Covid 5/6: Vaccine Patent Suspension

The Biden administration’s latest strategy for the pandemic is to suspend the vaccine patents without compensation. Our life expectancies are lower than they were last week.

It’s a shame. I like the idea of rewarding those who do amazing things for myself and for the world. I like people out there knowing that if they produce amazing things for myself and for the world, they would get rewarded for them. I like the idea of not dying for as long as possible thanks to future developments in medical science. I like being a nation of laws, where the executive doesn’t just take stuff when he feels like it. And I’d like, when nice things are taken away and we mortgage our future, to at least get something out of the exchange.

Alas, the man in charge does not agree, and the government was not content with its previous efforts to sabotage the vaccination effort. That’s how it goes sometimes. You can’t always get what you want. Nor, when no one is given the incentive to produce what you need, are you likely to get that either. 

Let’s run the numbers.

The Numbers

Predictions

Prediction from last week: Positivity rate of 3.9% (down 0.5%) and deaths decline by 6%.

Result:

Nailed the positivity rate. Johns Hopkins has us down from 3.9% to an all-time low of 3.6%.  Deaths rising makes no physical sense and the move up doesn’t show up in the Wikipedia data, so this has to be a data fluctuation one way or another. I’m going to guess that it will revert.

Prediction for next week: Positivity rate of 3.5% (down 0.4%) and deaths decline by 7%.

Deaths

DateWESTMIDWESTSOUTHNORTHEASTTOTAL
Mar 25-Mar 311445976256412626247
Apr 1-Apr 71098867178911604914
Apr 8-Apr 1410701037162111454873
Apr 15-Apr 21883987174711684785
Apr 22-Apr 287521173160911104644
Apr 29-May 5943122014409714574

The bump up in the West comes from California, which makes it harder to dig in deeply. The bump in the Midwest is more curious, but should reverse soon. Overall we see a disappointingly small decline, but still a decline, and it should pick up speed.

Cases

DateWESTMIDWESTSOUTHNORTHEAST
Mar 18-Mar 2447,92172,81099,568127,421
Mar 25-Mar 3149,66993,690102,134145,933
Apr 1-Apr 752,891112,84898,390140,739
Apr 8-Apr 1460,693124,161110,995137,213
Apr 15-Apr 2154,778107,700110,160119,542
Apr 22-Apr 2854,88788,97397,48278,442
Apr 29-May 552,98478,77885,64168,299

Progress in the West remains slow, but improvement in all regions, with many states seeing large declines. We didn’t sustain the giant improvement rate in the Northeast but we still see pretty great improvement. This is what the endgame looks like. 

India

Things continue to get worse in India, but the graph no longer looks as fully vertical as it did previously, so this continues to count as good news relative to the range of possible outcomes. If things peak not too long from now, it will still be the biggest disaster of the pandemic, but it won’t be anywhere near as bad as things could have gotten.

Vaccinations

We all know how it started. 

How’s it going? Keeping up the momentum?

As a reminder, we were once over 3 million doses, and we’re giving out more second doses now than we were then.

Every week, the graph of vaccinations looks more like the electoral college maps:

I found this chart enlightening when I first saw it:

The problem is that this isn’t what I thought it was. I thought it was what percent of each group did each thing. Instead, it was what percent of everyone who did the thing was in each category. That forces us to consider base rates, which makes the whole thing complicated.

The good news is that even now only 55% or so of all adults are vaccinated, which means that people who are vaccinated are indeed doing more things. Yay!

Indian Strain Does Not Escape from Vaccines

The situation in India is terrible, but at least there is this bit of good news – the vaccines will continue to function, at least against the current strain:

Mutations not being additive seems like very reassuring news, implying that there could be a maximum amount of infectiousness or vaccine escape that a Covid-19-type thing is capable of easily achieving. I don’t see why we would stop using the term double mutant, but it makes it a lot less scary. 

If there’s one place I’m most worried about engaging in motivated reasoning, it’s the possibility of vaccine escape. I notice a much larger flinch away from looking here than I do elsewhere. I think I’ve overcome that flinch, but I could be wrong about that, and it’s a super important thing to not make an effort to avoid seeing. So while I’m confident, I want to task my readers with keeping me honest on this one even more than usual. 

