I posted this on Twitter last night:
If we are short of vaccines why aren't AstraZeneca, Pfizer and Moderna letting other drug companies manufacture their vaccines that were created at public expense? Is profit more important than speed of delivery?
— Richard Murphy (@RichardJMurphy) January 28, 2021
In the space Twitter allows the argument was under-developed but clear, I hoped, nonetheless.
What we know is that we have a shortage of vaccines.
We also know that public funding has underpinned the production of those vaccines.
And we know we have a pandemic, which by definition is global.
And yet there is no sign that we are seeing what would, in effect, a war style production approach to the production of these vaccines being put in place. Even if some drug companies are likely to profit considerably from this crisis, there is no reason at all why the production of these vaccines need be limited to their production facilities. It is impossible that there are no other facilities that could be used for their manufacture.
So why isn’t that happening?
Are supplies deliberately being kept short?
Or is price being maintained?
Or is this simple failure of government to intervene, in not just the UK, but many other countries?
What I do know is that in wartime this did not happen. Manufacturing was diversified way beyond the original designers of equipment in WW2, for example. That was the only way supply could be sustained. And yet, although we face a crisis at least as bad now, I have heard nothing of this for vaccine manufacture.
So, four questions.
Is this happening, but it’s just not being talked about?
If it isn’t’t happening, why not?
And on the basis of the very safe assumption that more manufacturing capacity exists than is being used, when is something going to be done to address this?
Or, are yet more people going to die needlessly, in many countries?
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As I understand it Sanofi is going to do this with Pfizer (as its own vaccine is months away because of disappointing trial results requiring some further work). See https://www.france24.com/en/france/20210127-french-firm-sanofi-to-help-produce-100-million-doses-of-pfizer-covid-19-vaccine
I don’t know how many other pharma institutes and companies have the specialist facilities available to participate in a collaborative effort but certainly it should be explored. Building new facilities will take months. Many have been working on their own vaccine, eg Johnson & Johnson, Novavax, GSK, no doubt many others.
Not all of the companies are in it for the money, at least not straight away. AstraZeneca is working with Oxford University on a no profit/costs covered basis.
And what are costs?
I am no expert in drug manufacture but I nearly always prefer the “cock-up” over the “conspiracy” as a theory.
I have no knowledge about any firm other than AZ (where I have a contact) but at AZ, as far as I understand it, I think….
First, it is a genuine Not For Profit exercise. AZ staff are human, too!
Second, last summer/autumn it was unclear which vaccines would “win the race”. So, AZ (i) manufactured a large quantity of its vaccine at its own risk (but subsequently backed by the UK government) so that in the event of effectiveness/approval it could be rolled out quickly (ii) pledged to use its production facilities to manufacture other vaccines if they proved to be better (iii) allow other facilities to manufacture its vaccine if it proved to be most effective.
I am prepared to believe unless proved otherwise that AZ is operating with good intentions and I feel some sympathy for them in the rather unedifying scramble to secure supplies. (D Allen-Green wrote interestingly on this in the FT).
I also wonder what capacity there really is to manufacture. How long it takes to re-tool (a) a non-vaccine factory over to making vaccines and (b) a vaccine factory from one vaccine to another. If there is extra capacity at present then it will almost certainly be gearing up by its owner to produce their own vaccine which they hope will be approved shortly. Should governments force them to re-tool? Possibly – but we would be concentrating our hopes on one or two vaccines that came first rather than promoting diversity that might be valuable?
In short, I think it is a really complicated picture…. and the only people I know involved (at AZ) are really trying to do the right thing.
This is complicated, of course
But if AZ could create capacity in months so too could others
And the need is massive around the world and will be ongoing
I think my point stands
According to Jay Hancock at Kaiser Health News (in an article from 25 August 2020) Oxford University had promised to donate the rights to its coronavirus vaccine to any drug manufacturer, the idea being to provide medicines preventing or treating Covid-19 at a low cost or free of charge. “That made sense to people seeking change” to the way vaccines were manufactured and delivered, wrote Hancock. “The coronavirus was raging. Many agreed that traditional vaccine development, characterized by long lead times, manufacturing monopolies and weak investment, was broken.”
Oxford University, however, did not follow through on its promise. “A few weeks later, Oxford–urged on by the Bill & Melinda Gates Foundation–reversed course. It signed an exclusive vaccine deal with AstraZeneca that gave the pharmaceutical giant sole rights and no guarantee of low prices–with the less-publicized potential for Oxford to eventually make millions from the deal and win plenty of prestige.”
