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The experience of J&J and Novavax in vaccine manufacturing shows the importance of vaccine manufacturing and of Quality Assurance in the production of vaccines for coronavirus. The success of Pfizer and Indian companies in vaccine manufacturing shows how important it is to think early and plan early for vaccine manufacturing technologies, personnel and quality assurance. This is also why the US effort, India's billion vaccine target in 6-12 months of planning, is a great effort in thinking ahead of every aspect of vaccines and vaccinating, planning of all details, hard work, by Pfizer, by Indian pharmaceutical companies, and by the Modi and Biden administrations. 

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Pfizer's Covid vaccine is expected to bring in $6 billion in profit in 2021. Pfizer increased its sales forecast by 70 percent. The coronavirus vaccine is expected to bring in $26 billion in revenues in 2021 with 1.6 billion vaccine doses manufactured for the year 2021. The total could be much higher with the company striving for supply contracts to manufacture 2.5 billion doses.

India has approved the Pfizer, Moderna and J&J vaccines, with this bringing American companies into the Indian vaccine market in 2021.

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How do you setup a vaccine business. Consider Mr. Adar Poonavalla in the city of Pune in India. His company Serum Institute of India, remains family owned. Founded in 1966 by Cyrus Poonavalla, it produces billions of doses of vaccines for measles, polio and other diseases. It is expected to be one of the key sources of vaccines because of its expertise and the stocks of vials and other supplies that it has in stock for the next 2 years of vaccine production. It is working on a separate facility for coronavirus production that could turn out 800 million doses of vaccine at a price of about $13 a dose over 2 years. Serum Institute is working with 3 companies that are doing the research on the vaccine for coronavirus in the U.S. and Europe, and will play a key role in the manufacturing of vaccines. To respond to the question how do you setup a company to produce vaccines for the people of the world. This is what Mr. Poonavalla says- he will only work with ethical long term funds and sovereign funds because he does not want to be in the situation where he has to charge high prices to give them returns. Unlike most countries in the world, India is unique in making certain that most of the basic pharmaceutical drugs are available to over a billion people at a low cost. Serum's goal is low cost quality vaccine production so that over a billion people in Asia can be "protected from the birth onwards." As the U.S. and Europe and large parts of Asia, Africa and Latin America, face the second vaccine phase of the coronavirus response following difficulties in PPE, Ventilators, and Masks in the first phase, they can have confidence because of companies such as Serum and the research centers in U.S. and Europe like the one at Oxford University. ...

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The French British collaboration effort will bring a new vaccine to the global effort against coronavirus. This vaccine was expected in February 21. It will be ready by the third quarter of 2021 just as vaccine supplies are being ramped up. The Sanofi Pasteur unit and GSK Glaxo SmithKline are the two companies in this vaccine venture. This vaccine will address the problem of new mutations of the virus in the British and South African versions and can be stored at normal temperatures. 
 

The new vaccines will boost supplies just when the situation is bleak for vaccine supplies in Latin America and Africa, South East Asia, places left out in the vaccine race in advanced countries and in India. Britain has ordered 60 million doses. 

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With better control over the coronavirus than U.S. and Europe, South Korea is not rushing to buy the vaccines developed by Pfizer or Moderna. It is waiting to see how the vaccine rollouts work in other countries before buying the vaccine. South Korea is also looking at getting better price from manufacturers after the rollouts in the U.S. and Europe. South Korea is moving cautiously and has said it wants to get 10 million doses through the Covax initiative the main global effort to provide broad access to vaccines. Another 20 million doses would be secured from private companies. This is in contrast to the approach in Japan where the government has signed deals for purchase of 290 million doses for 145 million people for its population of 126 million. The money allocated is $6.5 billion and the goal is to vaccinate everyone by first half of 2021.  If it works this would prepare Japan for the Tokyo Summer Olympics to open in July, after 1 year delay. South Korea has the freedom to do this and wait to see what vaccine works best with least long term effects because their are relatively fewer cases there. A total of 313 new daily cases on November 18, lower than daily cases in a single county in the state of Michigan in the U.S. Moderna and Pfizer vaccines use anew kind of gene based technology that has never been approved to prevent infectious diseases. Other competition is the vaccine from Oxford and Astra Zeneca which uses an existing technology that is used in existing vaccines modified for use in coronavirus. The Oxford vaccine and a vaccine from Johnson and Johnson are expected to have a lower price. Because life is functioning very close to normal South Korea is in the unusual position of saying that its people have no reason to be anxious for vaccine procurement, as indicated by its deputy director of Korea Disease Control and Prevention Agency. Only three fifths of the population is the target for vaccination by fall of 2021. ...

