I wonder if they, like Pfizer, will take the opportunity to declare that they have shipped 2x as many doses retroactively (in Pfizer’s case it was an extra dose in every vial).
Do you have any source or proof regarding that "retroactively" claim?
Because AFAIK they only started to bill customers for 6 doses per vial when they received official regulatory approval for the 6th dose. Vials delivered earlier were not affected, so any 6th dose gathered from them was effectively free.
You are correct, it was not applied retroactively:
> Gottlieb, the former head of the FDA, clarified that the change is not going to be applied retroactively, meaning that all vials previously shipped out are counted as containing five doses.
You seem to imply that that's somehow a trick or a bad thing, but the only valid purpose to counting number of vaccines shipped[1] is as a proxy for the number of vaccines delivered. The extra doses in a vial were a happy accident, not a trick. And the number we actually want to know is the one we're being given now.
If a vaccine vial was shipped in December and was given wholly to one person, that’s one dose. You can’t claim it was two back then because it couldn’t have been used as two.
The real problem I see is that we count vaccine doses as one shot. For Pfizer and Moderna two shots = one dose. It is misleading to show a two vial dose as two doses.
the vials hold 5 shots and then they were approved to hold 6 shots. this was good because the packaging of the vaccine was one factor in slowing down the spread of the vaccines.
I didn’t think that was the case. I thought that the vials held the same volume regardless. But each vial has some “extra” to account for lost volume in extraction. Let’s say it had 5% extra per dose. That’s almost enough for a complete 6th dose, but not quite. But, if you use a more efficient syringe, then you might save an additional 1% per dose. So now, your 5 dose vial has enough “extra” volume for a complete 6th dose. And the manufacturing doesn’t need to change.
That’s the benefit.
Note: this was always accounted for as “extra” doses. It was part of the plan that there would be extra volume for each vial that could be pooled together for extra full doses. But because they are “extra”, you couldn’t plan on there always being that extra dose (or over the course of a day how many extra doses).
You do need a specific type of syringe in order to extract the 6th dose correctly and it was not the case that 100% of the distribution was set up with that particular syringe in mind.
Also, at least in some places there was a policy that you can't mix the leftover from two vials. So you could have three vials that each have only 0.8 doses in them, you have 0 extra doses, not 2.
That feels like one of the points where bureaucracy is stupidly killing people.
Nah. That's a good rule. Pooling of vials has caused contamination and severe consequences to patients in the past, and it also compromises traceability.
Having bad outcomes from pooling and not knowing whether it came from the combining practice, a certain vial, an entire lot, or even worse-- the fundamental vaccine-- could take the entire vaccination program off the rails. That's not worth it to stretch supplies a few percent.
Just to make sure it's clear to everyone, you need to extract every dose with the special syringes - not just the 6th one. If you use the low dead space syringes for the first 5 doses, the efficiencies add up to enough solution left over for a guaranteed 6th one.
But you can’t count that retroactively for vials where 5 shots were administered and at that point the vial was empty. You can only count that for unopened vials.
Hundreds of millions of people would pay 5x the current price to get the vaccine faster. I feel like the policy of governments getting a monopoly on vaccine distribution is stopping companies in competing for speed of vaccine production and building more factories.
No, that's preposterous, paying 5x more won't increase production capacity any more.
There's already massive incentive to ship first, since there are competing vaccines. If an additional $10B-$100B could result in additional production of mRNA vaccine, it would have been delivered by governments if not by investors.
This is simply a new tech with new techniques. Throwing extra money at a problem when there isn't a chance of increasing production capacity only causes inflation of prices, and rentierism. There is no benefit.
> If an additional $10B-$100B could result in additional production of mRNA vaccine, it would have been delivered by governments if not by investors.
No. No. No.
Not only is there no guarantee that it would have been delivered by governments, there is a major counterexample affecting hundreds of millions of people: the European Union.
The EU tasked a specific body, the European Commission, to negotiate vaccine purchases for the entire bloc at once. The commission approached vaccine negotiations like a trade deal, because they usually negotiate trade deals, and ended up extracting terms that would have been good for a trade deal. They refused to go easy on the manufacturers, and thus "saved" themselves many billions — billions that they would have been much better off sacrificing (to make the negotiations faster, instead of taking months) or outright spending (to speed up production).
Now they are tripping over themselves in an attempt to salvage the mess they made, issuing ill-considered threats to seize production that has been pledged abroad, rather than trying to speed things up.
