When will I receive the Covid vaccine? Operation Warp Speed ​​and the American Health System

Sign up here for our daily coronavirus newsletter on what you need to know, and Subscribe to our Covid-19 podcast for the latest news and analysis.

Moncef Slaoui was asked by the Trump administration in May to lead a Manhattan Project-like effort to dramatically reduce the time it takes to develop a coronavirus vaccine and produce hundreds of millions of doses for the American people.

The renowned immunologist and former head of the vaccine division at GlaxoSmithKline Plc is somewhat of a celebrity in the pharmaceutical world. He assumed the role of Chief Science Advisor for Operation Warp Speed ​​with two conditions: “Full Empowerment and No Interference”.

Slaoui, 61, considers the rapid development of several vaccines and the manufacture of millions of doses to be an unprecedented success. However, a slow and confusing rollout frustrated millions of Americans and led the Biden administration to promise to step up the pace. Slaoui said he was troubled that he had failed to get more gunfire.

“A vaccine is useless if it stays on a shelf,” he said.

Speaking to Bloomberg after stepping down earlier this month as an adviser on the US pandemic response at the behest of the Biden administration, Slaoui reflected on a fractured health care system he says is responsible administration problems.

His remarks have been edited for clarity and readability:

Bloomberg: What do you think of the Biden administration’s vaccination goal of 100 million doses in 100 days?

Moncef Slaoui: 100 million doses in 100 days is frankly below the plans we had. We had 100 million people vaccinated at that time. This means two doses. At least in terms of manufacturing and supply, there will be absolutely 200 million doses produced by the end of March or mid-April. So if the ambition is to only use half of it, then that is the ambition. I hope that this objective is achieved and largely exceeded.

Bloomberg: Why is the difference between the vaccine doses distributed and the doses administered so large? Of 39.8 doses delivered in the United States, only 19.8 million vaccines have been administered so far, according to Bloomberg’s Vaccine Tracker.

Slaoui: Having lived in Europe and now in the United States, it’s clear that healthcare systems are so radically different, like opposites. The problem in America is that the system is so fragmented, there are so many health care providers, so many health insurers, so many systems, so many jurisdictions, and people move so much more between them than people move to Europe. It is really difficult to send a consistent message to people and it is difficult to mobilize everyone in the health system at once to do something.

The way we did it, and clearly this turned out to be a problem, was to say, because we can’t align all of these systems, work through them, empower them. We were part of an administration whose worldview was based on less centralization.

Bloomberg: Why has the Trump administration’s approach to working across states not been successful?

Slaoui: What surprises me frankly is that we have visited health administration officials in many jurisdictions and states. We spent two to three hours with them in person and countless hours on the calls. We explained, we are going to have vaccines. There will be a limited number of doses. There will be a prioritization process, and we will assign doses to each state based on the population. And then every state and health care system has to tell us where to ship them.

Every week some health care system in New York or California would say, send 200 doses to that zip code, 300 to that other, and 500 or a thousand to that hospital, and so forth. How can the health care system say with such precision that it wants 200 here, 500 there, 700 here, and then when we ship them with 99.9% accuracy?

The assumption was that these places would be ready to be vaccinated and, frankly, we were not told that we don’t have the resources to do so. So it remains a puzzle for me.

Bloomberg: What could Operation Warp Speed ​​have done differently to meet its goal of delivering 20 million doses by the end of 2020?

Slaoui: I don’t deny the fact that this was far below our target. That we missed it. In terms of vaccine discovery, development and manufacturing, we have moved faster than ever. But a vaccine is useless if it stays on the shelves. It is clear that this has to end in the arms of the people.

Maybe having a hundred stadiums where people could come and get vaccinated would have helped. Or use 200,000 soldiers to come and immunize people in tents. Maybe that’s how you do it. The approach we have in our plan is that as soon as we get past phase 1a, that small population, we would go to pharmacies. There is a drugstore within 10 miles of 90% of Americans. As we reach these populations, which is happening now, the vaccination rate will increase. Right now we are reaching a million people a day, and that will continue to increase according to the previous plan.

Bloomberg: In one previous interview with Bloomberg, you said that Pfizer Inc. turned to the US government to get priority access to raw materials so that we can deliver 100 million doses by the second quarter of this year. Has the US government triggered Defense production law for this purpose? And what would that mean for the relationship between the US government and Pfizer?