P.1 Is The Medium-Term Infection

In many ways it is better to think of Covid-19 as a series of different infections from different variants. When the English strain shows up, it starts again from patient zero, starts again in each nation and region, and grows. When P.1 shows up and shows it is a more fit strain yet, it does this once again. 

If you’re looking at the endgame scenario, the question is whether we’re seeing an increase or decrease in the most dangerous variant’s numbers in absolute terms rather than relative to the overall number of cases. Thus, in a place like New York, the ‘real’ graph of our future situation is the graph in P.1. 

This is delayed due to how long it takes to do sequencing, but it looks like this:

Compare that to the graph of New York City’s cases, which looks like this:

Things had stabilized for P.1 by early April, when regular cases started cratering. Now, with regular cases declining even more rapidly in percentage terms, things are clearly improving even on the P.1 front, at least somewhat. We’ve passed the next test here, not only the previous one. As additional vaccinations come fully online, things will only improve, and I expect other areas to also hit this target. 

The last month has been far more impressive than it has looked on its surface. We went from mostly the old strain to mostly new strains, and we are still steadily improving overall. The news really is quite good.

I worried last week that in relatively hesitant areas, we might run out of willing arms before we get to herd immunity. That is still a real worry, but I am not worried that large other areas won’t get to New York’s current effective immunity level given how many vaccinated people aren’t yet finished being vaccinated. That doesn’t allow a safe return to normal, but it does allow suppression when combined with moderate levels of precaution from the unvaccinated. My trip to New York this week revealed a city still taking its precautions deeply seriously, despite the majority of people being post-vaccination. I was clearly taking below average amounts of precaution, which was a new experience. 

Exploring Vaccine Hesitancy 

As a reminder, and to avoid any possible misunderstandings, as I keep saying week after week, the vaccines are very safe and super effective. 

If you’re reading this, you almost certainly know this. If you’re reading this somewhere you can get vaccinated, and you haven’t done so yet, stop reading now, go get your first shot. We’ll wait.

Not everyone, unfortunately, is in your epistemic position. Thus, we have vaccine hesitancy. 

What are the real reasons for vaccine hesitancy? There are lots of theories out there, and I’m confident someone cares about any given justification one could come up with, but what are the most common true objections? 

There’s a lot of plausible candidates for the most common true objection.

A survey about vaccine hesitancy in the army has some good data on this, and is worth looking at in detail. I wish the data was better and came with numbers attached, but it’s still good to have a look at the slide of the Top 12 reasons soldiers are refusing vaccinations (it’s pasted here, but it’s a lot easier to read at the link.)

Or in written list form:

  1. It’s not FDA approved.
  2. It hasn’t been proven safe.
  3. What’s the point? I’d still need to wear a mask.
  4. This is the first time I get to tell the army NO!
  5. I am not in a high-risk population.
  6. I already had Covid-19.
  7. The vaccine symptoms are worse than the virus.
  8. The virus has the same morbidity rate then the flu.
  9. I don’t want to get my family sick.
  10. I am being safe. It has kept me healthy so far.
  11. The vaccine may impact my pregnancy.
  12. I just feel skeptical and don’t know what to believe.

It’s also worth taking in the perspective of the writer of the article and of the writer of the slide. Both writesr take it as common knowledge that the reasons to not take the virus are stupid and wrong, and that the job is to fix what’s wrong with these soldiers who are refusing. 

There’s no acknowledgement that maybe we’ve messed up in how we handled this whole thing, or that some of the concerns might be reasonable, or that maybe we treat our enlisted soldiers like garbage or worse and they might really, really want to tell the army where to go. It’s a volunteer army, but the recruiter can lie to you, and once you sign the contract you definitely can’t quit.

Consider this whole thing, as I will do from here, from the perspective of the hesitant soldier.

There are a few categories of objections here.

The first category (1,2,9 and 11) are the straightforward safety concerns. These concerns are wrong, but I say that as someone who knows they are wrong. And the responses suggested here other than to #9 are… not great.

The FDA didn’t approve your energy drink? How is that relevant or in the appropriate reference class? If the vaccines have undergone such a rigorous process as you say, then why hasn’t the FDA approved them? 

The clinical trials were three times as large as normal? How about the one hundred million Americans who got fully vaccinated? Maybe mention that? And again, what’s your answer to the obvious: If it’s so damn safe why hasn’t the FDA fully approved it?

