There's already massive incentive to ship first, since there are competing vaccines. If an additional $10B-$100B could result in additional production of mRNA vaccine, it would have been delivered by governments if not by investors.

This is simply a new tech with new techniques. Throwing extra money at a problem when there isn't a chance of increasing production capacity only causes inflation of prices, and rentierism. There is no benefit.

No. No. No.

Not only is there no guarantee that it would have been delivered by governments, there is a major counterexample affecting hundreds of millions of people: the European Union.

The EU tasked a specific body, the European Commission, to negotiate vaccine purchases for the entire bloc at once. The commission approached vaccine negotiations like a trade deal, because they usually negotiate trade deals, and ended up extracting terms that would have been good for a trade deal. They refused to go easy on the manufacturers, and thus "saved" themselves many billions — billions that they would have been much better off sacrificing (to make the negotiations faster, instead of taking months) or outright spending (to speed up production).

https://www.economist.com/europe/2021/02/03/how-europe-dodge...

https://www.wsj.com/articles/how-europe-tripped-in-covid-19-...

https://www.politico.eu/article/europe-coronavirus-vaccine-s...

Now they are tripping over themselves in an attempt to salvage the mess they made, issuing ill-considered threats to seize production that has been pledged abroad, rather than trying to speed things up.

https://www.economist.com/graphic-detail/2021/02/01/vaccine-...

So yes, clearly the EU has made mistakes (fully agree with the 1st part of your post), but they had good intentions and it is not as bad as you make it sound.

No. The UK government publishes a list of medicines blocked for export[1] and the vaccine isn’t on the list. The EU is solely to blame for being at the back of the queue and are the only state I know of to threaten blocking exports.

[1] https://assets.publishing.service.gov.uk/government/uploads/...

If you buy up all a local farmer’s apples for your cider business that is not protectionism. If you arrange for him to effectively become your sole supplier during your busy period that is not protectionism. It’s free trade, that well known opposite.

Hard enough to defend the EU’s protectionism and disorganisation when it’s just food, didn’t think I’d see anyone lining up to do it over vaccines.

Back on topic: recently read on CNN that the UK contract's exactly the same as the EU one (best effort) and it was signed later than the EU one even if it was negotiated earlier.

If we combine that with the fact that the UK is not exporting any vaccine and the EU is, including to the UK, it seems to me that the EU was right to be upset with AZ and put pressure on them.

The UK is being selfish and trying to make the EU look like the bad guy.

> it seems to me that

You've busted that flush.

This is what OP claimed and there is only one argument that can be made against that: a list of countries where the UK or the US is exporting vaccines. By now it should be clear to anyone reading this far that you can't provide that.

No, this is what the OP claimed:

> It is the US + UK that are blocking all exports

As to this:

> there is only one argument that can be made against that

Again - no, there are other arguments against that, the best being that black and white thinking is a terrible way to analyse reality, the second best being that a list was provided above of medicines blocked for export by the UK and no SARS-COV-2 vaccines are on it.

If the logic evades you further it may help to ask a question: which vaccines are you exporting and is it because you are blocking exports?

That should make it clear that there are more possible reasons for exports not to happen than their being intentionally blocked.

This is the measure that will be used to judge the UK. Whether the vaccine is on some list may be an aggravating factor, but it's otherwise immaterial.

How convenient. Considering you claimed one thing that was false and are now claiming another thing that is also false but would help make your original claim true because you say so, I think I'll stick with the "narrow" form of interpretation that humans have managed so well with up till now.

> This is the measure that will be used to judge the UK.

Only by those with such strong prejudices that it requires a reimagining of the English language and of logic to help protect them from having to re-examine their notions.

> Whether the vaccine is on some list may be an aggravating factor, but it's otherwise immaterial.

Unless you have evidence of the vaccine being blocked then it is material indeed, however inconvenient that is for you. Feel free to supply actual evidence of the vaccine being blocked that goes beyond "because I say so" and doesn't require pushing words beyond their actual meaning.

Have you noticed the lack of logical necessity in your argument yet?

I'm glad that you now acknowledge that "there is only one argument" is not so, that is definitely progress.

Those people are still dead.

