- They are preventative. Americans are scared that regular people walk into hospitals and debt peons walk out. We are too sickly and scared for preventative medicine, and like our infrastructure which is never maintained to the point of being in "good working order".
- They are O(1) dose. The unity economics of once-and-done is bad. Better to sell something which makes a customer for life.
It's really depressing.
Because money. Operation warp speed started mass manufacturing at the same time as clinical trials. 70% of drugs fail the 3rd stage of trials, so that would be a hugely wasteful endeavor to parallelize this when failure is the norm.
Safety? I'm not wild about new vaccines requiring emergency use authorization and indemnity for the manufacturer. It worked out fine for COVID, but this is not a model I would _want_ to replicate.
Or re-focus the monetary models around either markets or patient outcomes. Right now, medicine is not a market, it's a strange game. The most money that can be made is finding a treatment that may provide a modest increased benefit over what is live, then sell it to medicare at "name your own price". This incentives high probability wins (which are typically things we already understand well).