There aren’t any obvious problems with pregnancy? Gee, mister, that makes me feel way better. No idea why we’re voluntarily going with this weaksauce over much stronger alternative arguments. If I’m listening for bullshit, guess what I’m thinking right now? 

In related news, Stat News argues that the emergency use status of the vaccines shouldn’t interfere with vaccine mandates by employers and schools. As a matter of law I think they’re probably right (although of course I Am Not a Lawyer and all that) but as a matter of practicality this is a strong argument that it’s important that the FDA needs to issue a full approval. We’ve just had the biggest Phase 4 in history. Taking at least Pfizer and Moderna from ‘emergency’ use to full approval would do a lot to reduce hesitancy and free the hands of those who want to mandate vaccinations, without being coercive. 

If you want to solve this issue, the FDA should simply approve the vaccines, full stop, not simply emergency use. Problem solved. 

If not, the response to a soldier should be that the FDA are a bunch of ass-covering assholes who would prefer never to actually approve anything, and maybe that would get through to them in a language they can understand. 

The second category (7, 8 and 10) are claims that Covid-19 isn’t that big a deal compared to the cost of getting the vaccine. 

Here we see that response #10 says both “masks and social distancing work” and then goes straight to “but they don’t ‘directly combat’ the virus” implying they don’t count. When you’re lying about everything, it’s hard to keep your lies consistent, so I guess I’m somewhat sympathetic to this local predicament, but man it’s glaring. 

The answer to #7 isn’t going to convince actual anyone. The ‘mild symptoms lasting 24-72 hours’ are exactly what the soldiers are complaining about, and the response is to tell them they’re imagining things, which they most definitely aren’t. Smooth. 

For #8 they quote some statistics and it seems fine, I guess, although it leaves some ammo on the table. It’s kind of bending over backwards to be maximally generous to the flu’s deadliness. I’d have gone with different wording, but mostly this one is fine. 

It’s interesting when they strengthen the answer to the point of deception, and when they weaken the response to the point where it doesn’t respond to the concern. 

The third category (3, 5, 6) are claims that it’s not in the soldier’s personal interest to get vaccinated, because they’re young and healthy, as most active soldiers are, so why should they get sick for several days and maybe face risks they don’t know about? This also overlaps with 7. 

The response to #6 isn’t an outright lie exactly, since the word ‘may’ does a lot of work. The sun might have just exploded. But in practice, yeah, this is lying.  

The response to #3 is, and I quote, “F*** you.” If you all mostly comply, we’ll lift the outdoor mask mandate? That’s your pitch?

The response to #5 is, and I quote, “F*** you.” Or, technically, ‘it’s not about you.’ It completely accepts the (incorrect) premise that the soldier doesn’t benefit, which doesn’t seem like the approach I would take.  

Then there are two standalones.

There’s the remarkable #4: This is the first time I get to tell the army, NO!

And oh my is the answer to that one “F*** you.”

Which leaves #12, which is the most interesting of the responses. 

That’s because the soldier has spoken The Words, and has spoken them rightly.  

Rather than voice a specific and explicit concrete objection, to which the answer of necessity is going to be some combination of ‘you’re wrong’ and ‘F*** you,’ the soldier has given a general feeling of uncertainty without any concrete objection. Thus, there’s no way to say they are wrong, and no basis to curse them out. 

Instead, “I just feel skeptical and don’t know what to believe” elicits this response:

“The choice to get vaccinated is a personal decision and should not be taken lightly. Talk to a medical professional, consult the FDA Factsheet, and review the educational materials available at www.carson.army.mil and from the CDC to weigh risks and benefits.”

Suddenly we’re acting like this is a Very Reasonable and Responsible Position, which needs to be solved by consulting official sources and doing further research. Only after that, when the soldier comes back with an actual concern, can we know which of our two responses to use, and justify using it. I mean, there’s no way this person is skeptical after talking to all the Responsible Authority Figures, right?

NPR claims that lower rates of vaccinations among blacks and latinos are entirely due to accessibility issues and have nothing to do with hesitancy. I completely buy that the access issues are doing a lot of work here, but it seems odd to attempt to suddenly shift from “here are all the legitimate and sympathetic reasons why these groups would be hesitant” into “they are not and have never been hesitant, it’s that we didn’t give them access and made access depend on things that systematically excluded them.”

