The coronavirus vaccine has arrived. The U.K. began the first post-trial injections of the BioNTech/Pfizer vaccine with a 90-year-old woman on Tuesday, with hospital workers not far behind her. (China and Russia have also begun deploying their own vaccines, but it is not clear yet how effective they are.)
The Food and Drug Administration is somewhat behind the U.K. in its approval process for the BioNTech vaccine, but it is expected in the next few days. Though the virus is spreading completely out of control in almost every state, it's good news on that front at least. Except there's another problem: The U.S. will not have nearly enough doses from Pfizer to vaccinate everyone until well into 2021 at the earliest. Though we may get other vaccines from different manufacturers, the shortfall is just one more inexplicable failure from the most incompetent clod who has ever occupied the White House.
Here's the story. Months ago, the Trump administration agreed to buy 100 million doses of vaccine from Pfizer for $1.95 billion (part of its Operation Warp Speed). But because the vaccine requires two doses, this is only enough to inoculate 50 million people — far, far short of the whole population. Now The New York Times reports that Pfizer repeatedly offered the administration another bite at the supply apple, and it turned them down several times. Other countries have naturally snapped up the doses, and Trump has shamefacedly rushed out an executive order trying to prevent other countries from getting their doses before America. "But the order appears to have no real teeth and does not expand the U.S. supply of doses," notes the Times.
People seem completely baffled as to why the administration rejected Pfizer's offer, and nobody in the administration has even attempted an explanation. The entire point of Operation Warp Speed (the smart if obvious move) was to both incentivize vaccine development and get first crack at the vaccine supply. Yet apparently the explicit goal outlined by the administration was to secure just 300 million doses — or less than half as many as would be required. In this administration the simplest explanation — that it is staffed from top to bottom with gormless, irresponsible sycophants — is usually the right one. (My personal theory is that Jared Kushner did not understand that the vaccine requires two shots.)
Now, as noted above, there are more vaccines just slightly behind Pfizer in the approval pipeline. The U.S. might be able to fill in the gaps with doses from Moderna and AstraZeneca. But declining the additional Pfizer doses was still a brain-meltingly terrible decision, and may well delay a return to normal in this country by several months.
But there are still more intriguing possibilities regarding vaccines that were all foreclosed by Trump's presence in power. As David Wallace-Wells writes at New York, it turns out that the vaccine development happened even faster than I understood in my previous article celebrating how fast it was. The Moderna vaccine took just a single weekend to be developed — literally two days after Chinese researchers released the coronavirus DNA sequence publicly. The Pfizer/BioNTech and AstraZeneca/Oxford formulations were not far behind. What's more, the reason these were developed so fast was that they were built on pre-existing templates that were already fairly well-understood, and therefore experts had a solid and correct suspicion that they would work. "None of the scientists I spoke to for this story were at all surprised by either outcome — all said they expected the vaccines were safe and effective all along," writes Wallace-Wells.
He thus suggests that it might have made sense to start distributing the vaccine as soon as it was known to be safe — skipping the lengthy Phase III trial to find out it was efficacious, which started back in July. That would have involved a certain risk, as people might have believed it made them totally immune to the virus (it may still be possible to spread it after vaccination even if you do not personally get sick), and gone out socializing before true herd immunity was reached. On the other hand, counting all excess deaths this year, something like 350,000 Americans are dead. Cutting that number even by one tenth would have been worth a very large gamble.
But that option would have required careful attention to detail, critical thinking, moderate foresight, competent governance, and above all honest messaging so people would not suspect the president was lying or pulling some sort of self-interested scam. And anything premised on even a scrap of those qualities is completely out of the question so long as Donald Trump is president. The man is a complete dolt who is pathologically incurious about the world and does not care a whit about anyone but himself, and his brand of shameless, emboldened stupidity has conquered the Republican Party. A man who can't even count up how many shots are needed to vaccinate the country would never be the one to grasp the subtle shortfalls in our vaccine approval process, much less shepherd reforms through Congress.
Let's just hope there aren't too many more world-historical failures in store for his last two months in office.