Looking ahead to a COVID vaccine: Who will make it? Who will receive it? How much will it cost?

With the number of new cases of COVID-19 continuing to set records in the U.S. and deaths from the disease rising daily, public health officials and politicians have increasingly pinned their hopes of overcoming the coronavirus pandemic on a vaccine.

On May 15, the Trump administration announced the kickoff of “Operation Warp Speed,” an ambitious government effort “to have substantial quantities of a safe and effective vaccine available for Americans by January 2021.” Since then, the administration has identified a number of companies it believes are most likely to successfully produce a vaccine, including Novavax, AstraZeneca, Moderna, Johnson & Johnson, Emergent BioSolutions, Merck and Pfizer, and has awarded them billions in grant money.

On July 4, President Trump all but guaranteed that a vaccine would be ready before the end of the year.

“We are unleashing our nation’s scientific brilliance and we’ll likely have a therapeutic and/or vaccine long before the end of the year,” Trump said during his address from the White House.

Asked about that prediction one day later, Food and Drug Administration Commissioner Stephen Hahn was less certain.

“I can’t predict when a vaccine will be available,” Hahn said.

BONN, GERMANY - JUNE 29:  In this photo illustration a syringe with indefinite content is laying on a globe on June 29, 2020 in Bonn, Germany. (Photo by Ute Grabowsky/Photothek via Getty Images)
BONN, GERMANY - JUNE 29: In this photo illustration a syringe with indefinite content is laying on a globe on June 29, 2020 in Bonn, Germany. (Photo by Ute Grabowsky/Photothek via Getty Images)

The urgency of developing a COVID-19 vaccine is underscored by the number of people killed by the disease. As of Thursday afternoon, nearly 133,000 Americans had died of the disease caused by exposure to the coronavirus. The Centers for Disease Control and Prevention estimates that by July 25th, that number could be as high as 160,000 Americans.

In order to slow the transmission of COVID-19 in the U.S., Dr. Anthony Fauci, the leading expert on infectious diseases on the Coronavirus Task Force, has said that 70 to 80 percent of the population will need to be immunized against it, meaning that at least 230 million doses will need to be manufactured.

Who will pay for a COVID-19 vaccine to be developed and produced?

On Tuesday, the Trump administration announced it was awarding Maryland-based biotech firm Novavax a $1.6 billion grant to deliver 100 million doses of a two-part vaccine (enough to inoculate 50 million people) by January, if it is shown to be safe and effective in clinical trials. That’s a bet using taxpayer money, of course, and it follows other grants already made to private companies who are also funding their own research. All told the U.S. government has so far spent nearly $4 billion on vaccines for COVID-19 that it can’t be sure will ever be brought to market. Congress has appropriated $10 billion for a vaccine, but the Trump administration has said more may be needed.

Dr. Rhonda Flores looks at protein samples at Novavax labs in Gaithersburg, Maryland on March 20, 2020, one of the labs developing a vaccine for the coronavirus, COVID-19. (Photo by ANDREW CABALLERO-REYNOLDS / AFP) / The erroneous mention[s] appearing in the metadata of this photo by ANDREW CABALLERO-REYNOLDS has been modified in AFP systems in the following manner: [Gaithersburg] instead of [Rockville]. Please immediately remove the erroneous mention[s] from all your online services and delete it (them) from your servers. If you have been authorized by AFP to distribute it (them) to third parties, please ensure that the same actions are carried out by them. Failure to promptly comply with these instructions will entail liability on your part for any continued or post notification usage. Therefore we thank you very much for all your attention and prompt action. We are sorry for the inconvenience this notification may cause and remain at your disposal for any further information you may require. (Photo by ANDREW CABALLERO-REYNOLDS/AFP via Getty Images)
Dr. Rhonda Flores looks at protein samples at Novavax labs in Gaithersburg, Maryland on March 20, 2020. (Photo by ANDREW CABALLERO-REYNOLDS / AFP)

To speed deployment, “we’re going to start manufacturing doses of the vaccines way before we even know that the vaccine works,” Fauci said in an interview with the Journal of the American Medical Association.

China is also pouring money into five experimental vaccines for COVID-19 and could come up with a safe and effective one before the U.S., but no one manufacturer has the capacity to produce as many doses as will be needed; health experts estimate from five to 10 different companies will probably need to be enlisted in the effort.

Who will receive the vaccine first?

Because there will be a significant lag time — perhaps several months — between when the first doses of the vaccine are produced and enough are ready to inoculate the majority of the U.S. population, the government has begun working on a ranking system to determine who will receive it first, the New York Times reported.

The Centers for Disease Control and Prevention and a committee of health experts outside the government began meeting in April on the ranking system. The plan, which has yet to be finalized, calls for medical and national security officials to receive the vaccine first, the Times reported. Next up would be workers deemed essential to the economy and people who fall into high risk categories for COVID-19 such as the elderly and people with underlying health conditions.

More controversial, however, is a the discussion of whether to inoculate Black, Latino and Native American citizens ahead of whites since those racial groups are have fallen ill from COVID-19 at disproportionate rates.

BOSTON, MA - JULY 8: A worker with Whittier Street Health Center prepares to collect a specimen from a man who had recently attended a protest outside the Catherine Hardaway Residences in the Roxbury neighborhood of Boston, MA on July 08, 2020. A full day of free community-based testing took place at Central Boston Elder Services and its Catherine Hardaway Residences for the elderly and people with disabilities in the Roxbury. CBES and partner Whittier Street Health Center provided this opportunity to all members of the community who wish to be tested. (Photo by Craig F. Walker/The Boston Globe via Getty Images)
A man is tested for COVID-19 in the Roxbury neighborhood of Boston, MA on July 08, 2020. (Photo by Craig F. Walker/The Boston Globe via Getty Images)

“Among some racial and ethnic minority groups, including non-Hispanic black persons, Hispanics and Latinos, and American Indians/Alaska Natives, evidence points to higher rates of hospitalization or death from COVID-19 than among non-Hispanic white persons,” the CDC states on its website.

Black Americans and Native Americans (including Alaskan native persons) are hospitalized due to COVID-19 at a rate five times that of whites, the CDC data show, while Hispanics are hospitalized at a rate of four times that of whites.

A final decision on the ranking order has not yet been made.

Who makes money off a successful vaccine?

While it is still unclear how much drug companies will charge for a COVID-19 vaccine, most insurance companies have gone on record as saying they will cover that expense for members. There is also a push by Democrats in Congress to make sure that any American who needs a vaccine can receive one free of charge. At the same time, companies have a lot to gain if their vaccines show promising results. Since the Trump administration announced its grant to Novavax, for instance, the company’s stock has risen by 2,527 percent, the Wall Street Journal reported.

In part, that’s because health experts believe that COVID-19 will, like the common flu, become seasonal, requiring a different vaccine every year. That may help explain why companies are rushing to make sure their vaccine is the first to be adopted. The long-term benefits of that association are easily worth billions.


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