It’s a claim that we’ll be able to evaluate soon enough. As appointments become widely available via walk-ins in more places, with essentially no hoops involved, either the rates will converge or they won’t. I am skeptical because it seems like it’s a motivated shift in explanation rather than an attempt to track the truth – we want to make skepticism more blameworthy, so we need to not identify these increasingly blameworthy motives in the wrong places, hence the shift. I am only somewhat skeptical because it seems clear that providing easier access has a dramatic effect on vaccination rates. 

Overall, that evidence means that the article seems like very good news. What it does make a strong case for is that there is a lot of ‘soft demand.’ The bad scenario for where we are would be that 60% of eligible people have already been vaccinated, and most of the remaining 40% are actively having none of it. They are like the soldiers. They won’t accept the shot unless convinced or heavily coerced. 

Instead, this new picture finds evidence that what we have are a lot of people who prefer being vaccinated to not being vaccinated, but don’t prefer it enough to jump through a bunch of hoops. That’s great! All we have to do is get rid of the hoops and the need to jump through them, and offer them easy access. Now that we have abundant supply, that is relatively easy. Certainly I buy the anecdote that Asians have relatively low levels of hesitancy when given good access. 

As someone who spent a substantial amount of time and effort to get vaccinated earlier rather than later, and to get those around him vaccinated earlier rather than later, I think those unwilling to do so are setting their price too low. We can separate this setting of a low-price into a few different components. 

One explanation, which is the most hopeful with respect to the vaccines, is that their circumstances mean that paying the relevant costs is more expensive, and they have less ability to pay such costs. They care, but as the article claims, they are simply unable to take even a few hours off of work, or figure out how to navigate the barriers previously required. There is some of this, but we have some evidence that is then hard to explain if this is the main thing happening, such as the failure of J&J shots to rebound, and the distribution of shots on different days of the week. 

J&J shots are going, well, not great:

If people simply cannot miss work, and are worried about side effects causing them to miss work in addition to the appointment itself, this suggests people will plan their shot around not missing work. That means getting a shot on Friday or Saturday, and yes we see giant spikes in shots given on Fridays and Saturdays, including during periods when supply constraints looked like they were binding. That seems like strong support. We’ll see if this can be sustained; if this theory is correct, Friday and Saturday throughput should continue to bind. 

A second explanation is that this is shallow demand, pure and simple. If someone wouldn’t be willing to spend much time, let alone much money, to get a vaccine, that’s a revealed preference that they don’t value the vaccine much. This seems highly plausible to me, that there are essentially three camps rather than two camps. There’s the people who want the vaccine enough to ‘bid’ on it in various ways and make it a priority. There’s the people who actively don’t want the vaccine, often violently so. But then there’s also a large group, plausibly larger than the second group, who are fine with it but are mostly trying to live their lives and value the vaccine at some positive but small number. 

I wonder how much of that is because we’ve set the price of the vaccine, and much of health care, to $0, thus sending the implicit message that such services are, in emergencies, not that valuable. And also the general instinct to not think about one’s health when one isn’t forced to. We do seem to see a pattern of people who have the ability to get expensive medical care that they ‘should’ want, but not to spend small amounts of time (and aggravation) to collect it. 

What’s The Worst Possible Thing You Could Do?

If you’re the President of the United States, in terms of actual impact the answer is presumably ‘launch all the nuclear warheads.’ 

If one restricts to the pandemic, the answer would be to sabotage vaccine production and distribution. Nothing else comes close. One could plausibly argue that nothing else even much matters.

How would one sabotage vaccine production and distribution? 

Sabotaging distribution means doing things like not approving known-to-be-safe-and-effective vaccines, or suspending existing approvals and sending the message the vaccines are unsafe, or holding up distribution to worry about things like equity, or holding onto vaccine doses for extended periods with no intent of approving them ever. 

Oh, wait. Those are all things done by the Federal Government during the Biden administration, with no visible attempt to prevent them from happening or even regret expressed about them. You could even add, during the campaign, questioning the vaccine development process as ‘rushed’ or ‘politically motivated,’ plausibly being the cause of vaccines not getting approved a month earlier and creating much additional vaccine hesitancy.  

You’d also give doses to children who don’t need them rather than those in other countries that badly need them, so naturally Pfizer is on that one and soon will be applying for approval for children as young as two years old. And of course you’d continue not to do the first doses first, and continue to use full way-too-big doses of Moderna, and so on and so forth. 

None of that means one couldn’t have done or in the future do more of those things, so actions haven’t been maximally destructive. But they’ve been quite destructive. 