It's one thing to be upfront from the start about how you're going to independently produce vaccine for yourself first, ensuring nobody plans on receiving your production.

It's another entirely to promise to export and then later threaten to hold back.

It's not even that, it's being up front about paying all the local manufacturers to make vaccines for you first.

Perhaps you were referring to something else?

Because from your second sentence it read like an awfully short list if nobody's expecting on receiving vaccine.

But would it really have changed things if they didn't?

There wouldn't magically have been more factory capacity and it's not like the UK/US would allow for a substantial part of their capacity to be exported.

Then there was also the unfortunate failure of the Sanofi vaccin and the late arrival of the Jannsen vaccin which was just really bad luck for the EU.

What makes you so sure of that? What's the manufacturing bottleneck that an extra $100B up front couldn't parallelize?

I just have trouble believing that without some evidence?

But if you think that producers are intentionally holding back, and don't understand mRNA vaccine differences from adenovirus vaccines that have been used forever, this might help:

https://blogs.sciencemag.org/pipeline/archives/2021/02/02/my...

So I can see how that can't go much faster.

For regular tech vaccines, you're probably right.

Its a big claim to say another $100B wouldn't have scaled it faster. I'm sure they still have bottlenecks, and financial risks they weren't willing to take.

$100B is a lot of resources - but a justified amount given the economic costs, which is the point.

This is a similar sort of process. There's extremely specialized knowledge held by only a tiny number of people, and though there is a plan to vastly expand production, it's never been done before.

The bottleneck is not money, the bottleneck is people. People who have undoubtedly been working themselves to the bone to get this done as quickly as possible.

This is a mechanical problem. It involves setting up assembly lines. These lines consist of expensive medical equipment, highly skilled installation experts, and skilled operators.

$100 billion could definitely buy or lease more equipment, get it installed, get it inspected, and pay more operators to operate the equipment. It could pay for for scientists and technicians working in related med-tech fields. It could pay their current employers to lend them from their current jobs, guaranteeing their positions upon return. The money could likewise supply any needed training, and if necessary, it could pay them extra money and extra vacation to compensate for the disruption in their lives from working third-shift, so that the machines run overnight.

Money to the tune of billions and hiring lots of the best people is specifically what makes it so people don't have to "[work] themselves to the bone".

Yes, 100% yes.

Adding substantial resources can hugely speed up a project.

I will requisition the very best engineers, the best support staff, remove all financial bottlenecks, dedicate shadowing teams to work in isolation in parallel on the critical sections, etc.

> A classic of the software engineering industry, The Mythical Man Month, is all about this process.

First off, if i recall correctly, and it's probably been 20 years since I read it, that mostly applies to late projects that have already gone off the rails.

The broader point isn't true anyway. We're way better at writing software than we used to be.

I've personally been on quite a few software projects where they became more strategic or promising than they initially seemed, and we threw more engineers at them to speed them up, and they sped up excellently.

Now granted any money in the world won't have the plant replicated by tomorrow, but enough money will have it replicated much faster. And the process could have been started months ago. Pretty much any vendor will do things faster if you pay them more money and I'm sure this is true for Pfizer's various vendors here. You can order some machine part produced in 3 months or in 3 days (with the latter being like x20 the price, but who cares now).

What would you say the effect of the government offering half as much would be? 1/10th? At one point does economics matter? I think once you admit money matters on the downside, you have a hard time proving that the point it zeros out of effect as it increases exactly matches the arbitrary point it was actually set at.

Regulation ensures those in need receive it.

Scarcity ensures demand, supply erodes price.

The ability for companies to charge what they want for the vaccine would ensure only those that could afford it would receive it, and there wouldn't be additional capital investment because that would dilute profits.

But look at food - capitalist economies have been much more successful at feeding their people than socialist/other highly regulated ones. (Not that they're perfect, no system is). But I think your story of "people trying to make money leads to exploitation" needs some refinement, because it implies outcomes we don't see in reality.

Just compare HK & Singapore to China in the 1960s - free market countries did fine, while communist economies starved their people. The difference is, if you let people do things they want to improve their lives or offer valuable services to others, they will do it. If you make it tough and complex to do this, or prevent them from profiting by their labor, they won't do as much.