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Moderna has made the initial batches of doses of the vaccine for the variant of coronavirus including South African variant, and shipped these to the National Institutes of Health in the US. If the test results are positive the vaccine for variant could be given authorization by the third quarter of 2021. It is becoming crucial to stay ahead of variants developing from the coronavirus and pharmaceutical companies Pfizer, J&J, Astra Zeneca are working on the technology to tackle this.

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This video in The Indian Express shows how president Biden invoking US defense act provisions to ensure supplies of vaccine ingredients to US companies prevents exports to countries that badly need it. India has surpassed 300,000 daily cases of coronavirus on April 22, and India's largest vaccine manufacturer Serum Institute of India says vaccine manufacturing in India is restricted because of president Biden invoking that law. 

India's vaccination drive is stalling because of not enough vaccine supplies.

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In some countries such as Tanzania and Chad the vaccination drives have not even begun says this report in the DW.com. A new surge now underway in Africa as cases increase by 30% in June comes at abad time with African vaccination drives stalled. Only 31 million doses adminstered in Africa for a population of 1 billion people. Less than 1% of world vaccine supplies are going to poor countries in Africa and Latin America.

Vaccine companies chose to sell their vaccines to the highest bidders, putting Covax  behind. Aims of Covax are also coming down and watered down to vaccinating 20% or 30% of the population in poor countries, says this report in DW.com.

This means new variants could develop and move back to Asia and Europe, the US in 2022. It means the coronavirus could affect African economies in 2022 and beyond.

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As the coronavirus surges in India with over 300,000 cases a day on April 26, a clear picture on the vaccination drive in the country is critical. The following is the picture of the vaccination progress from Union Health Ministry in India as shown in The Hindustan Times. India has vaccinated 140 million people with at least one dose says this report in The Hindustan Times.  On Saturday 24th April 2.4 million doses were given for that day at 8 pm. This was done over 99 days. This means about 12% of the population of 1.2 billion has been vaccinated.  This compares with the vaccination in Germany for about 21% of people vaccinated with over 18 million getting the first dose in Germany by around April 25. Both Germany and India have suffered from vaccine shortages, some skepticism about vaccinations. Gradually sentiment is shifting in both countries so that once skeptical Germany now has about 75% of people willing to take vaccine on April 25, 2021. In India about 6 million healthcare workers have 2 doses of vaccine, and about 9 million have 1 dose. About 6 million frontline workers have 2 doses and 12 million frontline workers have 1 dose of vaccine.  There is a shortage of vaccine supplies and a bold decision was made by the Indian government on April 25th 2021, after the surge of cases to a world wide maximum of over 300,000 cases a day. The decision was to give immediate regulatory approval for the three major vaccines in the US to be brought and used in India. And delivery will be speeded up - no customs duties and fast processing of supplies access to speedy logistical supply routes. This is a huge step forward for the vaccination drive as this means Pfizer, Moderna and J&J vaccines can now be used in India. The government is also urging the companies to make in India or export to India with prices that provide flexibility in pricing for the private market. The locally produced Covishield Astra Zeneca based vaccine produced by Serum Institute will be allowed to be sold to the private market at 600 rupees or close to about $10. Pfizer and Moderna, J&J can price in a way that would be somewhere around this price range. The access to more vaccines and the ability of the companies to make a reasonable profit in the Indian private market means that vaccine supplies should open up in May and June.  This could give a huge boost to vaccination numbers so that India's vaccination percentage of population vaccinated should keep up with that in countries like Germany and France that were slower to get started in Europe but are now catching up quickly. This is a massive achievement because the population numbers are huge compared to Europe. ...

