The COVID equivalent of the WW2 Manhatten Project
Just fourteen weeks ago, at the beginning of November, there was scepticism from many about whether a Covid vaccine would be possible, even given the low bar (50% efficacy against moderate symptoms) set by the World Health Organisation and the FDA. And even if one of the vaccine candidates did work, could it be produced in volume?
Since then, we have seen a few things happen in vaccine land.
The Pfizer/BioNTech and Moderna vaccines both appeared to be safe and to offer 95% protection against even the mildest of symptoms. The AstraZeneca/Oxford vaccine was somewhat less efficacious, but still cleared the “useful” bar with ease. More recently Novavax announced their UK trial demonstrated 90% efficacy, while Johnson & Johnson’s single shot vaccine proved capable of offering some reasonable protection.
That’s five Western vaccines that have undergone rigorous 20,000+ person trials in a variety of countries, and all of which (to put it simply) work. Plus, if you care to go beyond the West, Russia published results in the Lancet showing 90%+ efficacy for its Sputnik V vaccine. And the Sinovac, Sinopharm and a few other Chinese vaccines also appear to offer some protection – albeit just in the 55-65% range.
Back to the West. CureVac is in Phase 3 right now, and will produce results in the next few months. Valneva has finished Phase 1/2. And there are others, from India, from Canada and from elsewhere that are waiting in the wings.
It’s a scientific effort that parallels the Manhattan Project in the Second World War.
Every single one of the companies listed above is ramping up production right now. Countries have been ordering and reordering and taking up options.
It’s entirely possible that the world will produce more than ten billion doses of CV19 vaccines in 2021.
Scratch that; it’s now looking more than likely that the world will produce more than ten billion doses this year.
Just three companies: Pfizer (two billion), Serum Institute of India (two billion) and Moderna (now forecasting a billion, up from 500 million at the beginning of January) will produce at least five billion doses between them. This year. And the bit that’s really worth noting is that just six weeks ago, those three firms thought they’d only make a little over two billion doses.
Economics dictates that, if you have a vaccine, you need to produce as much of it as you can, as quickly as you can. If your vaccine is available now, you will make billions. If it isn’t around until 2022, you might need to give it away. This is leading to an extraordinary push to ramp up production quickly. Pfizer has licensed Sanofi and Novartis to make its vaccines – which is a little bit like General Motors letting Ford and Volkswagen build its cars. AstraZeneca and Novavax have gotten the Serum Institute of India involved. CureVac has signed up Bayer. And Moderna has gotten Lonza of Switzerland in on the act too. (Their plant alone will be producing close to a million doses a day by the end of May, and exactly none of them will be heading to the US.)
14 weeks ago, the world production of CV19 vaccines was probably no more than a million or two a week. It’s north of 25 million a week now, albeit including production of vaccines that have not yet gotten regulatory approval. Production will exceed 100 million a week by the end of April. It’s insane to think that right now little glass vials are one of the biggest gating factors to greater vaccine production. But you know what – that’ll get solved too.
All of this is unequivocally good news for the world. In just 18 months, we will have gone from the first Western cases of CV19, to sequencing a unique and unusual virus, to at least half a dozen different working vaccines, to everyone in the developed world (and increasing chunks of the developing) having been vaccinated.
A lot of thanks for this needs to go to the UK and US governments. Their willingness to back unproven technologies with big orders, and to encourage investment in manufacturing capability was exactly the right thing to do. And they have also done an enormous favour to the world, because they have both ordered 3-4 times what they need, and that means production capacity exists to serve those who failed to get their act together. Those who paid the bills and made the investment will come out quicker – but their margin of victory will be surprisingly small.