STAT reports:

The WHO has called for equitable sharing of Covid-19 vaccines, insisting they should be seen as a global resource. But there have been concerns from the earliest days of this pandemic that countries that are home to vaccine production facilities will nationalize any output to ensure domestic needs are met before vaccine can be exported for use elsewhere.

Robin Robinson, who led the Biomedical Advanced Research and Development Authority from 2008 to 2016, said the agency has spent billions of dollars building up vaccine production capacity in the United States based on that assumption.

A recent recipient of BARDA funding is Moderna, which is expanding production capacity at its Norwood, Mass., facility. “We’re going to be making millions of doses per month in 2020, ramped to tens of millions of doses a month in 2021,” CEO Stéphane Bancel said recently.

“We are highly aware that given almost everybody on the planet needs to be vaccinated, we’re going to need a lot of capacity. And we are discussing with a lot of parties how to get there,” Bancel said. “Are we going to get to a place where we can do seven billion doses next year? The answer is clearly no. But are we in a place where we could be even doing another five-times, ten-times increase from the tens of millions of doses per month? We’re working very hard and when we have a clear plan we’ll communicate about it.”

The Cambridge, Mass.-based company announced last week that it had signed a deal with Swiss pharmaceutical company Lonzo to help produce 1 billion doses of the vaccine in the U.S. and in Switzerland.

While China has extensive vaccine production capacity and several developing countries — including India, Indonesia, and Brazil — are among the world’s largest vaccine producers and exporters, a sizable amount of the manufacturing capacity belonging to pharmaceutical companies that sell vaccine in North America and Europe is based in the United States.

Marie-Paule Kieny, who formerly led the WHO group responsible for spurring development of epidemic and pandemic vaccines and drugs, said when the global health agency worked on pandemic planning in the lead-up to the 2009 H1N1 influenza pandemic, it was proposed that health care workers around the world have first access to vaccine. That group, she said, is estimated to be about 2% of the global population — roughly 156 million people.

“I think it’s reasonable to say that this should be the first target, because as we’ve seen everywhere, including in the U.S., when you have a health system which cannot accommodate sick people, then everybody suffers,” said Kieny, who is now research director at Inserm, the French equivalent of the National Institutes of Health.

Health care workers would likely followed by people at the highest risk — those 65 and older and people with chronic health conditions, like diabetes, that have been seen to increase the risk of dying from Covid-19, Robinson said.

“I don’t think that the general population will have vaccine probably until the second half of 2021. And that’s if everything works OK,” he said. [Continue reading…]