Other pharmaceutical companies have followed suit. Take the public money for the development and then privatize the profits. “Moderna, another company working on a vaccine candidate, received nearly $1 billion from the U.S. government to pay essentially all costs to research the product and get it approved by regulators. It’s using a vaccine designed in large part by the National Institutes of Health and academic scientists using federal grants. If the vaccine works, the company gets an additional $1.5 billion to cover 100 million doses…That deal comes to $15 a dose. Moderna told Wall Street analysts it might charge as much as $37 a dose for smaller-volume contracts.”
As to only providing the vaccines at cost, all financial information is kept confidential so who knows what cost means. “No one will be able to confirm whether the vaccines are truly being sold at cost…Under its deal with AstraZeneca, Oxford will receive no royalties during the pandemic but could make millions after it ends through a web of patents including those held by Vaccitech, a for-profit spinoff. Vaccitech’s ownership includes a 50% stake held directly or indirectly by Oxford.” These millions will arise if the virus becomes endemic and we all require vaccination repeatedly in the coming years.
I don’t think that ‘altruism’ is in the pharmaceutical dictionary.
Your conclusion summarises my concern
I think I am right in saying (based on media reports) that AZ at least have indeed contracted out manufacturing in the way you suggest in order to increase supply. Certainly it has been well publicised that the final packaging (checking purity and dispensing into vials for distribution) is being done at a factory in Wrexham owned by the Indian company Wockhardt. I think the Belgian factory where the production delays are reported was also described as belonging to a different company. And I think they are working with the big Serum Institute company in India to create global supplies.
Pfizer and Moderna are different. They use a new pharmaceutical technology which may be less adaptable to other existing production lines, and there may be other blocks to expanding production. Some of the ingredients are specialist chemicals that have previously only had a research use and were made in small quantities – in those cases production delays may happen at various points in the supply chain. Newspaper comments suggests that Biden’s assumption of the sort of powers you refer to are more likely to be used to get other chemical companies making supplies, presumably the company thinks vaccine manufacture can readily be increased to match supplies.
Sanofi to Make Millions of BioNTech-Pfizer Vaccine Doses
https://www.msn.com/en-us/money/companies/sanofi-to-make-millions-of-biontech-pfizer-vaccine-doses/ar-BB1d7Oal?ocid=uxbndlbing
And that is one of the more difficult ones to manufacture.
But is that the only company that could so so?
Why not mass rollouts? I am still baffled that there is not a command and supply mentality about this
There are maybe 100 people in the world that know how to get miRNA inside the lipid nanoparticles. Much of it needing to be done with specialized equipment at lab bench scale and cold temps, from what I understand. The more mature vaccine technologies really should be able to scale faster.
This seems to me to be another example of the lack of sufficient “redundancy” in the bio-tech/pharma industry. Like other industrial sectors it is dominated a a small number of large companies who are “too big to fail”. We are allowing our economy, our governance and our political system to evolve in the wrong direction – too few and diverse business models, too few and diverse companies, too few and diverse political parties, too few and diverse trade unions – the list goes on….and to cap it all off too much concentration of power in the executive and the drift toward authoritarian government. It is a recipe for social and environmental breakdown.
I know nothing about vaccine manufacture, but I found a paper on “The complexity and cost of vaccine manufacturing — An overview” (https://www.sciencedirect.com/science/article/pii/S0264410X17307703)
I’ve only read a few paras of the report but “complexity and cost” seem key, as does the availability of facilities and trained personnel.
That said, if cost is a major impediment then when they ask where’s the money we know the answer: Governments.
As you point out in WW2 government acted: people were re-deployed, facilities built, Russia even moved their factories to Siberia. Governments need to act.
I am not disputing cost and complexity
But there are many drug manufacturers who do know about this stuff
I think that I am content with how big Pharma is handling the supply of vaccines and that they should be able to make a reasonable profit on it. Certainly AZ do not seem to be profiteering. I would certainly be content with public money being paid for something useful even at a slight premium.
The EU, as I understand it, started with noble ambitions of getting significant supply to all 27 which helps the poorer countries in the bloc have fair access. Katya Adler on R4 this morning summed it up very well in my view. Where EU probably went wrong was to attempt too many things in one agreement and perhaps in particular: minimise dose cost and put too much liability on producers.
If I engage a builder and put him on a tight fixed price contract and want him to warrant what he does for say 10 years and fix every defect,; I am not going to get a very happy builder and something is going to suffer – actually everyone suffers (builder, his team and me as client).
As noted above, Pfizer is having its vaccine produced by Sanofi. Seems to me that the market is working well.
We should however, hold all to account – governments and pharma – if we do not quickly move to get vaccine to developing nations and the very poorest. Moldova is a case in point.