The other half of the worst thing you could do is sabotaging production. The easy way to do this is to screw up distribution. If things aren’t approved yet, at best then that’s going to slow down production until after approval. So are all the regulations involved in production, like needing to apply for permission and wait substantial time for permission for things like ‘put more of the vaccine into each vial because we’re short on vials.’ 

That’s all passive resistance to lifesaving medicine. Could we kick this up a notch or two?

The ultimate way to hurt vaccine production, not only now but indefinitely into the future, would of course be to destroy the financial incentive to produce vaccines. The less you’re willing to pay, and the less you let companies profit, and the less you reward those companies for quick scaling up and delivery of production, the less doses you’ll get. This starts with not paying for building production capacity, and its central action is not paying much per dose or paying more for early delivery. If you want to go for bonus points, you can be like Europe and hold up negotiations for weeks to drive down the price even lower. 

That’s all negative actions, though. It’s easy to sabotage efforts by not doing the right thing, especially when the right thing costs tiny amounts of money and looks like rewarding corporations, and is an action rather than inaction and thus blameworthy. 

So it’s a big step-up in the civilizational sabotage game to actively take away the incentive to create vaccines, by stripping away intellectual property protections without any compensation, in the middle of a pandemic:

There’s a simple solution to the problem of intellectual property if you wanted to make the situation better rather than worse. You could buy the intellectual property rights from the companies involved. So, basically, this:

It’s not that much money, everyone would be happy, and the precedent would be excellent. Pay enough, and they’ll even aid you in technology transfers. Even better, you could repeat this process with other drugs. Buy out the monopoly at its economic value, remove protections, and the people save many times that much money in costs. It’s a great idea.

Doing this without compensation is about the worst thing one could do. If your new ideas outright save the world, we’re going to reward you by confiscating them, voiding the contracts and promises agreed upon and informing you that we are not a nation of laws. That’s exactly how not to get vaccines next time there’s a crisis, or anything else next time there’s a crisis, or really anything else useful at any time for any reason.

The message we’ve sent, loud and clear, is that we are not a nation of laws and we do not reward those who deliver the goods for us. Instead, we retain protections on things like insulin that are pure rent seeking, while taking away protections that are doing exactly what patents are designed to do: reward those who produce world-changing positive innovations via temporary ability to profit. 

We are a nation of a person in charge, and if that person decides to confiscate your property because it’s good politics, well, tough. 

It’s a horrible, horrible precedent. We will pay for it in money, will pay for it with our freedom, and we will ultimately pay for it in blood.

mRNA vaccine technology is potentially a full cure for infectious disease, and plausibly also a cure for cancer. The federal government sabotaged all that, big time.

What did we get in exchange? What’s in the box?

NOTHING!

Unless, of course, they are not so stupid In which case the destruction of the rule of law and of private incentives, and the signaling that political expediency is the most important thing, was the point.

You see, this will not increase vaccine production (MR link with full explanation, recommended), for two reasons, even if vaccine ingredients didn’t prove to be limiting factors. MR also recommends this Barron’s column. Here’s another confirmation that no, this won’t improve short term supply.

Many people have this idea that all the knowledge and skill required to produce the vaccines lies in the patents. Once you lift the patents, lots of other companies can go start producing vaccines. Except, that’s not actually true because

  1. The vaccines require technical expertise not included in the patents, which is expensive and slow to transfer, and which would also transfer valuable knowledge that can be used for other R&D and other production and thus which the vaccine producers are not going to transfer without compensation.
  2. Moderna explicitly already said they wouldn’t enforce the patents, and no one really expected the others to either.

Read that second one again, if it’s new to you. The greedy capitalists whose rights you took away without compensation were already voluntarily giving those rights away. If there was already clearly no intent to enforce the patents, what good does lifting those patents do?

It sends the message that the United States is willing to confiscate property for political gain, when it feels like it, on the basis of the executive’s say so. 

Even though that won’t produce anything useful, yes, it’s still bad for business and still punishes exactly who we should be rewarding, or at least demonstrates that such punishments should be expected, as measured by the stock market. Remember Moderna already waived its rights:

As usual, the usual suspects wasted actual zero time demonstrating exactly the slipperiness of the associates slopes, as they quote the decline in shareholder value as a good thing:

What makes such a statement so maddening is that she’s right. We should totally do insulin! It’s completely insane that we’ve allowed regulatory capture and rent seeking via intellectual property protections on “inventions” like insulin. The congress should get together, write a bill and pass a law that stops such things from happening now or in the future via changing protections, ideally without confiscating private property, and then the President should sign it, and then the bill should become law. Then do copyright.