Please note that the EU is the _only_ Western country that is currently exporting vaccines to the world. It is the US + UK that are blocking all exports. Even Canada gets its vaccines from the EU, since the US is not sending them any.
So yes, clearly the EU has made mistakes (fully agree with the 1st part of your post), but they had good intentions and it is not as bad as you make it sound.
No. The UK government publishes a list of medicines blocked for export[1] and the vaccine isn’t on the list. The EU is solely to blame for being at the back of the queue and are the only state I know of to threaten blocking exports.
Not much difference between using 100% of the locally produced doses locally and blocking it for export. Let's rephrase the question: which countries are the US and UK currently exporting vaccine to and in which quantities?
If you buy up all a local farmer’s apples for your cider business that is not protectionism. If you arrange for him to effectively become your sole supplier during your busy period that is not protectionism. It’s free trade, that well known opposite.
Hard enough to defend the EU’s protectionism and disorganisation when it’s just food, didn’t think I’d see anyone lining up to do it over vaccines.
That's literally apples and vaccines. In the future you might as well not bother with such pointless digressions.
Back on topic: recently read on CNN that the UK contract's exactly the same as the EU one (best effort) and it was signed later than the EU one even if it was negotiated earlier.
If we combine that with the fact that the UK is not exporting any vaccine and the EU is, including to the UK, it seems to me that the EU was right to be upset with AZ and put pressure on them.
The UK is being selfish and trying to make the EU look like the bad guy.
If you're unwilling to be civil and also unwilling to engage in the argument presented to you - even when made clear via analogy - then I'm not sure why you think anyone will bother to listen to you.
The UK is currently not exporting vaccines and there are no countries which are receiving vaccines from the UK.
This is what OP claimed and there is only one argument that can be made against that: a list of countries where the UK or the US is exporting vaccines. By now it should be clear to anyone reading this far that you can't provide that.
> there is only one argument that can be made against that
Again - no, there are other arguments against that, the best being that black and white thinking is a terrible way to analyse reality, the second best being that a list was provided above of medicines blocked for export by the UK and no SARS-COV-2 vaccines are on it.
If the logic evades you further it may help to ask a question: which vaccines are you exporting and is it because you are blocking exports?
That should make it clear that there are more possible reasons for exports not to happen than their being intentionally blocked.
Human beings are able to move past the narrow meaning of specific words and look at the bigger picture, which is that vaccines are neither leaving the UK, nor reaching other countries.
This is the measure that will be used to judge the UK. Whether the vaccine is on some list may be an aggravating factor, but it's otherwise immaterial.
> Human beings are able to move past the narrow meaning of specific words
How convenient. Considering you claimed one thing that was false and are now claiming another thing that is also false but would help make your original claim true because you say so, I think I'll stick with the "narrow" form of interpretation that humans have managed so well with up till now.
> This is the measure that will be used to judge the UK.
Only by those with such strong prejudices that it requires a reimagining of the English language and of logic to help protect them from having to re-examine their notions.
> Whether the vaccine is on some list may be an aggravating factor, but it's otherwise immaterial.
Unless you have evidence of the vaccine being blocked then it is material indeed, however inconvenient that is for you. Feel free to supply actual evidence of the vaccine being blocked that goes beyond "because I say so" and doesn't require pushing words beyond their actual meaning.
I've been trying to say for quite a while now that it doesn't matter why something/someone is not present where they should be, if the consequence is people will die. How hard can it be to understand that? :)
Every country they promised to, which is the core of the matter.
It's one thing to be upfront from the start about how you're going to independently produce vaccine for yourself first, ensuring nobody plans on receiving your production.
It's another entirely to promise to export and then later threaten to hold back.
The EU's local manufacturers were supplying non-locally because they had a contract to do that and the EU hadn't set up such a contract, or a contract at all. Usually, if you've not got a contract then you don't get a say, and usually, if other people set up a contract first, they get supplied first, which is why the EU tried to use other means, and because that jeopardises the most fundamental part of all trade - contracts - everyone condemned them. Quite rightly.
I agree that they shouldn't have tried to squeeze the last cent out of it, while the pandemic is costing much more.
But would it really have changed things if they didn't?
There wouldn't magically have been more factory capacity and it's not like the UK/US would allow for a substantial part of their capacity to be exported.
Then there was also the unfortunate failure of the Sanofi vaccin and the late arrival of the Jannsen vaccin which was just really bad luck for the EU.