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The title may not reflect the content of this report on Admiral Giroir who heads the U.S. coronavirus testing effort. He is a pediatrician who worked for hospitals in Texas before heading a vaccine project at Texas A&M University.  Internal politics led to his resigning from the effort to build a vaccine development capability with pharmaceutical companies at Texas A&M. Most of the rest of this report shows a physician who is determined to pursue big projects such as the one he is tackling today. President Trump appointed him to lead FDA, and to be the Assistant Secretary of the Department of Health and Human Services. With the missteps of Secretary Azar testing suffered in the early months of the crisis as reported in the WSJ. Adm. Giroir has taken a leading role since  this period. He also heads the U.S. Public Health Service Commissioned Corps of 6200 staff playing a vital role. On March 13 he was asked to lead the effort in testing.  He comes to this role with experience in the field of vaccines realizing that "the challenges are not just biological but engineering." New technology would be needed to make massive amounts of vaccine. His idea is that transformational efforts are needed. His idea for a billion dose per month facility in Texas did not work, yet he worked on it for about 5 years from 2010 to 2015 at Texas A&M University, at one point being the vice chancellor. He was selected by Texas Governor Perry as chairman of the task force in Texas in 2014 to oversee the effort to fight the Ebola virus. He now is in a position to bring all his experience and aspirations to tackle the coronavirus, cutting through much of the red tape and bureaucracy, and pulling together the effort combining science of pharmaceutical companies with the technology of manufacturing billions of vaccine doses in a record time. Today he sees capacity for testing reaching 40-50 million tests a month by September 2020.   ...

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The crowded sports stadiums for soccer games during early February in the Lombardy region accelerated the spread of coronavirus in Italy by the end of February. The sports stadiums soccer games spread the virus like wildfire in northern Italy. This is why along with nursing homes, sports stadiums pose the greatest threat from coronavirus. The tens of thousands of people from a single game can contaminate as many as 40,000 or 50,000 people as these 10,000 people go on subways, restaurants and other places. This spreads to millions very quickly creating a wildfire effect. Airports and sports stadiums or music venues, theatres have this wildfire spreading effect that is then compounded by the use of public transport and restaurants other close proximity places, spreading it far and wide. These are also not essential activities as work and office, employees working at companies or in manufacturing, which are essential to the economy.  This is why in terms of priority sports and leisure travel can be deferred till a vaccine is developed. Business travel is increasingly being substituted by using videoconferencing and other ways of staying in touch remotely. ...

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The Labour party's support for not withdrawing from the European Medicines Agency is the subject of an argument after Prime Minister's Questions in the British parliament. Labour leader Keir Starmer confronts prime minister Boris Johnson in parliament after Johnson reminds Labour that it had on repeated occasions called for the UK not to withdraw from the European Medicines Agency.  The UK vaccination drive is far ahead of the vaccination drive in European Union countries including France and Germany, because of British initiative in boldly betting money on vaccine supplies with pharmaceutical companies, and earlier approval by the UK health regulatory authority. Here is the comment in the House of Commons by Boris Johnson- "If we had listened to (Starmer), we would still be at the starting blocks because he wanted to stay in the European Medicines Agency and said so four times from that dispatch box." Starmer disputes the statement. The Times cites Hansard, the official record of the House of Commons. It records that Starmer questioned why Britain would want to withdraw from the Medicines Agency in Jan. 2017. In 2018 Labour party supported an Amendment to the Trade Bill that called for the UK to seek participation in the European Medicines Agency. Germany, Spain and France are hit hard by the second wave of the coronavirus and the lack of adequate vaccine supplies is causing grief in European Union. The EU president Von der Leyen, another European Union style bureaucrat, seen as having bungled the handling of vaccine supply. ...

