So you criticize the Janssen vaccine's 20 million projected doses in March, but after months of cranking up their production, Moderna is only at about 40 million doses in that same month. That's the same number of people immunized, of course. Why are you not saying Moderna and Pfizer need to do better? Seems inconsistent.
Anatomically modern humans appeared at least 300,000 years ago, with genetic evidence indicating 500,000. I have no idea where you got that figure of 50,000.
Did you see the coverage of the Kekst survey, indicating increased acceptance of COVID-19 vaccines over essentially the entire developed world?
I don't think I said J&J needed to do better. My comment was pointing out that the major impacts of this vaccine coming to market won't be apparent until April, which is quite true. I think what I actually said was "This is unprecedented and I think it is maybe the second or third greatest healthcare achievement in history..."
Pfizer is leading the pack here, by the way--they anticipate shipping 13 million doses per week in the US during March, meaning at least 26 million vaccinations can be completed. You've opened the door, with this comment, though, to hear my full criticisms of the vaccine rollout in the US, so you're going to hear them :)
In general, we--not any specific company--need to do better. The pace is, unfortunately, still too slow. The US has completed vaccinations among 7% of its population, which is obviously far too low. 20 million doses have been distributed but not administered, which represents 10 days of capacity nationally. We need to expand our capability to administer the vaccines as well as manufacture them.
To forecast on the back of the envelope a little, here's where I see things going: about 25 million people in the US are fully vaccinated. 25 million more are awaiting second doses of an mRNA vaccine (so, of the ~90 million pending mRNA vaccine doses either warehoused or expected to be distributed in March, 25 million will go to completion of existing regimens, leaving 65 million doses for new individuals). Since Pfizer vaccinations can be completed inside a month and Moderna vaccinations require exactly one month, about 13 million of those 65 million doses will go to fully vaccinating individuals. Then the Johnson and Johnson vaccinations should be factored in, offering about 16 million more complete vaccinees (I've just seen a story that indicates J&J will not meet 20 million doses this month, so I've had to revise downward). This puts us on track to reach 66 million vaccinated Americans by end of March, presuming we can actually administer all of the vaccine doses that I'm talking about here, which is a big presumption. That will bring us to ~20.6 of the population fully vaccinated, a far cry from where we need to be. Substantial expansion in J&J deliveries is expected in April still, but do we have the infrastructure ready to deliver them? Time will tell, but I don't think anyone has a very good handle on how effective programs will be as they start to open up to additional people.
I think there are a few key things we could be doing to accelerate this program. (1), the US could purchase the patents for these vaccines and then void them, while paying a premium for the manufacture of additional doses. This would accelerate the process of manufacture; there is currently extant manufacturing capacity for all of these vaccines that is not being used because it is owned by companies other than the inventors. While some manufacturing agreements have been made and others are in negotiation, the private sector approach is moving slower than it might if there were no patents in the way of manufacture. Buying the patents would reward the inventors but remove this obstacle. It wouldn't be a perfect fix because there are regulatory hurdles to pass, but this would indeed bring some more capacity online. (2) Mobilize the national uniformed services' healthcare professionals to support the national vaccination program. I don't believe this has happened yet because vaccinations are being administered at the state level. The states have used the National Guard in some cases to set up vaccination sites, but the federal military has played a logistical advisory role only so far.
And look, I'm aware these are the amateurish policy suggestions of a science communicator. Hammering out the details of these kinds of plans is not my responsibility, though. We have a government that is supposed to be doing that job, and I'd like to see them use every resource available to get it done faster. Maybe it can't be done very much faster than it is currently going, but any increase to the speed of vaccination is a good increase. We need to be creative about this and very aggressive. So far I just don't think we have been, though matters have gotten substantially better with the Biden administration than they were at the end of the Trump administration. Regardless, it's slow, and that worries me not just for the US but for the world.
If the US has been slow, I worry about how soon we will really be able to vaccinate substantial numbers of people globally. Thankfully the COVAX program stands to ship a further approximately 1-1.5 billion doses from Serum Institute of India sometime this year, but that still doesn't come close to fully meeting demand. Since our entire species is susceptible to this virus and there are about 7.5 billion of us, we really need to step up our game.
Re: modern humans, "anatomically" modern is not enough to reach fully modern humanity. There are key aspects of the "modern human" that we do not have evidence of before 50,000 years ago--things like language, music, evidence of shared culture, etc. These things are quite important to what we think of as "humanity." Behavioral modernity and anatomical modernity are separate concepts in anthropology, as described in this review paper: https://www.annualreviews.org/doi/10.1146/annurev.anthro.012809.105113
What I said was that our earliest evidence of modern humans goes back about 50,000 years (to the Upper Paleolithic period). This is a well-known model of the emergence of modern humans in anthropology, called the "Late Upper Paleolithic Model." Modernity in humans very possibly did emerge more than 50,000 years ago, but then again, malaria probably also emerged more than 50,000 years ago (100,000 is considered an upper bound to that estimate). But these are both estimated timelines, and so we are left with a very plausible scenario where "malaria" and "humanity" are equally old. Regardless, this is why I said no matter what the reality is, I feel confident saying malaria is older than *human history*, which is substantially younger than humanity itself.
I did see the Kekst survey data. I don't know exactly what to say about it, but I'm glad that public sentiment for vaccination is improving globally. I think we're nearing the point where if we can vaccinate the percentage of people who say they actually want to get the vaccine, we might get COVID-19 really under control, which is definitely a critical threshold to reach.
