On Vaccinating the World

From TPM Reader JL

I wanted to pass along some thoughts on vaccinating the world. I don’t claim any particular expertise or even objectivity on the subject, but I do have a perspective that seems a bit contrarian and perhaps worth sharing for that reason alone.

The gist is that I’m fairly optimistic that the world will get vaccinated in not much more than a year. Let me start with a huge caveat, which is that by the world getting vaccinated I mean that the world as a whole will get close to the point where the US will be in a few months or so—approaching 60% of the population fully vaccinated. If that happens the global situation will be vastly improved but it certainly doesn’t mean the pandemic will be over. How not over it will be will depend on variants, ability/willingness to test & trace, and a myriad of other factors.

Back to the optimism part though. I start by looking at the current rate of global vaccination (excluding China which is balls to the walls right now but is already starting to taper off as happened in the US). Per Bloomberg we’re doing 20 million doses a day ex China. If that is sustained for 10 months that would be 6 billion doses. Adding that to the 1.5 billion non-Chinese doses to date, you get 7.5 billion doses, which would cover 3.8 billion people or about 60% of the non-Chinese global population.

I have a strong hunch that this rate of vaccination is a pretty good proxy for global vaccine production. If that’s right then the question becomes (a) can that rate of production be sustained, (b) will the financing be found, and (c) can distribution problems be resolved. Again, I don’t have any particular expertise here but I’m optimistic. The Novavax vaccine is particularly helpful. It will help directly on the production piece but indirectly on the financing piece as well, as countries/consortiums will have multiple options and competitive pressures will keep prices manageable. And if production and financing are in place, that gives everyone a lot of motivation to solve distribution challenges.

I think there is this sense out there that our current rates of vaccination & production are a drop in the bucket and we have to find a way to scale things up dramatically. Hence the patent debate, which seems completely beside the point to me. The fact is though that we’re producing enough vaccine to get this done relatively soon. There are a million problems to be solved to make it happen, but I suspect the incentives are powerful enough that the world will stumble through. If there’s one piece I’m concerned about it’s the local distribution piece. But my sense is a lot of developing countries actually have relatively functional public health systems.

Let’s hope my optimism proves well founded!

It’s this last part JL mentions that I’m most curious about. Last mile distribution is perhaps the most critical part of the equation, particularly since the most effective vaccines require deep freeze refrigeration. I would think this will be or could be a big challenge in sub-Saharan Africa, some parts of South and Southeast Asia and in certain parts of the Americas. But often I realize that my gut sense of the state of infrastructure in the ‘developing world’ is a quarter century out of date. So I’m curious to hear what people more knowledgable than I can tell us about this distribution part of the equation.

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