Won’t Someone Please Think of the Children?

The minds of many parents I know are turning to the question of summer camp. Is it safe to send your young child? 

Are all the people you care about that will be in contact with that child either other young children or fully vaccinated by the time the camp starts?

If the answer to that question is yes, then yes. 

If the answer to that question is no, then given that vaccinations are now available to everyone pretty much on demand, why isn’t the answer yes? 

If the answer to that question is that someone is seriously immunocompromised, or otherwise super important to the child’s life and won’t get vaccinated (for whatever reason), then and only then is it time to look at the camp’s procedures to see whether you’re comfortable with the level of risk being taken. In particular, you’ll need to ask how many children and unvaccinated adults will be in contact with your child, how close that contact will be, and how much time will be spent indoors, and do a calculation.

I still think that calculation should almost certainly be ‘yeah, it’s fine’ but at that point, as they say in the advertising business, it’s up to you. 

My general answers regarding children generalize this. Young children are not at enough risk from Covid to let this change how they live their lives, so them catching it only matters to the extent that they would pass it on to vulnerable others. 

By the end of May, with notably rare exceptions, patience with those in the United States who are still vulnerable can reasonably be at an end. Those who decline the opportunity to be vaccinated can manage their risk however they choose, but life beckons.

Speaking of life beckoning: I strive not to use the word evil, I avoided using it in the previous section, but this is evil in its purest form:

Anyone who doesn’t recognize this as such has lost their soul. Any parent or teacher who enforces this should be treated as the mustache-twirling villain they are. I am deeply sorry to any child who has been so absurd and tortured, or living in so much fear, that they are tempted to put up with this. 

If you do not think school’s primary nature is ‘child prison’ and/or that those running it are pro-children, then you have new data your model needs to somehow explain. 

In Other News

V-NY day approaches, and Cuomo fully opens up stadiums, opens up Broadway, offers subsidized vaccinations at Mets and Yankees games. Took everyone on Broadway by surprise, so it’ll be a while before they can actually get on with the show. Remember, you’ll want to wait to get vaccinated until you attend a game at the stadium, together with tens of thousands of other people. That way you get free tickets! 

Alternatively, you can show up at the local CVS and maybe pick up a gift as well :

In many cases, Walmart too. Basically everywhere at this point. No excuses!

South Korea says AstraZeneca shot 87% effective after one dose. Which would be pretty good after two doses. First doses first, indeed.

Police have low rates of vaccination, endangering those around them who they forcibly interact with and likely killing them (WaPo), but no one is able to make them do the right thing and stop endangering the public. A little on the nose, if you ask me.

Airline boarding procedures were already worse than random, and changes in response to the pandemic made them worse still. It seems that looking like a good procedure is more valued than being an actually good procedure. There seems to be a strong match between ‘this is a quick boarding procedure’ and ‘this is a safe procedure,’ so the problem is purely that good procedures don’t look good and/or don’t feel ‘fair’ somehow, or miss out on some opportunity for price discrimination. Is there an improvement that would also look and feel like one?

MIT requires vaccinations, although so far only for students. I expect most colleges to follow suit if only to avoid potential liability concerns. Not spreading the requirement to faculty and staff seems like a clear mistake.  

New higher estimate of true number of Covid deaths via MR, not enough data to know how much credit to give this.

The Covid Response Project chronicles the Covid-related experiences of people across different states. I’ve sampled and it seems like a good source of real people’s anecdata. There will definitely be surprises.

Twitter thread and paper discussing origin of variants of concern. Not sure there’s practical updates to be had, but interesting information.

Pfizer begins shipping some vaccine doses manufactured in the United States abroad, starting with Mexico.

Potential universal coronavirus vaccine proposal. From what I can tell this is highly unlikely to work but you never know.