A tech comparison would be 4 or maybe 3 nm chips. Imagine everybody in the world would fork over 200B and order 7 billion chips this year... your constraint in that case is the manufacturing equipment and there are only so many experts in that area. The vaccine technologies we are using are scaled for the first time so you don’t have a big pool of experts or companies. The Chinese vaccine is probably the one best suited for scaling up and they are doing that rapidly.
It's a far more remarkable claim that $100B would improve production capacity, since that's a tiny tiny fraction of the costs of delay.
But if you think that producers are intentionally holding back, and don't understand mRNA vaccine differences from adenovirus vaccines that have been used forever, this might help:
OK, but conversely there were literally no mRNA vaccines mass produced a year ago, and now they are delivering hundreds of millions of doses this year - so they've clearly being able to scale production quite quickly.
Its a big claim to say another $100B wouldn't have scaled it faster. I'm sure they still have bottlenecks, and financial risks they weren't willing to take.
$100B is a lot of resources - but a justified amount given the economic costs, which is the point.
If you're writing software, and want the project to be completed faster, does throwing another $100B at a project make it go faster? Usually, this will slow it down, not make it go faster. A classic of the software engineering industry, The Mythical Man Month, is all about this process.
This is a similar sort of process. There's extremely specialized knowledge held by only a tiny number of people, and though there is a plan to vastly expand production, it's never been done before.
The bottleneck is not money, the bottleneck is people. People who have undoubtedly been working themselves to the bone to get this done as quickly as possible.
They're not writing software. Insofar as the vaccine is like software, they wrote the software in about a week. The problem is deploying the software.
This is a mechanical problem. It involves setting up assembly lines. These lines consist of expensive medical equipment, highly skilled installation experts, and skilled operators.
$100 billion could definitely buy or lease more equipment, get it installed, get it inspected, and pay more operators to operate the equipment. It could pay for for scientists and technicians working in related med-tech fields. It could pay their current employers to lend them from their current jobs, guaranteeing their positions upon return. The money could likewise supply any needed training, and if necessary, it could pay them extra money and extra vacation to compensate for the disruption in their lives from working third-shift, so that the machines run overnight.
Money to the tune of billions and hiring lots of the best people is specifically what makes it so people don't have to "[work] themselves to the bone".
Money and time. You can't make the assembly lines overnight, but enough money could make them in a few months. Just copy the designs for the machines they already have. There is probably opportunity to make more efficient machines as well, there almost always is, but that takes longer than a blind copy. Better in the long run, but takes longer to work out the bugs in the new design.
Adding substantial resources can hugely speed up a project.
I will requisition the very best engineers, the best support staff, remove all financial bottlenecks, dedicate shadowing teams to work in isolation in parallel on the critical sections, etc.
> A classic of the software engineering industry, The Mythical Man Month, is all about this process.
First off, if i recall correctly, and it's probably been 20 years since I read it, that mostly applies to late projects that have already gone off the rails.
The broader point isn't true anyway.
We're way better at writing software than we used to be.
I've personally been on quite a few software projects where they became more strategic or promising than they initially seemed, and we threw more engineers at them to speed them up, and they sped up excellently.
This is very different than software. We have plants producing this, we only need to replicate them, all the machines in those plants have drawings, the plants have drawings, the process is documented. It's not like some Ph.D. dude is mixing up liquids in a test tube.
Now granted any money in the world won't have the plant replicated by tomorrow, but enough money will have it replicated much faster. And the process could have been started months ago. Pretty much any vendor will do things faster if you pay them more money and I'm sure this is true for Pfizer's various vendors here. You can order some machine part produced in 3 months or in 3 days (with the latter being like x20 the price, but who cares now).
Yet you presume that the current price is magically the correct one - even though that price is different by region.
What would you say the effect of the government offering half as much would be? 1/10th? At one point does economics matter? I think once you admit money matters on the downside, you have a hard time proving that the point it zeros out of effect as it increases exactly matches the arbitrary point it was actually set at.
The ability for companies to charge what they want for the vaccine would ensure only those that could afford it would receive it, and there wouldn't be additional capital investment because that would dilute profits.
You argue that allowing free markets for vital needs leads to exploitation.
But look at food - capitalist economies have been much more successful at feeding their people than socialist/other highly regulated ones. (Not that they're perfect, no system is). But I think your story of "people trying to make money leads to exploitation" needs some refinement, because it implies outcomes we don't see in reality.
