3 ms·

The thing I don't get is why not try to mass manufacture the candidates before we know they are effective? It seems the work of what drug to make was done reall

The thing I don't get is why not try to mass manufacture the candidates before we know they are effective? It seems the work of what drug to make was done really quickly, and most of the time is spent in the trials, and then mass production. Maybe I missed it, but you'd think with something so devastating we'd just make a bunch of candidates, get them out to the clinics for storage, and as soon as we thought a given candidate was effective start injecting everyone? And if a given drug doesn't work, what's a few billion?

bodyfour 6y ago
That is exactly what happened -- governments around the world paid for pre-approval manufacturing and the pharma industry has spent the last 6-8 months ramping up production. That's the reason we have any supplies at the moment. The truth is just that mass-manufacturing of a brand new vaccine is a hard problem. The fact that we're only a couple months from the very start of vaccinations and the world is already nearing 200 million doses delivered is, frankly, amazing. The only problem is that due to the severity of the crisis we wish we had a magic wand that gave us 10x the supply right this instant. The good news is that manufacturing continues to ramp up dramatically. It just feels like it's slow because we're all so eager for it to improve. If you look at the month-on-month growth, though, it's clearly ramping up fast: https://covidvax.live/ https://covidvax.live/
- hef19898 6y ago
  10 times that! The site you linked is really nice! Not sure where they get the numbers from, but regardless a great resource. One of the more interessting metrics in there is "daily doses per mil", as it shows the difference between the vaccination campaigns. Would be even better if the also shwed when each campaign started.
  - bodyfour 6y ago
    Yeah it's an interesting visualisation of the data. I can't personally vouch for its exact accuracy -- every government reports their metrics on a different schedule and I guess they're building realtime estimates based on that. Certainly seems reasonable enough to look at for the broad trendline.
- bzbarsky 6y ago
  While there was some pre-production, I disagree that vaccine supply is the only binding constraint we have going on. And the lack of sane regulatory approvals and sane distribution setups has been heartrending. If you look at https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/ https://www.bloomberg.com/graphics/covid-vaccine-tracker-glo... and scroll down to "U.S. Vaccination Campaign" you will see that in the US 74.5% of the vaccine doses that have been delivered have actually been used. This could happen for a combination of two reasons, as far as I can see: either delivery is ramping up so fast that most of the delivered doses were delivered very recently, or because people are doing a terrible job of using doses that get delivered. My impression is that the latter is a larger factor than the former, so far, based on the wide variation by state in the "Supply used" column. West Virginia has used ~96% of their supply. D.C. and Rhode Island have used only 60% (and it's not like their populations are larger or more spread out than West Virginia's!). And I should note that I can imagine various poverty-and-social-whatever issues D.C. might be facing, but they don't obviously apply to Rhode Island in the same way. Things like http://www.arnoldkling.com/blog/virus-update-3/ http://www.arnoldkling.com/blog/virus-update-3/ item 3 are pretty common: crazy vaccine-distribution setups meaning people who want vaccines can't get signed up to get them, while vaccines are getting thrown out due to spoilage. Things like https://www.nytimes.com/2021/02/10/us/houston-doctor-fired-covid-vaccine.html https://www.nytimes.com/2021/02/10/us/houston-doctor-fired-c... are, I hope, not common, but you can bet that case will have a chilling effect on efforts by doctors to avoid wasting vaccines. https://www.theguardian.com/global-development/2021/feb/14/we-took-a-huge-risk-the-indian-firm-making-more-covid-jabs-than-anyone https://www.theguardian.com/global-development/2021/feb/14/w... includes this incredible from a major vaccine manufacturer: "Instead we have a patchwork of approvals and I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April." Does that sound like a manufacturing supply constraint to you? Similar is https://marginalrevolution.com/marginalrevolution/2021/01/approve-the-astrazeneca-vaccine-now.html https://marginalrevolution.com/marginalrevolution/2021/01/ap... where we have a vaccine, and a factory that can produce it, and the vaccine is approved in the UK, but it's not approved in the US. This is also not a supply constraint.
  - jounker 6y ago
- aquadrop 6y ago
  Do you have any data/links for "ramping up production"? What exactly was done, how many doses vaccines were available at the moment of approval etc?