Vaccination availability site of the week, Vaccinate the States

Marginal Revolution points us to a study of future work-from-home (WFH) patterns (paper), and finds dramatic effects the study expects to linger beyond the pandemic. I hope to check this out in detail in the future, but the headline impacts are gigantic. They expect WFH to go from 5% of full workdays to 20%, and for this to be a 5% productivity boost, most of which will be due to reduced commuting. Commuting is much worse than people think it is, so this is a really, dramatically large effect, in the range of ‘potentially a bigger long term deal than the pandemic.’ This isn’t a fake productivity boost, it’s literally getting rid of purely wasted unpleasant time (that also burns a bunch of carbon to boot). Given the amount of time being saved, it also implies that on the margin there’s still going to be a dramatic underutilization of WFH as an option. If a change to 15% of the workforce produces a 5% productivity boost by saving useless time (and it’s still an if, the story has to check out), clearly we are not using anywhere near enough of it. 

Not Covid, therefore… we’re coming back, baby! HYPE!

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55 Responses to Covid 5/6: Vaccine Patent Suspension

  1. cakridge2 says:

    Attempting to parse out Biden’s position on patents, evil and mustache-twirling as it is:

    “There is no innovation, just theft. All “innovation” was built on the skulls of the oppressed.”

    And the worst part is, almost everything you hear will be celebration.

    This just makes me want to give up the fight for a better world. Moloch could declare victory today, AFAIC.

    • Anonymous-backtick says:

      But TRUMP was the one who had to be stopped, because *mumble mumble*.

      • Well he was shitting on the environment and minorities so he was objectively pretty bad from a relative stance. Both are absolutely dismal, though, the whole system is dismal.

  2. Eigengrau says:

    I’ve been pretty agnostic on the IP question due to lack of knowledge, so I thank you for making a solid pro-IP case.

    I have some questions though.

    1) If these companies no longer having ownership rights of their IP is so monstrously terrible, with tragic outcomes certain to come in the long term without even a short-term benefit, why had Moderna already explicitly waived its IP, and the others expected to not enforce theirs’ either?
    2) Consequently from 1 — what’s actually changed by the US government “waiving” the IP, other than (temporarily?) spooking investors? Why is it so bad that the US is waiving what had already effectively been waived?
    3) The announcement mentions forthcoming “negotiations” — does this not at least hint that the pharma companies are going to be compensated somehow? What else would it mean?
    4) The announcement also commits to expanding vaccine production and distribution, including raw materials, and including partnering with private firms to make it happen. Shouldn’t this be the real good-news headline? Isn’t this the exact end-goal we’re supposed to be working towards?
    5) How does this actually disincentivize e.g. Moderna from making a vaccine for the next pandemic? Even if this IP-theft by the gov — which they weren’t enforcing anyway — ultimately hurts their bottom line, surely there is still immense profit to be had by creating a world-saving product? They could just take the expected value loss from the gov hypothetically interfering with their new IP down the line and add it to the price of the product up front. You really think in the next crisis that Pfizer’s gonna be like “nah, no point, we’ll just let the world, including ourselves, burn, because we might not make *as much* money as we’d like, though still quite a lot of money”.

    At the moment I am shifting my position from “I have no idea” to “waiving the IPs changes little to nothing on its own because the companies weren’t enforcing them anyway and the bottlenecks are elsewhere so this is just left-wing virtue-signalling, but the good news is there will be more investment in addressing the actual bottlenecks. I am currently unconcerned by the future profits/incentives for pharmaceutical companies, but remain confused on that point because all the economic-minded folks are fuming about it.”

    Things to change my mind: 1) a very good argument/explanation addressing my questions, but especially 2) the real-world outcome of whether this leads to greater production and distribution of the vaccine.

    • TheZvi says:

      1) They knew that without technology transfer it wouldn’t matter, and their future profits from other mRNA vaccines/treatments (e.g. cancer isn’t really a vaccine) are where the real money is. But now they have to worry those will get confiscated, too.

      2) The USA is announcing it is not a nation of laws that protect private property and that IP from pharma companies is considered a legitimate political target for expropriation. If there was another future blockbuster drug, chances are now much higher that they would get the same treatment and/or the threat would be used to hold down profits.

      3) “Negotiations” means, I would assume, trying to bully them into technology transfer, or into not responding to their new incentives. If we’re lucky it means they’re going to try and buy more production.

      4) The way you make this happen is you *pay more for vaccines* and the market takes care of the rest. Trying to do it manually any other way is at best vastly inefficient and plausibly misallocates resources and makes things worse. As does having other countries hold back resources to try and make their own when they don’t really know how. Plus, to state the obvious: If those components weren’t being secured before and are now, what the hell? You’re only interested in helping when the pharma companies don’t profit?