Just compare HK & Singapore to China in the 1960s - free market countries did fine, while communist economies starved their people. The difference is, if you let people do things they want to improve their lives or offer valuable services to others, they will do it. If you make it tough and complex to do this, or prevent them from profiting by their labor, they won't do as much.
The ability to charge what they want and have a monopoly would be bad - but I don't think that's what is being suggested.
The jump from "letting people make things other people want, and charge prices for them" to "let sellers restrict supply of competing goods, and / or force people to buy items at high prices" is a big one - it's the difference between successful capitalist countries which provide cheap goods for their people, and horrible states. The US and Europe still resemble the former, more than the latter, which is why millions of people still try to emigrate here annually.
Needs are wants with greater urgency. Demand is ensured by the ongoing widespread death associated with the virus. Government should stand ready to pay a large price to ensure supply and provide subsidy for those with less means. Regulation, in this case, introduces inefficiency. Inefficiency, in this case, costs lives.
I don’t always want my wants either. The point is that needs usually produce greater motivation. The alcoholic who really wants that drink describes it as a need and works to satisfy it as if it is.
Alcoholism is a disease and addiction. They feel physical withdrawal so alcohol is a need to an alcoholic.
It's sometimes hard to see that because alcoholism is a spectrum and people joke about being alcoholics. Dismissing alcohol as a vice is not unlike dismissing an autistic as overly sensitive.
The OP doesn't actually propose giving the money as profit. An alternative interpretation of his proposal to "let people pay more" would be for the government to offer a prize to companies for producing X number of additional vaccines by a certain day, offering to buy them from the company for say 3x the current price - then selling a portion of those at 5x and giving the rest away for free to need people, to balance out the cost.
This would be a truer test of "Do companies really, really not have any extra capacity? Or are they just allocating resources according to profit maximization, not to maximum effort?"
This is what normal markets ARE - companies take risks and investments for a chance at profit. The government could fake the system by offering high rewards... or we could just let companies do reasonable things like sell 20% of their output at market price.
This reminds me of the CCP in the 1950s where most private land was socialized... and farmers ended up putting all their effort into their private plots, because that was the only work they could do that they'd actually get to keep.
> Free market ignores need and just exploits want.
No, free market relies on the person with the need/want to decide which is which. And the person then takes the consequences of their choice.
> Regulation ensures those in need receive it.
No, regulation ensures that the people making life and death decisions about what is a "need" and what is just a "want" are unelected bureaucrats with no personal stake in the outcome, instead of the people who will actually suffer the consequences.
What do you mean? That individual people aren't capable of deciding what they need vs. what they want and prioritize accordingly? Even if that were true (and I don't think it is), it would not imply that unelected bureaucrats with no stake in the outcome could do any better.
Or do you mean that you refuse to accept any structure of society that allows people to make such decisions for themselves?
No, I mean that no one gets to decide what is a need or a want.
Things are intrinsically a need or they aren't. A need can also be a want, and people can choose to want things but you don't get to decide if something is a need. Calling something that isn't a need, doesn't magically make it need.
You also can't arbitrarily decide you no longer need something. If you can then it was never a need.
> I mean that no one gets to decide what is a need or a want.
If you mean that, for example, no one can "decide" that they don't need food, yes, I agree. But that sense of "need" is irrelevant to the question of how food gets allocated to people, which was the original subject of this subthread. The fact that food is a need, not a want, does not mean a free market in food is not possible or that it does not allocate food better than regulation would. Many countries over the course of human history have run the experiment of having a central authority regulate food allocation instead of letting a free market do it. All of those experiments failed--they resulted in famine, mass starvation and death.
Some people confuse a free market in food with subsidizing food purchases for the poor, as, for example, food stamps do in the US. They're not the same thing. People on food stamps effectively get a certain amount of money each month that they can spend on food. It's true that "food" is, strictly speaking, a regulation of a sort, since, for example, gas stations or car repair shops or drugstores don't accept food stamps, so they're not exactly equivalent to money. But it still leaves a very wide scope for free choice; people on food stamps are purchasing food in a free market, even though their purchases are being subsidized by the government. They are able to choose what items they buy at the grocery store and thereby are sending price signals into the market about their preferences, just like everyone else.
This is true, but also misleading. There would not be more vaccines made if every country were overbidding, Israel is just moving ahead in the queue. It can do this because it is rich and is really tiny.
