[BostonCard]

Operation Warp Speed seems pretty useless I will say. The main thing they did was throw a ton of money at drug companies but when they had a promising vaccine candidate they could have bought more of, they didn't. It seems this will lead to a several month delay or replacement with a likely less effective vaccine.

I'm not sure this is quite right.  Pfizer opted not to participate in Warp Speed for vaccine development.  And for smaller companies like Moderna or Novavax, Warp Speed was a source of funding for an accelerated development program that they would not have been able to undertake without partnering with a large pharma company (as BioNTech did).  The second thing it allowed was manufacturing development at risk.  Normally, manufacturing scale-up would happen in conjunction with clinical scale-up.  You wouldn't develop large-scale manufacturing until you were well into the phase 3 trial because so many things can go wrong.  Warp Speed shifted the risk of building a large manufacturing facility for a failed vaccine from the company to the government.

I'm not sure why the government declined the Pfizer option. It could be because they were not part of Warp Speed, or it could be because they already ad more than enough vaccine ordered up to cover everyone from Warp Speed participants (though of course, timing is an issue).  But the government did seem to miss a chance to order more vaccine from the frontrunner.

As to distribution, although the cold chain is much more logistically challenging, the "last mile", getting vaccine into deltoid, is something that we do have a lot of experience with using annual flu shots.  About 40% of the country's population gets an annual influenza vaccine over the course of about 4 months (October through January).  COVID-19 vaccination is more complicated (cold storage requirement, two doses required), but this is not something entirely new.

BC

[BostonCard]

Operation Warp Speed seems pretty useless I will say. The main thing they did was throw a ton of money at drug companies but when they had a promising vaccine candidate they could have bought more of, they didn't. It seems this will lead to a several month delay or replacement with a likely less effective vaccine.

I'm not sure this is quite right.  Pfizer opted not to participate in Warp Speed for vaccine development.  And for smaller companies like Moderna or Novavax, Warp Speed was a source of funding for an accelerated development program that they would not have been able to undertake without partnering with a large pharma company (as BioNTech did).  The second thing it allowed was manufacturing development at risk.  Normally, manufacturing scale-up would happen in conjunction with clinical scale-up.  You wouldn't develop large-scale manufacturing until you were well into the phase 3 trial because so many things can go wrong.  Warp Speed shifted the risk of building a large manufacturing facility for a failed vaccine from the company to the government.

I'm not sure why the government declined the Pfizer option. It could be because they were not part of Warp Speed, or it could be because they already ad more than enough vaccine ordered up to cover everyone from Warp Speed participants (though of course, timing is an issue).  But the government did seem to miss a chance to order more vaccine from the frontrunner.

As to distribution, although the cold chain is much more logistically challenging, the "last mile", getting vaccine into deltoid, is something that we do have a lot of experience with using annual flu shots.  About 40% of the country's population gets an annual influenza vaccine over the course of about 4 months (October through January).  COVID-19 vaccination is more complicated (cold storage requirement, two doses required), but this is not something entirely new.

BC