I see The European Medicines Agency has approved the Oxford /Astra Zeneca vaccine a day after the Germans were saying it didn’t work on the over 65s.. you seemed very quick to take the Germans side (as you thrive on negative news).. have you now changed your tune?
There remains very limited evidence to support AZ use in the over 65s
The German concern seems wholly justified according to medics I know
It is an unlicensed medical use. These are not uncommon, most medicines used in children are unlicensed as they are rarely tested on children. But that does require extra patient counselling so they know the risk. There is no evidence that this is happening. AZ ≠Pfizer in other words, with the matter being superior right now.
That is an argument
Your comment was not.
Please don’t call again.
Poor vaccine response in the elderly is a well-known phenomena, so much so that the elderly have their own influenza vaccine to produce an enhanced immune response.
The data, at least my reading of the data, suggests that the immune response of the elderly to the Astra vaccine is similar to that of the young[er] trial participants.
There is a paper in the Lancet detailing these tests:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32466-1/fulltext
Quite interesting, considering that my vaccination for this is tomorrow, with the Oxford/Astra vaccine being used.
Good luck
I read somewhere on an American website I think the average cost of a Covid vaccination shot is $20 (£14-55) with both the Federal government and UK government picking up the tab. So just taking the United States alone and assuming 250 million people ultimately get vaccinated with a double shot vaccination (December 2020 to December 2021) that amounts to 100 million dollars worth of business in a year which may continue well into the future. I’m assuming those who’ve had Covid understand immunity only lasts for five to six months and Covid keeps on mutating like flu. Hard to figure out what the cost to the UK will be with the country using the single shot Astrazeneca vaccine but supplies of other vaccines currently also being uncertain.
Maybe we’ll do vaccines properly one day, rather do unlicensed use
I strongly suspect the ongoing cost will be high
That figure excludes delivery by a person, I suspect
Yes I think it does. It’s just the manufacturing cost I’m fairly sure. Can’t remember anything being said about the vaccination administering cost..
I think that $20 is the estimated cost of the Pfizer vaccine itself, excluding distribution and delivery (and all the infrastructure and support necessary to deliver millions of vaccine shots within a few months). Moderna might be $40 according to some reports, but AZ is easier to make and they are working on a cost recovery basis (not for profit) and might be just £3 per dose.
Taking the $20 as a reasonable estimate, 20 * 2 * 250 million is $10 billion.
AstraZeneca = $4 / £2.92
Pfizer = $20 / £14.59
Moderna = $10-$50 / £7.30-£36.48 (No, I don’t know)
Cost of administering = £12.58, per jab.
https://www.bmj.com/content/371/bmj.m4354
My nephew has a senior role in the bio tech sector….although not pharma….he tells me that small companies cannot survive long as they get taken over by the big ones. Therein lies the nub of the problem….and institutional investors like pension funds are at the heart of it, as is the financing structures which predominate….shareholder equity….which treats companies as tradeable commodities. No wonder we have a vaccine crisis.
When a small company has a decent idea it is bought
That is what its owners will aim for
It is a two sided problem
yes I accept that its a two sided problem but I think this is probably because the new companies and the dynamic individuals behind them can’t access development capital unless they merge into a bigger entity. Again it comes back to the problems in our banking and financial system which is hostile to diversity and to the creation of “redundancy” in the economy….they are far happier with the other kind of “redundancy” we think of – job losses.
At the start of WW2 a group of plane manufacturers got together and decided to collaborate. They shared everything and provided everything for their workforce too. This collaboration led to the largest production capability in USA history ever.
At the start of this pandemic scientists from across the globe began a huge collaboration to find answers and potential vaccines. The scientific knowledge on viruses has grown exponentially over a few months compared to the previous decades. VaccineS have been produced and immunisations started in miraculous time frame. All other vaccine developments have taken decades.
Collaboration has unlocked human endeavours on a monumental scale. If it weren’t for greed and concentration of power, how much more could be achieved by collaborative human endeavour.
As soon as scientists started looking for a possible vaccine back in January 2020, is when governments should have collaborated with manufacturers to expand local PPE production, expand vaccine manufacturing facilities, and enabling of efficient distribution lines. Governments should have also collaborated to facilitate maximising all the above for all nations and all people.
Some collaboration has taken place in Government circles such as Covax, EU PPE purchasing. But on the whole many Western democracies have failed miserably, especially populist ones (USA and UK). From a governmental perspective there’s been a distinct lack of collaboration with everything playing out in a slow reactive cartwheel. Lacking energy, commitment and ability to learn from past mistakes.
I agree with you that vaccine manufacturing should be driven as if at war. This will be achieved through collaboration. Something wholly lacking outside the scientific community. Perhaps, perhaps collaboration can make the leap that self interest and capitalism has so wantonly failed to do so far.