As of Monday, every person 16 or older in the United States is officially eligible for a coronavirus vaccine shot. Daily doses administered have crept up past 3 million, and in most parts of the country appointments are easily available. Half of all adults have gotten at least one shot, and about a third are fully vaccinated.
But some parts of the country are already struggling to use up their available shots, a problem that is only going to get worse. Meanwhile, much of the rest of the world has barely started on its vaccine rollout, and numerous poorer countries have not administered a single dose. The pandemic is still raging out of control — last week saw the highest number of global infections ever.
What’s more, American regulations are potentially starting to get in the way of the rest of the world producing their own vaccine supply. It’s long since time President Biden started sharing America’s surplus vaccine and also took steps to make it easier for the rest of the world to crank up production.
What’s happening in the American vaccine rollout is easy to understand: steadily-increasing supply is catching up with demand or outstripping it in some states, and so doses are starting to pile up fast. The problem is worst in conservative regions, because Republicans are disproportionately resistant to the vaccine — Arkansas, Mississippi, Alabama, Georgia, Tennessee, and Wyoming have used less than 70 percent of their allotment (and that figure is falling), and the Biden administration is considering altering deliveries to get shots to where demand is higher. Other states are still managing to get their supply into arms, but within weeks they will no doubt run into the same problem. Already many places are adding community vaccination clinics in addition to large, central facilities to make it as easy as possible for busy or distracted people to get their shot. But this will probably not take up the ever-growing supply, and in any case America has already ordered enough doses to vaccinate our entire population more than three times.
Very soon we will be swimming in surplus.
That is not remotely the case outside the U.S. Big chunks of sub-Saharan Africa have not gotten any, and most of the rest of the continent is at less than 1 percent vaccination. The situation is similar in much of Central and Southeast Asia. Europe is doing somewhat better, but that continent is still far behind the U.S., and Belarus and Ukraine are also barely started.
The world very badly needs those surplus vaccines, and America should start sharing. As I have previously argued, we should just give them away for free — it would be both a diplomatic coup and a way to ensure that payment worries don’t foul up vaccination campaigns in the poorest countries.
But not only that — the Biden administration must act to protect and expand the global vaccine supply chain. Biden has invoked the Defense Production Act to accelerate domestic vaccine production, but this comes with rules against exporting related products, which will soon screw up international production. The point of the DPA is to allow the government to control domestic production and raw materials in times of emergency or war, and using it made sense earlier in the pandemic so that we could make sure U.S. factories are going at top speed. But now that the kinks have mostly been ironed out, it makes sense to allow exports to maximize global capacity. For instance, India has the largest vaccine factory in the world, and The Economist reports: “Production lines in India, making at least 160 million doses of COVID-19 vaccine a month, will come to a halt in the coming weeks unless America supplies 37 critical items.” (These include things like plastic tubing, special bags, chemical reagents, and so on.) It would be stark madness to let those factories fall idle; Biden must either issue export clearances or retract his invocation of the DPA.
Intellectual property rights have also tangled up efforts to accelerate vaccine supply and get it to where it is needed, as Alexander Zaitchik writes at The New Republic. Rich countries have so far blocked efforts from poorer ones to get IP waivers through the World Trade Organization so that anybody with the equipment could manufacture the vaccines. Instead of the vaccine technology being placed in the public domain where any laboratory could potentially use it, pharmaceutical companies are keeping their patents under lock and key (obviously because they are scenting huge future profits), and countries like South Africa and India have only been able to manufacture vaccines through licensing agreements, and so far the Biden administration has stood behind Big Pharma.
Now, it is not entirely clear that a waiver alone would speed up production that much. Pretty much every pharmaceutical company with appropriate facilities is already working on vaccines. The mRNA production process in particular is exceptionally complicated and difficult, and it may be that a lack of broader technical knowledge and equipment is the real bottleneck. But in that case, there’s no reason why the U.S. government couldn’t, say, buy Moderna — whose vaccine was already developed with help from the National Institutes of Health, and on which the federal government owns part of the patent — and broadly share the details of its entire production process, as opposed to just the vaccine itself. Or the government could use that patent to force Moderna to license all needed information. In any case, an IP waiver would certainly not hurt.
I suspect that Biden has so far prioritized American vaccine supply over political concerns — he didn’t want Fox News shouting about foreigners getting “our” vaccine (though who knows what they would say given that the network has become a hotbed of anti-vaccine misinformation), and of course Big Pharma always has the ear of political elites in this country.
But the supply worry is now moot. America has enough vaccine to go around, and soon it will be far more than enough. Most Americans will intuitively understand the case for sharing — this pandemic started outside the country, and we have already seen multiple coronavirus variants crop up (indeed, a recent poll found 60 percent of Americans support a patent waiver). It’s not impossible that another variant might emerge that gets around all the existing vaccines. Allowing the virus to continue circulating anywhere is therefore a clear and present danger to the health and safety of Americans (in addition to, you know, being a screaming humanitarian emergency).
Whatever it takes to start getting shipments of vaccines sent around the world, the cost would be microscopic compared to the risk of another pandemic. The Economist estimates the world could produce up to 14 billion doses of vaccine this year, but many poorer countries are predicting at their current rate they will not be fully vaccinated until 2024. Let’s stop being greedy and end this thing.