Three hundred million doses from Pfizer. Three hundred million from Moderna. One hundred million from Johnson & Johnson. One hundred million from Novavax.
One by one, the chief executives of America’s COVID-19 vaccine makers promised in congressional testimony to deliver the doses promised to the U.S. government by summer. The projections of confidence come after months of supply chain challenges and companies falling short of year-end projections for 2020.
What changed?
In vaccine making, one of the key bottlenecks is, well, the bottles. The vials that contain the drugs have to be filled, and that can only go so fast.
“It’s simply the throughput of finding the facilities that are able to fill,” said Clem Lewin, an independent vaccine consultant. “You need to qualify them because these are highly regulated products where safety is critical.”
But he said drugmakers that normally compete are now actually helping one another. For instance, Sanofi, whose vaccine is not ready for production, is filling vials for Pfizer. As is Novartis.
Perhaps the drug companies feel they have to collaborate.
“There is some discussion that they’re kind of reluctant,” said Anna Nagurney, supply chain scholar at the University of Massachusetts at Amherst. “But I think sooner or later if they’re promising to double the capacity, you have to keep your promises.”
Another efficiency gain is Moderna’s plan to squeeze 15 doses into a vial, instead of 10, Nagurney said. Some vaccine developers have struck deals with contract manufacturers for so-called fill-and-finish work.
But not every challenge has been solved.
Vaccines from Moderna and Pfizer, which deliver genetic instructions to produce virus proteins that trigger immune system responses, require special compounds called lipids. Certain lipids provide exterior protection for the RNA but were only manufactured in boutique quantities before the pandemic.
“We had never imagined that we were going to need these lipid nanoparticles in the quantities that we now need them,” said Prashant Yadav, supply chain scholar and fellow at the Center for Global Development. “Which means there are very few suppliers in the world, one or two.”
Vaccine company CEOs said they have found new lipid sources, but the specific details of these transactions are vague because supply chains are secret.
“If you’ve got a line on some really good material, or a supplier who is reliable and can provide at scale, you don’t want everybody else to know about that,” said Derek Lowe, a drug discovery researcher.
Two more doses of good news: Johnson & Johnson expects its vaccine to receive Food and Drug Administration authorization any day. And the Novavax version, which is expected to be scaled up quickly and affordably, is assumed to be close behind.
Will offering employees vaccination incentives work?
These incentives range from stipends and extra pay to gift cards and even time off. But there’s plenty of debate among behavioral economists about whether incentives work and what the unintended consequences might be. Incentives are a first step for many businesses to encourage employees to get the vaccine, even though there is precedent for them to require it. Rewarding vaccinations, however, remains legally murky.
What happens if some relief funds are not spent?
Depending on how you count it, the federal government has put up about $4 trillion of pandemic-related relief so far, from loans to tax cuts to new spending. But, said Marc Goldwein, senior vice president of the Committee for a Responsible Federal Budget, “there’s a lot of money still in the pipeline.” Leftover PPP money is sitting in an account. But other expenses, like unemployment, are more like Congress saying, “We’ll spend it if we need to.” But whether this or that program spends everything it was expected to is a very different argument than how much total need is out there in the economy.
How should companies compensate their employees’ work-from-home costs?
A new survey from the compensation software and data company PayScale found that less than 25% of organizations provided any kind of stipend to employees working from home last year. As companies make some level of working from home permanent, they need to think carefully about their compensation policies because figuring out stipends can get tricky, said Shelly Holt, chief people officer at PayScale. Also, a study from the University of Washington found that about 75% of Americans can’t work exclusively from home. Folks working in health care and at grocery stores among so many others.
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