Post #698: Vaccines, the US begins to do the right thing

Posted on May 21, 2020

Edward Jenner.  Source:  Wikipedia.

I read some truly astounding news today:  The US chipped in $1B toward development of the Jenner Institute (Oxford University) vaccine, via AstraZeneca.  And AstraZeneca agreed to provide 400 million doses with manufacturing capability for up to 1 billion (world-wide).

This doesn’t astound me on the technical or financial aspects.  It astounds me because this is absolutely the right thing to do, and the US Federal government is actually doing it.

It’s the right thing to do because a) they are ahead of everyone else, b) their vaccine looks promising, c) they’ve already lined up the manufacturing capability, and d) AstraZeneca has agreed to provide the vaccine at cost.

For those of you not up on the minutia of the US drug industry, AstraZeneca has a major local presence in its research facility in Gaithersburg, MD.  Among several other such facilities worldwide.

You can look back to my Post #677 (4/30/2020) for references to the original news coverage of this vaccine.  That’s the date on which the Jenner Institute partnered with AstraZeneca. And less than three weeks later, the USA BARDA is partnering up as well.  May miracles never cease.

Isolationism and Crony Capitalism

Up to now, the US vaccine effort seemed to be a toxic mixture of isolationism  and crony capitalism. 

Isolationism.  When the rest of the world got together to pledge a group effort at vaccine production, and pledged to provide vaccine to the third world — the US pointedly refused to participate.

Offhand, I can’t recall the US ever, in my adult lifetime, refusing to help provide vaccines to poor nations.  Why?  Because we’re nice guys?  No.  Because we make money doing it?  No.

We did that because it’s insane not to, given the cost/benefit ratio for the vaccines in question. E.g. polio vaccine costs about a dollar a dose.  At that price, the idea that the wealthiest country on earth wouldn’t do its bit to (e.g.) try to eradicate polio just made no sense.

Trust me, I was not the only person who was shocked and appalled by the US refusal to participate internationally.  You can read several quotes here.

Historically, our leadership in this area was one of the great, unambiguously good things that the USA did for the world.  Ranks right up there with the Marshall Plan.  Or did, back when the US actually was a great nation, like, four years ago.  For us to abandon that role, at this time, is just an amazing statement about what we’ve become.  And it doesn’t speak well of us.

But today, this contribution to the Jenner Institute effort is, in effect, a back-door way to join the international effort.  Even if we only made the contribution to obtain access to the vaccine, money is money.  This helps us, and because AstraZeneca has made a strong commitment to provide this vaccine internationally, it de facto makes the US a participant in those international efforts.

Which is why I’m waiting to see if this particular move gets countermanded from above.

Crony Capitalism:  At present, the head of the Federal effort to coordinate domestic COVID-19 vaccine production is the former head of one of the companies in the running.  And so, we’re all supposed to turn a blind eye to that, and say, oh, I’m sure he’ll make a fair and even-handed choice.  Regarding the billions of dollars the US will spend purchasing COVID-19 vaccines over the next few years.

Believe what you want.  To me,this had the stench of crony capitalism.  The decision is wired, one of the good ol’ boys gets the dough, because the head of the chosen firm gets to direct the flow of tax dollars.  You, the taxpayer, get to live with the results.

The upshot:  With that as background, I had assumed that the US would just ignore the British vaccine, resulting in months of delay in getting any vaccine unto the US market.  Astrazeneca has already committed to providing 30M doses in Great Britain in September, assuming that all the trials show that the vaccine works.  (Everything so far suggests that it does, but you never know until the final test results are in).

And so, cynic that I am, I assumed that the US public would have to wait an additional half-year or so, for vaccine, so that the chosen US company could make the required high level of profits producing it.  Then, today, the US BARDA announces this decision.

So cynic that I am, I’m waiting for somebody higher up in the administration to countermand that, to protect the monopoly position of the anointed US firm.   I would normally say, that’s too cynical, but I’m not sure that phrase applies to the US federal government any more.