Hi, John,
So you criticize the Janssen vaccine's 20 million projected doses in March, but after months of cranking up their production, Moderna is only at about 40 million doses in that same month. That's the same number of people immunized, of course. Why are you not saying Moderna and Pfizer need to do better? Seems inconsistent.
Anatomically modern humans appeared at least 300,000 years ago, with genetic evidence indicating 500,000. I have no idea where you got that figure of 50,000.
Did you see the coverage of the Kekst survey, indicating increased acceptance of COVID-19 vaccines over essentially the entire developed world?
https://www.kekstcnc.com/media/3137/kekst-cnc_research-report_covid19_opinion-tracker_wave-7_march2021.pdf
I don't think I said J&J needed to do better. My comment was pointing out that the major impacts of this vaccine coming to market won't be apparent until April, which is quite true. I think what I actually said was "This is unprecedented and I think it is maybe the second or third greatest healthcare achievement in history..."
Pfizer is leading the pack here, by the way--they anticipate shipping 13 million doses per week in the US during March, meaning at least 26 million vaccinations can be completed. You've opened the door, with this comment, though, to hear my full criticisms of the vaccine rollout in the US, so you're going to hear them :)
In general, we--not any specific company--need to do better. The pace is, unfortunately, still too slow. The US has completed vaccinations among 7% of its population, which is obviously far too low. 20 million doses have been distributed but not administered, which represents 10 days of capacity nationally. We need to expand our capability to administer the vaccines as well as manufacture them.
To forecast on the back of the envelope a little, here's where I see things going: about 25 million people in the US are fully vaccinated. 25 million more are awaiting second doses of an mRNA vaccine (so, of the ~90 million pending mRNA vaccine doses either warehoused or expected to be distributed in March, 25 million will go to completion of existing regimens, leaving 65 million doses for new individuals). Since Pfizer vaccinations can be completed inside a month and Moderna vaccinations require exactly one month, about 13 million of those 65 million doses will go to fully vaccinating individuals. Then the Johnson and Johnson vaccinations should be factored in, offering about 16 million more complete vaccinees (I've just seen a story that indicates J&J will not meet 20 million doses this month, so I've had to revise downward). This puts us on track to reach 66 million vaccinated Americans by end of March, presuming we can actually administer all of the vaccine doses that I'm talking about here, which is a big presumption. That will bring us to ~20.6 of the population fully vaccinated, a far cry from where we need to be. Substantial expansion in J&J deliveries is expected in April still, but do we have the infrastructure ready to deliver them? Time will tell, but I don't think anyone has a very good handle on how effective programs will be as they start to open up to additional people.
I think there are a few key things we could be doing to accelerate this program. (1), the US could purchase the patents for these vaccines and then void them, while paying a premium for the manufacture of additional doses. This would accelerate the process of manufacture; there is currently extant manufacturing capacity for all of these vaccines that is not being used because it is owned by companies other than the inventors. While some manufacturing agreements have been made and others are in negotiation, the private sector approach is moving slower than it might if there were no patents in the way of manufacture. Buying the patents would reward the inventors but remove this obstacle. It wouldn't be a perfect fix because there are regulatory hurdles to pass, but this would indeed bring some more capacity online. (2) Mobilize the national uniformed services' healthcare professionals to support the national vaccination program. I don't believe this has happened yet because vaccinations are being administered at the state level. The states have used the National Guard in some cases to set up vaccination sites, but the federal military has played a logistical advisory role only so far.
And look, I'm aware these are the amateurish policy suggestions of a science communicator. Hammering out the details of these kinds of plans is not my responsibility, though. We have a government that is supposed to be doing that job, and I'd like to see them use every resource available to get it done faster. Maybe it can't be done very much faster than it is currently going, but any increase to the speed of vaccination is a good increase. We need to be creative about this and very aggressive. So far I just don't think we have been, though matters have gotten substantially better with the Biden administration than they were at the end of the Trump administration. Regardless, it's slow, and that worries me not just for the US but for the world.
If the US has been slow, I worry about how soon we will really be able to vaccinate substantial numbers of people globally. Thankfully the COVAX program stands to ship a further approximately 1-1.5 billion doses from Serum Institute of India sometime this year, but that still doesn't come close to fully meeting demand. Since our entire species is susceptible to this virus and there are about 7.5 billion of us, we really need to step up our game.
Re: modern humans, "anatomically" modern is not enough to reach fully modern humanity. There are key aspects of the "modern human" that we do not have evidence of before 50,000 years ago--things like language, music, evidence of shared culture, etc. These things are quite important to what we think of as "humanity." Behavioral modernity and anatomical modernity are separate concepts in anthropology, as described in this review paper: https://www.annualreviews.org/doi/10.1146/annurev.anthro.012809.105113
What I said was that our earliest evidence of modern humans goes back about 50,000 years (to the Upper Paleolithic period). This is a well-known model of the emergence of modern humans in anthropology, called the "Late Upper Paleolithic Model." Modernity in humans very possibly did emerge more than 50,000 years ago, but then again, malaria probably also emerged more than 50,000 years ago (100,000 is considered an upper bound to that estimate). But these are both estimated timelines, and so we are left with a very plausible scenario where "malaria" and "humanity" are equally old. Regardless, this is why I said no matter what the reality is, I feel confident saying malaria is older than *human history*, which is substantially younger than humanity itself.
I did see the Kekst survey data. I don't know exactly what to say about it, but I'm glad that public sentiment for vaccination is improving globally. I think we're nearing the point where if we can vaccinate the percentage of people who say they actually want to get the vaccine, we might get COVID-19 really under control, which is definitely a critical threshold to reach.