The Israel strategy would only work for a few select countries in the world.
In the case of mRNA vaccines, according to what I've read the limiting factor is that they depend on specialized precursors that very few companies can make.
Before the COVID-19 mRNA vaccine all mRNA vaccines that had been developed for humans didn't make it past testing. There was no need to have the ability to make them beyond what was needed for research and testing.
And if one of the prior human mRNA vaccines had looked good in the middle of the phase III trial, the low manufacturing capacity would not have mattered. A normal phase III trial takes years, and the diseases the vaccines were for were not pandemics. So even if it takes a couple years to get up to the needed capacity, that would be fast enough.
With COVID-19 mRNA vaccines, we've got (1) an emergency use authorization rather than a normal approval, so a much shorter time between finding out that the thing works and the start of consumer distribution, and (2) it's a pandemic so the number of doses needed is very very high. That's the worst possible combination.
I read that the precursor was using an animal and there is a way to make it artificially (which was not approved by the FDA so far).
I just wish governments were focusing on helping in ramping up manufacturing instead of using the current crisis for stealing as much money as possible (which is happening in my country).
The critical path is microfluidics and machines to make lipid nanoparticles. It's likely these paths are ramping as quickly as possible.
There's no use of intact animals to make these vaccines. I don't think there are any use of animal cell cultures in any of the mainline vaccine paths (though there are some human cell lines used in the adenovirus, etc, vaccines that many people consider problematic).
Oh, well, sure. But the COVID vaccines even at peak production will likely only be using a single digit percentage of the endotoxin tests done in the US in a typical year. In no way can this be considered limiting.
About 60k doses/lot, figure 30 endotoxin tests per lot, that's 1 test per 2k doses =~ 300k endotoxin tests to vaccinate the US.
I guess I can't say I've read them closely, but I don't recall any of the recent articles about the crabs having figures like that (which it is good that it isn't a problem, I'm referring to the articles not getting to the important bit about it not being an issue).
"For now, the industry says it has plenty of horseshoe crab blood to screen coronavirus vaccines. Pharmaceutical companies test a sample from a batch of vaccines, not every dose. And that sample size, say three vials, doesn’t change whether the batch contains 100,000 doses or 1 million, says Allen Burgenson of Lonza.
In fact, Burgenson says, the industry produces enough tests in one day to screen 5 billion doses of coronavirus vaccine."
(I think this is unduly optimistic, because mfrs are likely to screen at multiple steps during production, since the latency of batches is ~100 days, and because lot sizes aren't so large yet. So divide 5 billion by a small integer).
Please do not bring the American healthcare mentality to a product that is needed by literally everyone. The minute people can spend 5x to get the vaccine means that people will need to spend 5x to get the vaccine.
There's absolutely no evidence that this is the case. Money can't buy things instantly, the vaccine ramp is progressing very well as it is, and if you want to claim that a giant check would somehow produce more shots in arms you need to make that case with data. There are only so many units of the nanolipid production equipment available, and only so many factories that can make more, and only so many engineers who know how to operate those factories.
A gaint check could make a difference in the rate six months from now. Though with other vaccines in development that use different processes it is questionable if those would be shots in the arm vs shots made and discarded because we don't need them. Your guess is as good as mine as to which vaccines will work.
> A gaint check could make a difference in the rate six months from now.
Six months from now, assuming no further ramp in vaccine production (which seems extremely conservative given that it reflects only Pfizer and Moderna production), the US will have fully vaccinated almost 60% of the population, which is likely close to a herd immunity threshold.
Increased production beyond that would be wasted money, as the pandemic will be controlled.
If this were purely a logistics problem then I would sort of agree with this, at least in the sense of being an avenue worth trying - but as far as I can tell the current problems with the vaccine are mainly in the nitty-gritty details of actually making it in the first place. Right now the companies doing that can basically write their price.
There aren't many people with the expertise to produce the vaccine, and they're all already working on the existing production lines. The lead times are just inherently long here; takes months to start up a production line.
I would normally argue this case, but "factories" is sort of hand-wavy here. The factories dumping out the feedstock are all producing enough to meet a higher level of production. The mixing step is the bottle neck, and is a really hard, expensive process to scale up. Demand for the vaccine is likely to dry up in a year or two, and companies don't want to drastically over shoot building out expensive single purpose tooling.
> Demand for the vaccine is likely to dry up in a year or two
Aren't many scientific advisors saying that 1) it will take years to vaccinate the developing world, and 2) risk groups may need annual booster shots in perpetuity to deal with mutations?