In general, the vaccine situation looks promising

You will read, and you will continue to read, negative coverage about a vaccine for COVID-19.  In my opinion, the people writing that stuff understand neither the economics nor (typically) the technology of vaccines in this case.  And, weirdest of all, they completely ignore what the absolute cream of drug manufacturers, world-wide, have already pledged to do.

For example, read Post #623The world’s largest (and most profitable) health care manufacturer has said, they’ll have an effective COVID-19 vaccine in production by Spring 2021.  With a billion doses soon to follow.

Do you really think that organizations of that caliber and expertise are just kind of shooting the breeze about this?  Or do you think that various pundits are in the business of producing gloom-and-doom click-bait?

Let me just list a few that I know about, that have promising vaccines in the works, and either have the capability or can partner with the capability to produce the resulting product:

Those are just the heavy hitters that I happened to have stumbled across.  Within that small group there is a variety of methods, a range of delivery dates, and billions of doses of manufacturing capacity already committed to production.  I just find it hard to remain pessimistic given those facts.

Economics:  People who point to typical vaccine development times totally ignore the economic factors that drove vaccine development in the recent past.  Here’s what they miss:  Historically, the development of generic vaccines for common diseases was a truly lousy business to be in.  There was just no money in it, compared to alternative drugs that companies may pursue.  You can read a good overview of this at The Atlantic.

So a lot of what you read about how long it takes to produce a vaccine comes from that era.  Nobody was particularly interested, nobody could make good money doing it, and it was not in the vital national interest to see vaccines developed.  In most cases, there was only a limited market, and much of that might be in low-paying third-world countries.

And, accordingly, yeah, in the typical case, nobody was in any particular hurry to do so.  I hope it goes without saying that none of that applies to the current situation. 

Technology:  Again, much of what you will see from the pessimists, about vaccine development times, dates to earlier epochs.

When I was a kid, they literally cultured the raw material for vaccines — including the annual flu vaccine — in chicken eggs.  (No, I am not making that up.)  They would literally inoculate the eggs, one at a time.  They’d have batches of vaccine fail because the eggs didn’t turn out right.

Back in the day, that was the only approach possible.  It was time consuming, chancy, and expensive.

Now, that’s laughably out-of-date, right?  Nope, that’s still how they do it, for most flu vaccine, even today.  But at least today, for flu vaccine, that’s only one of several methods in use.

My point being,  you don’t need to incubate millions of chicken eggs to produce a vaccine any more.  (Though, apparently, that’s still a viable way of doing it, for flu vaccine.)

And the same goes for all the techniques and methods of vaccine production.

The Jenner Institute vaccine, for example, more-or-less produces a dummy COVID-19 virus, and gets the body to react to that.  So that, if the real thing shows up, the body is already producing the relevant antibodies, and will recognize and destroy the COVID-19 virus.

In this case, they took a weakened form of a cold virus and spliced in the genetic code for a key protein of the COVID-19 virus.  The resulting Franken-virus is at least as safe as the common cold, but it shows that key COVID-19 protein on its exterior coat.  And, in theory, the presence of that foreign protein in the body stimulates the immune system.  The body produces antibodies to that latch onto that specific COVID-19 protein.

That way, when the real COVID-19 shows up, the body is ready for it.  The antibodies do their job — they latch onto a specific protein, and in so doing uncurl a flag that signals the immune system to attack whatever they are attached to.  And the body mounts an immediate defense against the virus.

And this is only one of the approaches in the modern vaccine tool kit.  It’s a long way from culturing virus in eggs, carefully heating it to kill it (but not destroy key proteins), and injecting the resulting dead virus.

All I’m trying to say is that much of the historical timelines for vaccine development really don’t apply to the modern era.  Back in the day, sure, there was a strong hit-or-miss element to it.  And even today, it may prove difficult, which is why the US is backing a portfolio of contenders, and so spreading its risks.  But it would be foolish to take historical timelines as our guide to what can be achieved today.