-19, more Americans than died in combat in the first and second world wars and the Vietnam war combined. Yet, even as its country suffered and struggled, the mighty power still found time to bomb Syria."
Wasn't this article supposed to be about vaccines? This is just a tendentious" and Biden and the Democrats are BAD" tacked on to the end of an unrelated article.
Like, vaccine restrictions are bad, pharma profiteering is bad... but Christ alive, so is this article.
posted by Dysk at 1:53 AM on March 18, 2021 [3 favorites]
Also, given that the best bang for vaccination buck is to be had by deploying vaccines fastest where the risk of spread is highest, having the US suck up most of the available vaccine supply is currently still a good thing from a worldwide public health point of view.
This is not at all the same thing as saying that vaccine nationalism is a sound principle in general - it obviously isn't - just that it won't actually be doing the world much damage for as long as the US remains the world leader in killing its own citizens off with plague and pestilence.
posted by flabdablet at 3:07 AM on March 18, 2021 [1 favorite]
This is not at all the same thing as saying that vaccine nationalism is a sound principle in general - it obviously isn't - just that it won't actually be doing the world much damage for as long as the US remains the world leader in killing its own citizens off with plague and pestilence.
posted by flabdablet at 3:07 AM on March 18, 2021 [1 favorite]
the US remains the world leader in killing its own citizens off with plague and pestilence
This is true, but it's also easy to overlook the damage the pandemic has done in places like Africa, where the recorded death rates from Covid haven't been high, but poverty and hunger have increased significantly in populations that were on the brink to begin with. (I don't have time to source articles right now, and there's some evidence that malnutrition results haven't been quite as apocalyptic as feared early on, but the toll is apparently still serious in a lot of ways that aren't reflected in covid case numbers.)
posted by trig at 5:20 AM on March 18, 2021
This is true, but it's also easy to overlook the damage the pandemic has done in places like Africa, where the recorded death rates from Covid haven't been high, but poverty and hunger have increased significantly in populations that were on the brink to begin with. (I don't have time to source articles right now, and there's some evidence that malnutrition results haven't been quite as apocalyptic as feared early on, but the toll is apparently still serious in a lot of ways that aren't reflected in covid case numbers.)
posted by trig at 5:20 AM on March 18, 2021
So the article could have been better. However it has interest in that it is written from a non US / 1st world centric point of view; something that is much needed.
Why does South Africa pay twice as much for vaccines as European countries?
Why has Africa - home to 1.3bn people – been allocated just 300m doses?
Not nice questions but they need to be asked.
Pakistan has administered just 0.09 vaccinations per 100 members of the population, and there is vaccination hesitancy.
In India 6.5% of coronavirus vaccine doses are going to waste. One reason for the wastage is that, while many urban vaccination centres have been crowded, some rural sites have had to nudge people to get shots due to a lack of awareness among the public.
Then there is this: Israeli health minister says not country’s job to give vaccine to Palestinians in occupied territory.
Re hoarding: Vaccine hoarding threatens global supply via COVAX: WHO and Rich countries hoarding COVID-19 vaccines are making a mistake that could worsen their own death tolls.
posted by adamvasco at 6:29 AM on March 18, 2021
Why does South Africa pay twice as much for vaccines as European countries?
Why has Africa - home to 1.3bn people – been allocated just 300m doses?
Not nice questions but they need to be asked.
Pakistan has administered just 0.09 vaccinations per 100 members of the population, and there is vaccination hesitancy.
In India 6.5% of coronavirus vaccine doses are going to waste. One reason for the wastage is that, while many urban vaccination centres have been crowded, some rural sites have had to nudge people to get shots due to a lack of awareness among the public.
Then there is this: Israeli health minister says not country’s job to give vaccine to Palestinians in occupied territory.
Re hoarding: Vaccine hoarding threatens global supply via COVAX: WHO and Rich countries hoarding COVID-19 vaccines are making a mistake that could worsen their own death tolls.
posted by adamvasco at 6:29 AM on March 18, 2021
How is lack of awareness and vaccine uptake in rural India the fault of the U.S. or Europe?
posted by PhineasGage at 6:43 AM on March 18, 2021
posted by PhineasGage at 6:43 AM on March 18, 2021
No one said it was.
A call for global vaccine equity
The covid-19 pandemic will not be over for us until it is over for everyone.
inequity in global access to covid-19 vaccines is causing needless deaths, and prolonging the pandemic and viral transmission that fosters variants which undermine vaccine efficacy.
Aiming to make vaccines available to only a small portion of people in low- and middle-income countries in 2021 is a political choice, not an inevitability.
Vaccine production in Africa, Asia, and Latin America can expand within months if technology and know-how are shared more widely, beyond a few limited agreements.
Temporarily suspending enforcement of intellectual property on COVID-19 technologies during the pandemic, as proposed at the WTO, will not undermine innovation and research..
posted by adamvasco at 8:56 AM on March 18, 2021
A call for global vaccine equity
The covid-19 pandemic will not be over for us until it is over for everyone.
inequity in global access to covid-19 vaccines is causing needless deaths, and prolonging the pandemic and viral transmission that fosters variants which undermine vaccine efficacy.
Aiming to make vaccines available to only a small portion of people in low- and middle-income countries in 2021 is a political choice, not an inevitability.
Vaccine production in Africa, Asia, and Latin America can expand within months if technology and know-how are shared more widely, beyond a few limited agreements.
Temporarily suspending enforcement of intellectual property on COVID-19 technologies during the pandemic, as proposed at the WTO, will not undermine innovation and research..
posted by adamvasco at 8:56 AM on March 18, 2021
Biden administration to share millions of AstraZeneca vaccine doses with Canada, Mexico.
posted by PhineasGage at 12:31 PM on March 18, 2021
posted by PhineasGage at 12:31 PM on March 18, 2021
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Surely I'm oversimplifying and would love to be corrected here! But it seems like we have an opportunity to eradicate the virus globally and we aren't because, why would we, there is money to be made.
posted by windbox at 12:58 PM on March 12, 2021 [13 favorites]