The earliest Moderna probably would have sold the mRNA-1273 vaccine would have been after it began scaling up manufacturing. A company doesn’t begin manufacturing until it believes in a product. In the timeline above, that’s March 23. But manufacturing takes some time to get going. Let’s assume that by April 1, five weeks from the date the first batch was shipped, Moderna begins offering mRNA-1273 for sale.
Sales start slowly. Supplies are limited. Only the bold and brave get inoculated. The rest of us, and Moderna, get some early, albeit messy, safety and efficacy data. This data helps Moderna improve the vaccine, dose, and dosing schedule. Having a ready market and a steady source of revenue, Moderna scales up production faster than in the timeline above.
In this scenario, inoculations could have begun at least 8.5 months earlier and, perhaps, the pandemic would have ended 240 days and 240,000 lives earlier. There’s little talk of lockdowns and the economy remains resilient.
This is from Charles L. Hooper and David R. Henderson, “The FDA’s Deadly Caution,” AIER, December 16, 2020. In it, we consider various scenarios for what would have happened had we had a truly free market in pharmaceuticals.
The one above is the most optimistic.
Read the whole thing.
READER COMMENTS
Alan Goldhammer
Dec 17 2020 at 7:38pm
If your hypothesis was true, why was there not a vaccine available in China on April 1, or for that matter Russia or any other country with the know how to produce such a vaccine (and yes, China has been working on an mRNA vaccine among other constructs). Arguably, the Oxford vaccine could have been available then as they had past experience with their vector having used it for an Ebola vaccine.
Under your scenario, there appears to be a world-wide abundance of caution. Why?
Also, your estimates on manufacturing do not accord with vaccine production reality. It isn’t just flipping a switch but rather getting the process scaled up sucessfully (in the case of mRNA vaccines this had never been done before), establishing criteria for lot release, and a bunch of other stuff.
It’s easy to throw darts when you have a confirmation bias. And yes, I did read the whole thing
Mark Z
Dec 18 2020 at 12:27pm
Was vaccine development not constrained by the national governments in those countries? The main difference was merely that their governments were less cautious than ours.
And overall, their vaccines were safe and even effective. I would say there’s good evidence that retrospectively we in the west were excessively cautious, and our priors on the safety and effectiveness of even early stage vaccines should change. That, of course, does not prove that, at the time, given what information we had, the US’s level of caution wasn’t justified, but it’s also worth considering that people who were saying we should be much less cautious about releasing vaccines had a point all along. Turning out to be right about an apparent unknown in retrospect should count for something.
Peter Gerdes
Dec 18 2020 at 6:29pm
Why would there be? Authoritarian leaders are still concerned about public opinion (they stay in charge in large part by not generating too much discontent) and less concerned about the loss of life by their population.
So let’s game this out. If Putin releases a vaccine in April and then it turns out not to work or even be dangerous Russia is embarrassed on the world stage and he draws ire from his citizens. OTOH if he waits until other countries release a vaccine all that happens is some citizens die but he’s not blamed.
john hare
Dec 18 2020 at 5:03am
Find one country in the world where the vaccine distributer could operate unfettered Alan. Even besides control by politicians, there is the very real possibility that a company could save a hundred thousand lives with a vaccine, and yet get destroyed by lawsuits of a couple of alleged vaccine caused deaths. There is little downside to any politician in the world for obstructing distribution, and many incentives to not be held responsible for any problems. It’s not just in the US.
Thomas Hutcheson
Dec 18 2020 at 7:50am
OK. Just exactly how much, if any, delay by FDA is the correct amount? How should DFA go about figuring out that correct amount? If you and Hooper are entirely correct, who is supposed to do what right now?
It is really too bad (and I’m not being ironic here) that Libertarian skepticism about government and insights about public choice are not turned to proposals for institutional reform. They might not be the same reforms that neo-Liberals would favor, which will probably have some redistributive elements, but how could they not improve the likelihood of getting better outcomes?
Henri Hein
Dec 18 2020 at 1:30pm
There has been lots of libertarian proposals on how to reform the FDA. A common one is make it a labeling-only requirement. FDA approval allows the manufacturer to label the drug as such, but approval is not needed to market it. That way, manufacturers could choose to market non-approved drugs and consumers could choose to use labeled or unlabeled drugs, according to their risk preferences.
There has also been libertarian proposals what to do right now. One is to take government out of it and let Pfizer and Moderna sell the vaccines to the highest bidders. Another is to allot vaccines to health workers and other priority groups, but make them tradeable. In either case, there is no real need to have government involved in distribution.
Thomas Hutcheson
Dec 20 2020 at 1:31pm
I am award that that there are ideas for DFA reform floating around, but this article had no hint of awareness of those ideas or any tradeoffs involved in them.
J Mann
Dec 18 2020 at 2:38pm
I’m fascinated by Alan Goldfarb’s question – assuming it was possible to get a vaccine available by Summer 2020, why didn’t any country anywhere do it? I’d love some opinions from people with domain experience.
Some leading possibilities:
A combination of (a) countries that might have had the willingness to shorten or eliminate some of the safety or efficacy studies didn’t have the technical capacity to develop a vaccine quickly, and (b) companies that had the capacity to develop a vaccine over the weekend can’t participate in no-study or accelerated-study markets without getting sideways with developed country regulators or social pressure.
Fast tracking a vaccine is harder than it sounds to us non-experts for valid reasons. The vast majority of countries and companies wouldn’t want to make the shortcuts that it would take to get a vaccine on the shelves in 6 months, for reasons that we should take more seriously.
Some of the other possibilities (this is obvious, but nobody in power can see it; or people in power don’t take Covid seriously, etc.) don’t seem likely to me.
J Mann
Dec 18 2020 at 2:39pm
Alan Goldhammer! So sorry!
Jon Murphy
Dec 18 2020 at 3:05pm
Many countries (including the US and GB) have export restrictions on medical products. Those restrictions have become even stricter during the pandemic.
Peter Gerdes
Dec 18 2020 at 6:31pm
Releasing early (on this theory) is clearly a trade off between lives and popularity (ever dem country seems to have similar laws so ppl must like them). The authoritarian countries will tend to care less about the lives so it’s not surprising but see full response above.
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