The ability to charge what they want and have a monopoly would be bad - but I don't think that's what is being suggested.

The jump from "letting people make things other people want, and charge prices for them" to "let sellers restrict supply of competing goods, and / or force people to buy items at high prices" is a big one - it's the difference between successful capitalist countries which provide cheap goods for their people, and horrible states. The US and Europe still resemble the former, more than the latter, which is why millions of people still try to emigrate here annually.

You don't always want needs. Want is desire. Need is requirement.

People are notorious for trying to satisfy their needs with desires and left feeling unfulfilled.

It's sometimes hard to see that because alcoholism is a spectrum and people joke about being alcoholics. Dismissing alcohol as a vice is not unlike dismissing an autistic as overly sensitive.

This would be a truer test of "Do companies really, really not have any extra capacity? Or are they just allocating resources according to profit maximization, not to maximum effort?"

This is what normal markets ARE - companies take risks and investments for a chance at profit. The government could fake the system by offering high rewards... or we could just let companies do reasonable things like sell 20% of their output at market price.

This reminds me of the CCP in the 1950s where most private land was socialized... and farmers ended up putting all their effort into their private plots, because that was the only work they could do that they'd actually get to keep.

No, free market relies on the person with the need/want to decide which is which. And the person then takes the consequences of their choice.

> Regulation ensures those in need receive it.

No, regulation ensures that the people making life and death decisions about what is a "need" and what is just a "want" are unelected bureaucrats with no personal stake in the outcome, instead of the people who will actually suffer the consequences.

That's your fatal misunderstanding. There isn't a choice.

What do you mean? That individual people aren't capable of deciding what they need vs. what they want and prioritize accordingly? Even if that were true (and I don't think it is), it would not imply that unelected bureaucrats with no stake in the outcome could do any better.

Or do you mean that you refuse to accept any structure of society that allows people to make such decisions for themselves?

Things are intrinsically a need or they aren't. A need can also be a want, and people can choose to want things but you don't get to decide if something is a need. Calling something that isn't a need, doesn't magically make it need.

You also can't arbitrarily decide you no longer need something. If you can then it was never a need.

If you mean that, for example, no one can "decide" that they don't need food, yes, I agree. But that sense of "need" is irrelevant to the question of how food gets allocated to people, which was the original subject of this subthread. The fact that food is a need, not a want, does not mean a free market in food is not possible or that it does not allocate food better than regulation would. Many countries over the course of human history have run the experiment of having a central authority regulate food allocation instead of letting a free market do it. All of those experiments failed--they resulted in famine, mass starvation and death.

Some people confuse a free market in food with subsidizing food purchases for the poor, as, for example, food stamps do in the US. They're not the same thing. People on food stamps effectively get a certain amount of money each month that they can spend on food. It's true that "food" is, strictly speaking, a regulation of a sort, since, for example, gas stations or car repair shops or drugstores don't accept food stamps, so they're not exactly equivalent to money. But it still leaves a very wide scope for free choice; people on food stamps are purchasing food in a free market, even though their purchases are being subsidized by the government. They are able to choose what items they buy at the grocery store and thereby are sending price signals into the market about their preferences, just like everyone else.

The only government that didn't try to get the cheapest price for the vaccine is Israel, and we see the impressive results already.

The Israel strategy would only work for a few select countries in the world.

Before the COVID-19 mRNA vaccine all mRNA vaccines that had been developed for humans didn't make it past testing. There was no need to have the ability to make them beyond what was needed for research and testing.

And if one of the prior human mRNA vaccines had looked good in the middle of the phase III trial, the low manufacturing capacity would not have mattered. A normal phase III trial takes years, and the diseases the vaccines were for were not pandemics. So even if it takes a couple years to get up to the needed capacity, that would be fast enough.

With COVID-19 mRNA vaccines, we've got (1) an emergency use authorization rather than a normal approval, so a much shorter time between finding out that the thing works and the start of consumer distribution, and (2) it's a pandemic so the number of doses needed is very very high. That's the worst possible combination.

