My understand is that the problem isn't that we don't have "manufacturing capacity" (we do) but that 1) a lot of vaccine firms are already selling below cost; reprioritizing their production facilities that do money-making vaccines is $$$

2) it takes *time* to scale up https://twitter.com/MaxCRoser/status/1356253436648574977

Folks in the know on AZ seem to think it takes about 3-6 months for a given factory to learn how to get high yields from each batch of vaccine they grow. My understanding is Pfizer/Moderna are even more finicky.

Each vaccine has a somewhat different production process, but the point is that, in extremely brown not-very scientific strokes, vaccines are less "produced" and more "grown" or even "brewed." They have an incubation.

And while it's totally a scientific process, there's also art to it. Two factories using the exact same recipe will get slightly different yield rates based on local processes and conditions, so recipes have to be tweaked for local optimization.

Meanwhile, the idea that "we just don't have the capacity" is clearly wrong.

We have capacity to produce *billions* of vaccines.

But we also vaccinate for flu and measles and hepatitis and tons of other things.

This year we did 192 million flu vaccinations.

That's 20 million *more* than the previous record.

That is to say.... a larger-than-usual amount of influenza vaccines were produced and distributed this year.

Friends who work in the vaccine business tell me there's been a large increase in demand for tons of vaccine categories.

We could in theory tell companies to shut down production lines for, I dunno, Rotavirus vaccines, and repurpose for COVID.

But repurposing those facilities is not a trivial task. It takes months.

It should have been done ***months ago***. There are a LOT of vaccines we could have punted on manufacturing last year. We could have just walked back child/school vax schedules to 2010 norms for a year.

That's like 30-50 million vaccine doses right there that could have been freed up. The death toll from not providing HPV vaccines for a year would have been very low/virtually zero since there's a multi-year window in which it can be given.

But nobody wanted to make real sacrifices to beat COVID. We wanted to make theatrical sacrifices: lock yourself inside and order delivery groceries! That'll show the virus!

What we needed was early and decisive action on these key leverage points.

During the spring I focused my rhetorical fire on 1) effective NPIs like centralized quarantine and travel restrictions and 2) the importance of finding effective and cheap treatment. I talked a lot about worries about higher-R or antibody-evading mutations.

I didn't tweet a lot about vaccines because 1) we knew in February that vaccine trials were already beginning 2) it did not occur to me that governments would not think about the production volumes needed 3) we're all learning as we go here

But *it's not too late now*. Even if it takes two months to get it all online, ***we should be rolling out more vaccine production***.

Why?

Because we are probably gonna need booster shots for new variants, and new variants will continue to appear until *global* herd immunity.

See that's the thing is these new varieties didn't come from America. But they will spread here. And until *the whole world* has hit herd immunity to all circulating varieties, we're gonna need occasional COVID vaccine booster shots.

Which means, investing in "6 million doses a week" production capacity, as I call for in the thread below, is a *very good idea*. https://twitter.com/lymanstoneky/status/1356247853996388352

If we overproduce for ourselves, fine!

Give it away for free to other countries.

That reduces odds we need boosters, and is also a great diplomatic coup.