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This report in WSJ shows what offices would look like in a coronavirus economic reopening. Till a vaccine is developed in about one year from now what will the gradual reopening look like?   It shows a cafeteria at a company in Seoul with plastic shields separating each person, the Amsterdam office concept of six foot distancing offices at Cushman & Wakefield. This real estate company manages 800 million square feet in China real estate. It has developed a 300 page manual on safely reopening offices with every detail possible. Toyota plants will run at slower speeds because of large drop in demand, with plants reconfigured to maintain social distancing. Many companies are doing this now when it is easier to do without people. Protocols such as onsite health screenings are being integrated. A Knotel app  will add features for office tenants that gives employers the option to track some employee movements and trace their contacts to prevent illness. For sports and event venues the challenge is sanitation and cleanliness. Adding janitorial cleaning shifts and making food grab and go, cashless transactions and protective shields. Schools and colleges face a challenge of how many students to let in, and how many to seat and how, dorms with one room one student, and so on. One college in Maine is planning for thinning the students on campus, rotating students with shorter term modules, more online instruction.  ...

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Most American large companies support president Biden's decision to mandate vaccinations for all employers with more than 100 employees. Smaller business also supports the decision as it makes this decision for them. The US Business Roundtable of the largest US companies issued a statement saying it "welcomes the Biden Administration's continued vigilance in the fight against Covid." It went on to applaud the decision of some companies to implement a vaccine mandate before the president's decision. Companies would like to see a rapid ramp up in testing capacity as they see testing capacity levels not the vaccine mandate as the real problem today with the surge in Delta variant. These companies such as Target, Nike, and retailers see testing capacity as "stressed" and say "testing capacity must be scaled immensely to meet the new requirements." Labor unions clearly support president Biden's decision including teachers associations, and the AFL-CIO. Some companies including Delta Airlines are imposed health surcharges for unvaccinated employees, and United Airlines has brought in its own vaccine mandate. The president's vaccine mandate has broad and deep support of the American people and business, according to this WSJ report, with recognition of the huge risks posed by the transmission rates of the Delta variant in the surge of coronavirus in September 2021. However companies say the Biden Administration has to scale up testing capacity quickly to make it work. ...

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Some of the concern about the economy comes from the economic damage done by the coronavirus. The longer the shutdowns continue the more the damage. About 17 million have filed claims for unemployment benefits. The WSJ consensus of 57 economists is that 14.4 million jobs will be lost in coming months, and the unemployment rate will rise to a record 13% in June, from a 50 year low of 3.5% in February. The earliest the economy could go back to the level in February 2020 is 27 months says the WSJ economist survey. The brighter side of this comes in two aspects of this pandemic recovery curve. By flattening the curve and strict testing, contact tracing and isolation till the vaccine is developed about half the jobs lost can be recovered by the end of summer, says Moody's Analytics. The vaccine a year from now or in 9 months by November 2020 would allow the economy to recover faster. A more optimistic view comes from Daiwa Capital Markets which predicts many of people laid off will be recalled quickly allowing the labor market to recover in 6 months by September or October 2020. Only finance and real estate might take longer but most of the industries where the vast majority of jobs are could be back on their feet. The credible evidence supporting this perspective of a rebound comes from Colorado and Washington which require large employers to specify whether layoffs are temporary or permanent, 70% this year are temporary. Compare this to the prior 2009 recession where this figure was less than 1%- as reported by WSJ. The big push in this direction will be the $2 trillion that the Trump administration and U.S. Congress have committed to this task. Even more so is the determination of president Trump to protect American workers at all costs, that every job counts, and that businesses without exception to get the money have to show that workers are retained. The very success of the aid is being judged by how quickly people are back to work. Now for a look at where the situation is today- Oxford Economics, a UK based forecasting and consulting firm, projects 27.9 million jobs lost with industries other than those ordered to close making up 8 to 10 million of that number. It projects April's report will will capture late March layoffs. It will show cuts to 3.4 million business services workers, including lawyers, software groups, architects and consultants, advertising professionals, in addition to 1.5 million non-essential healthcare workers, 100,000 information workers. One conclusion of this report is that the virus does not discriminate across business groups and business service workers are also affected. Many companies that were hiring will cancel that move and many will cut hours worked. Many of these business services are not a priority. Hospitals are affected too, as they cut elective surgical procedures and routine care that are major revenue sources. Some are now charging for telemedicine visits to maintain some revenue stream. State and local governments employ 20 million workers. As tax receipts decline these local governments will face choices of cutting payrolls and services without enough federal government relief. In a way laying off workers and having them take unemployment benefits shifts that burden to the federal government so that services for overtime to police and paramedics, retention and deployment of nurses in schools.    ...