I just wish governments were focusing on helping in ramping up manufacturing instead of using the current crisis for stealing as much money as possible (which is happening in my country).

There's no use of intact animals to make these vaccines. I don't think there are any use of animal cell cultures in any of the mainline vaccine paths (though there are some human cell lines used in the adenovirus, etc, vaccines that many people consider problematic).

(and then horseshoe crabs and recombinant factor C)

The FDA should figure out if fFC works and then mandate use of it if it works.

About 60k doses/lot, figure 30 endotoxin tests per lot, that's 1 test per 2k doses =~ 300k endotoxin tests to vaccinate the US.

"For now, the industry says it has plenty of horseshoe crab blood to screen coronavirus vaccines. Pharmaceutical companies test a sample from a batch of vaccines, not every dose. And that sample size, say three vials, doesn’t change whether the batch contains 100,000 doses or 1 million, says Allen Burgenson of Lonza.

In fact, Burgenson says, the industry produces enough tests in one day to screen 5 billion doses of coronavirus vaccine."

(I think this is unduly optimistic, because mfrs are likely to screen at multiple steps during production, since the latency of batches is ~100 days, and because lot sizes aren't so large yet. So divide 5 billion by a small integer).

Six months from now, assuming no further ramp in vaccine production (which seems extremely conservative given that it reflects only Pfizer and Moderna production), the US will have fully vaccinated almost 60% of the population, which is likely close to a herd immunity threshold.

Increased production beyond that would be wasted money, as the pandemic will be controlled.

Aren't many scientific advisors saying that 1) it will take years to vaccinate the developing world, and 2) risk groups may need annual booster shots in perpetuity to deal with mutations?

Several counterpoints:

(1) “profit” is just another way of saying “effort”. Would you try and work hard and risk your own money if you knew you weren’t getting paid for it? If you say “yes”, do you actually do that?

(2) they’re probably used to it in this industry, but these pharma companies are really getting more hate than praise these days. “Damned if you do, damned if you don’t.” Except that they’re not actually damned if they don’t, they wouldn’t be in the news at all!

(3) same argument as above, except r/pharma/West. People here developed an amazing technological post-industrial civilisation over centuries, and now we can use this technology to rapidly produce vaccines... yet we’re getting all the hate for not producing, manufacturing, distributing it fast enough.

A bit unfair, don’t you think?

Profit is exploitation of needs or wants, which isn't necessarily evil. Evil is having the power to stop suffering easily without harming yourself but choosing to seek profits instead (e.g. insulin prices).

Just as we have regulations (e.g. patents) to protect business's profitability, we should have equal regulations to protect the public need.

If you build up the infrastructure you could quickly deliver a vaccine for another disease or practically any genetic therapy that could be delivered the same way. Moderna also has an advantage in that the logistics required are simpler.

What is the basis for saying the vaccine were developed "in a day" if this crucial, specific step was required?

Are there good sources with details on those steps and microfluidic chips?

This proposal is literally about putting high-risk people at greater risk - and by extension, killing them - so low-risk people with money can feel a little better about eating at a restaurant and drinking at a bar on a Friday night.

I know it’s a bit different with Covid vaccines (AFAIK they were largely sponsored by governments), but the underlying principle of your argument is just wrong - it’s good that rich investors sponsor new technology (even for selfish reasons!) because that makes technology available to everyone, sooner!

In a way, we're seeing this happen at the national/country scale already. Countries that can afford it ("that can be gouged the most") are buying hundreds of millions of doses and the systems that are supposed to be getting doses to countries that can't afford it appear to be going wanting.

That's the problem with health care as a capitalistic market. There's no upper bound on what someone would want to pay to preserve either their life or the life of someone they care about. The only limit is on the resources that person has access to, and people will make some screamingly bad long-term decisions in order to satisfy that short-term need for cash.

If we did as the grandparent proposed and opened something like a bidding market for vaccines, you'd absolutely have GoFundMe and whatever the digital equivalent of yard sales are for people who are desperate to get the vaccine but don't have the money. Hell, I already see "please venmo me some cash so I can shelter-in-place away from my relative who has COVID because I can't afford to catch it myself as I'm the only person who makes money for my household."