Nations jockey to see who gets coronavirus vaccine first

The race to develop a successful coronavirus vaccine is also setting off jockeying between countries on another key question: Who gets it first?

Even if a successful vaccine is developed in the coming months, already a massive challenge, there will not be enough initial doses to vaccinate everyone.

Nations and companies are pledging to cooperate and share a vaccine, but the country that first develops a successful one is likely to have the upper hand. 

Scott Gottlieb, President Trump’s former Food and Drug Administration commissioner, wrote an op-ed in The Wall Street Journal last month titled “America Needs to Win the Coronavirus Vaccine Race,” arguing that “the U.S. can’t rely on vaccines from China or even Europe being available in America quickly.”

“It’s not politically correct to say it, but it’s inevitable that the first country that’s able to mass inoculate the population’s going to probably have more of an ability to experience an economic recovery than other nations that will be further behind in that race,” Gottlieb said Wednesday during a forum hosted by the Duke Margolis Center for Health Policy. 

The first doses of a vaccine will not be available until late this year at the very earliest, an extremely ambitious timetable, but there are already emerging tensions over where they will go first. 

The drugmaker Sanofi provoked outrage in its home country of France this week when its CEO, Paul Hudson, told Bloomberg News that the U.S. will get the vaccine first because the U.S. government provided funding for its development. 

The U.S. expects “that if we’ve helped you manufacture the doses at risk, we expect to get the doses first,” Hudson told Bloomberg. 

French President Emmanuel Macron summoned Hudson for a meeting next week. Sanofi sought to clarify in a statement that it is committed to making the vaccine available to “everyone.”

“We have manufacturing capacity in the U.S., Europe and all other main regions,” the company said. “The U.S. production will be mainly for the U.S. and the rest of the manufacturing capacity will cover Europe and the rest of the world.”

The World Health Organization hosted a meeting at the end of April of world leaders from Europe and other countries to discuss cooperation on a vaccine, but the U.S. did not attend, and Trump has attacked the WHO. 

One of the potential vaccines that could be ready first, with the first doses as early as September, is being developed by Oxford University in the United Kingdom. 

Adrian Hill, director of the Oxford institute working on the vaccine, said Wednesday during the Duke forum that the U.K. government has already spoken to the university about getting priority for the doses of the vaccine. 

“We’re being told in the U.K. that we’ve had a lot of U.K. government money, we have, the U.K. would like some doses, soon please,” Hill said. “That’s going to be the response everywhere, how do you cut a deal?”

“How is all of this going to come together?” he added. “The big manufacturers are only in half a dozen countries, that can produce hundreds of millions. Are they going to keep all of the vaccine until they’ve vaccinated their own country? … Any country that can do that will be very, very tempted to do that.”

The White House declined to comment on the details of its plans for allocation of vaccines. 

President Trump, speaking at a vaccine event at the White House on Friday, expressed confidence countries would work together to allocate the vaccines, but did not get into specifics. 

“Whoever gets it, we think it’s great, we’re going to work with them, they’re going to work with us,” Trump said. “Likewise if we get it, we’re going to be working with them.”

Secretary of State Mike Pompeo told an Israeli journalist on Wednesday that, “We’ll figure out the model for distribution when the time comes.”

“I hope that we will all collectively find a way to produce this at high volume to get it all across the world,” he said. 

Of the eight potential vaccines that have entered clinical trials, according to the WHO, four are in China, which would pose an even greater diplomatic challenge for U.S. access compared to close U.S. allies like the U.K. Another of the eight is the Oxford vaccine and three others are developed by U.S. companies: Moderna, Inovio and Pfizer, though Pfizer is also working with the German biotech firm BioNTech. 

Pfizer spokeswoman Sharon Castillo said the company would work closely with regulators and health authorities to meet areas of “greatest need” around the world, not just in the United States. 

Three global health experts, Thomas Bollyky, Lawrence Gostin and Margaret Hamburg, wrote an article in the Journal of the American Medical Association this month to warn that in the 2009 flu pandemic “wealthy nations bought virtually all vaccine supplies.” They called for a framework, coordinated by the WHO, for “evidence-based, health-driven” allocation of vaccines. 

Another factor is all of the other supplies needed beyond the vaccine itself, like vials, syringes and needles. 

The U.S. recently awarded a contract for 500 million pre-filled plastic syringes for administering a vaccine, which can help get around a shortage of glass needed for making vials, said Prashant Yadav, a senior fellow at the Center for Global Development. 

Yadav said one way to deal with allocation of the vaccine between countries would be for the U.S. to use the first 100 million doses of a U.S.-made vaccine to inoculate vulnerable people like the elderly and health care workers, and then make the next batch of vaccines available to other countries. 

In return, the U.S. could ask for similar arrangements if another country develops a vaccine first. 

In doing so, he said, “we will hedge our bets.”