Some countries are seeking to give their citizens enhanced doses against the Corona virus, while many other countries are still far from achieving the goal of reaching the basic doses, which reflects a stark disparity in the availability of vaccines between countries that are able to do so and others that have nothing of their own. The purpose of the booster doses is to boost immunity as the effect of the primary vaccine begins to weaken over time.
Scott Duke Comminers, associate professor of economics at Harvard Business School, said in a report to “Bloomberg” that at a time when America and other developed countries began distributing booster doses of vaccines against the Corona virus, there are many countries concerned that this could slow down The global vaccination campaign thus prolonging the pandemic and causing more damage.
But Cominers explained that there is a way to deliver the booster doses and, at the same time, speed up the next phase of vaccination in what he saw as the difference between “push and pull.” He explained that nowadays vaccines are mostly purchased through so-called withdrawal contracts. Producers limit total production capacity and countries simply buy or withdraw from the resulting supply.
This means that if richer countries, which tend to honor their contracts more quickly, start offering boosters, other, mostly poor countries, will have to wait longer for their first doses.
In most markets, this type of equation in which the winners and losers are equal (zero-sum) is only a short-term problem. If enough buyers want to withdraw simultaneously, there is a strong incentive to expand capacity in order to provide new supplies. But a key part of the economic equation is missing for vaccines. Increased demand is not driving prices enough to make investment in new capacity worthwhile for producers.
Comminers says that the prices of contracts for Covid-19 vaccines are often much lower than market prices, and with good reason. Price increases would exacerbate already widespread inequality in access to vaccines, most of which are income-based. Besides, the faster we make vaccines available to everyone, the faster we stop the development of new mutated strains and we hope to put a sustainable end to the pandemic. This is the definition of the public good.
This means that we need to think about vaccine production and procurement differently from other commodities. Instead of buying vaccines through withdrawal contracts, we should use so-called payment contracts, that is, orders that represent explicit commitments to purchase additional doses of the vaccine and install additional production capacity to manufacture some or all of those doses. Cominers believes that this strategy will not solve the problem overnight, especially since orders for early booster doses limit current supply.
“But if capacity is expanded enough through the contractual shift that I’m proposing, then total production should be able to increase enough for other countries to catch up and eventually surpass the current vaccination pace,” he adds.
To be sure, expanding production capacity will require more than just contractual reform. America and other countries still have to do what they can to counter the effect of the booster doses on global vaccine supplies in the meantime. Medical ethicists Govind Persad, William Fisk Parker and Ezekiel Emmanuel have proposed a series of strategies for this purpose including giving boosters in smaller doses and mixing and matching vaccines to maximize antibody production.
And the layers of the supply chain will need support. Vaccines require a range of ingredients and trace elements on everything from bioreactor bags to marine horseshoe crab blood used in vaccine development. And vaccine production on our current, unexpected scale has put pressure on those elements.
So far, 6 billion doses have been administered, an astonishing feat in less than a year. Yet that is not enough to stop an epidemic that threatens to decimate countries at the bottom end of the vaccine availability line and release more harmful strains. To tackle a pandemic we have to change the way we think about buying the vaccines that help us beat it.