Potentially but that's not definite. No company will risk profits to invest in an unknown short term demand. They're fine letting people languish so they can ensure maximum profit.
(1) “profit” is just another way of saying “effort”. Would you try and work hard and risk your own money if you knew you weren’t getting paid for it? If you say “yes”, do you actually do that?
(2) they’re probably used to it in this industry, but these pharma companies are really getting more hate than praise these days. “Damned if you do, damned if you don’t.” Except that they’re not actually damned if they don’t, they wouldn’t be in the news at all!
(3) same argument as above, except r/pharma/West. People here developed an amazing technological post-industrial civilisation over centuries, and now we can use this technology to rapidly produce vaccines... yet we’re getting all the hate for not producing, manufacturing, distributing it fast enough.
Profit is not equivalent to effort, that's naive. Profit occurs as much from inaction as it does action.
Profit is exploitation of needs or wants, which isn't necessarily evil. Evil is having the power to stop suffering easily without harming yourself but choosing to seek profits instead (e.g. insulin prices).
Just as we have regulations (e.g. patents) to protect business's profitability, we should have equal regulations to protect the public need.
This may be true, but isn't vaccine fundamentally a delivery mechanism for a custom mRNA strand?
If you build up the infrastructure you could quickly deliver a vaccine for another disease or practically any genetic therapy that could be delivered the same way. Moderna also has an advantage in that the logistics required are simpler.
The mixing step ins't transferable. I'm not super familiar with micro fluid mixing, but it happens on specially created glass plates with channels as narrow as a molecule wide. They's essentially single purpose physical process microchips. Constructing them is a (maybe the) bottle neck. Apparently you can count on both hands the number of people who know how to build these things.
The cost is in ramping up production, actually after it is ramped up, it's generally cheaper to produce an additional vaccine (Wright's law). With the current pace people in most countries need to wear masks for years to come.
Is there any evidence that paying 5x the price would actually result in a faster rollout of the vaccine? At a certain scale and timeline you can't throw money at the problem anymore there's a finite limit to how fast our global infrastructure can operate.
The only thing it would result in is a faster rollout of the vaccine to low-risk individuals with money to spend. Distribution is currently [/supposedly] roughly correlated to risk and public exposure in the early phases. High-risk people with money would just have to spend money they otherwise wouldn't. So this type of plan would come at the expense of high-risk people without money.
This proposal is literally about putting high-risk people at greater risk - and by extension, killing them - so low-risk people with money can feel a little better about eating at a restaurant and drinking at a bar on a Friday night.
Do you feel the same way about Tesla? ”These selfish rich people just wanna feel better about themselves driving their EV vehicles that noone else can afford!” Yet the end result is, that more people can now afford EVs than otherwise could.
I know it’s a bit different with Covid vaccines (AFAIK they were largely sponsored by governments), but the underlying principle of your argument is just wrong - it’s good that rich investors sponsor new technology (even for selfish reasons!) because that makes technology available to everyone, sooner!
I think comparing driving a Tesla when plenty of other cheaper forms of transport exist, with a vaccine to a currently ongoing pandemic that is literally killing people and to which there is no other available vaccine option, is a tad on the ridiculous side.
Yeah but for that reason I’m very thankful that the government DOES have a monopoly on this process. That’ll ensure the vaccine goes to the people that need it the most first, not just the people that can be gouged the most.
Edited to add: I'm not sure what's controversial about this? What did I mess up here? People seem to disagree but aren't, as of about an hour after I replied, saying why.
In a way, we're seeing this happen at the national/country scale already. Countries that can afford it ("that can be gouged the most") are buying hundreds of millions of doses and the systems that are supposed to be getting doses to countries that can't afford it appear to be going wanting.
That's the problem with health care as a capitalistic market. There's no upper bound on what someone would want to pay to preserve either their life or the life of someone they care about. The only limit is on the resources that person has access to, and people will make some screamingly bad long-term decisions in order to satisfy that short-term need for cash.
If we did as the grandparent proposed and opened something like a bidding market for vaccines, you'd absolutely have GoFundMe and whatever the digital equivalent of yard sales are for people who are desperate to get the vaccine but don't have the money. Hell, I already see "please venmo me some cash so I can shelter-in-place away from my relative who has COVID because I can't afford to catch it myself as I'm the only person who makes money for my household."