bodyfour 6y ago

That is exactly what happened -- governments around the world paid for pre-approval manufacturing and the pharma industry has spent the last 6-8 months ramping up production. That's the reason we have any supplies at the moment. The truth is just that mass-manufacturing of a brand new vaccine is a hard problem. The fact that we're only a couple months from the very start of vaccinations and the world is already nearing 200 million doses delivered is, frankly, amazing. The only problem is that due to the severity of the crisis we wish we had a magic wand that gave us 10x the supply right this instant. The good news is that manufacturing continues to ramp up dramatically. It just feels like it's slow because we're all so eager for it to improve. If you look at the month-on-month growth, though, it's clearly ramping up fast: https://covidvax.live/ https://covidvax.live/

hef19898 6y ago
10 times that! The site you linked is really nice! Not sure where they get the numbers from, but regardless a great resource. One of the more interessting metrics in there is "daily doses per mil", as it shows the difference between the vaccination campaigns. Would be even better if the also shwed when each campaign started.
- bodyfour 6y ago
  Yeah it's an interesting visualisation of the data. I can't personally vouch for its exact accuracy -- every government reports their metrics on a different schedule and I guess they're building realtime estimates based on that. Certainly seems reasonable enough to look at for the broad trendline.
bzbarsky 6y ago
While there was some pre-production, I disagree that vaccine supply is the only binding constraint we have going on. And the lack of sane regulatory approvals and sane distribution setups has been heartrending. If you look at https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/ https://www.bloomberg.com/graphics/covid-vaccine-tracker-glo... and scroll down to "U.S. Vaccination Campaign" you will see that in the US 74.5% of the vaccine doses that have been delivered have actually been used. This could happen for a combination of two reasons, as far as I can see: either delivery is ramping up so fast that most of the delivered doses were delivered very recently, or because people are doing a terrible job of using doses that get delivered. My impression is that the latter is a larger factor than the former, so far, based on the wide variation by state in the "Supply used" column. West Virginia has used ~96% of their supply. D.C. and Rhode Island have used only 60% (and it's not like their populations are larger or more spread out than West Virginia's!). And I should note that I can imagine various poverty-and-social-whatever issues D.C. might be facing, but they don't obviously apply to Rhode Island in the same way. Things like http://www.arnoldkling.com/blog/virus-update-3/ http://www.arnoldkling.com/blog/virus-update-3/ item 3 are pretty common: crazy vaccine-distribution setups meaning people who want vaccines can't get signed up to get them, while vaccines are getting thrown out due to spoilage. Things like https://www.nytimes.com/2021/02/10/us/houston-doctor-fired-covid-vaccine.html https://www.nytimes.com/2021/02/10/us/houston-doctor-fired-c... are, I hope, not common, but you can bet that case will have a chilling effect on efforts by doctors to avoid wasting vaccines. https://www.theguardian.com/global-development/2021/feb/14/we-took-a-huge-risk-the-indian-firm-making-more-covid-jabs-than-anyone https://www.theguardian.com/global-development/2021/feb/14/w... includes this incredible from a major vaccine manufacturer: "Instead we have a patchwork of approvals and I have 70m doses that I can’t ship because they have been purchased but not approved. They have a shelf life of six months; these expire in April." Does that sound like a manufacturing supply constraint to you? Similar is https://marginalrevolution.com/marginalrevolution/2021/01/approve-the-astrazeneca-vaccine-now.html https://marginalrevolution.com/marginalrevolution/2021/01/ap... where we have a vaccine, and a factory that can produce it, and the vaccine is approved in the UK, but it's not approved in the US. This is also not a supply constraint.
- jounker 6y ago
aquadrop 6y ago
Do you have any data/links for "ramping up production"? What exactly was done, how many doses vaccines were available at the moment of approval etc?