      5) No, there really isn’t, and you can’t ‘pass on’ fixed sunk costs via other products when you’re already profit maximizing. If they make another world-saving product they have every reason to believe they won’t be allowed to make much money – and already we didn’t let them make much money on this one! If we’d paid them 10x as much money we’d have gotten much better and faster results much more reliably, for basically nothing. Instead we’re stealing from them. And investors who might fund research are going to be paranoid and not want to fund. Keep in mind that when they try to make something awesome, usually they fail, and lose a lot of money.

      The good scenario short-term would be if this turns out to be virtue signaling because the patents didn’t matter this time, but in that case the “virtue” that is being signaled is a willingness to expropriate private property exactly from the people who do us the most good, because they did us the most good. The fact that this is the “virtue” they want to signal is indeed the main point at issue.

      • Eigengrau says:

        1) I dunno this seems like a stretch. The thing that’s being confiscated was something they had no intention of keeping anyway. Will a future government be willing to put up the fight in a scenario when the company intends to strictly enforce their IP? Or is what’s happening now a case of easy-pickens, like using eminent domain on an empty abandoned lot?

        2) I personally am not convinced that this is a slippery slope towards the government using executive action to snatch up IP willy nilly at some point in the future. They seemed pretty reluctant to do it this time — it took months of cajoling!

        3) This is possible but I am skeptical considering the long and consistent history of the US being very cozy with large international corporations and their mutual interest in continued profits.

        4) The US recently lifted its export ban on raw materials (good!) and I see this move as a continuation of that.

        5) The fact that the pharma companies are currently charging orders of magnitude less for the vaccines than their true market value, sometimes even selling them at cost, suggests very strongly that yes there is quite the leeway for more profits to be had.

        I also don’t know for sure that throwing tons more money at them would have allowed them to make more vaccine quicker, better, etc.. It is VERY suspicious that we’ve spent so *little* on vaccines compared to stimulus, which for me opens up the possibility that there are things they know which I don’t regarding the difficulties of international supply chains. And whatnot. Big unknown unknowns for me here. (Of course, within my agnostic perspective it is still better to err on the side of caution and loudly scream at the government to spend more money on vaccines just in case).

        Then again, I see a Schelling point within the procurement negotiations where nations say “how much to cover our entire population?”, the companies provide an estimate, then the nations pay that and not a cent more (outside of programs like COVAX). Meanwhile the companies don’t push for more supply because they have never done anything on a scale like this and are already way in over their heads with the prospect of their existing commitments (note to self: find out if the companies pushed for more supply and the governments said no, if the governments pushed for more supply and the companies said no, or they mutually agreed oh gosh this is all so overwhelming I’m a total fraud I hope no one finds out let’s just agree this is the best deal possible).

        But also, governments are not the only source of money. If Moderna wants a leg up on the vaccine production race, and all the governments in the world are hopelessly stupid/evil, and all they need to get ahead is some extra capital, why not go to the banks? Get that magic money in the form of a loan, then they can quickly ramp up production and immediately become the world leader in vaccine-making, and therefore vaccine-selling and vaccine-profits. Plus, then the government doesn’t have that leverage over them to take their IP rights away, because they didn’t pay for the whole operation.

        And that’s another good point. Actually, a very good point. Some of these vaccines were largely or almost 100% funded publicly (Moderna and AZ at least, I haven’t looked into the others). So the argument that they need the IP to recoup their losses and take on risk is moot in this particular instance. What losses? What risk? The next time there’s a crisis like this it won’t matter if Moderna isn’t “incentivized” to develop a solution, because apparently the government will give them all the money to do it. (also, Dolly Parton. Should Dolly Parton have a piece of that IP too? Let’s get her thoughts.)

        Incidentally, this issue strikes me as an excellent Shiri’s Scissor. About half the population is calling the government a bunch of sadistic murderers for waiving the IP, while the other half regards it as totally obvious that the government is a bunch of sadistic murderers for *not doing it even sooner*.

      • TheZvi says:

        Cutting off here so this doesn’t continue endlessly, but basically the governments refused to allow market prices, thus destroying the motive to use private money to accelerate production or research, give Moderna+co a small amount of money, rely on the existing expertise and long term research capacity bases of these companies, throw barrier after barrier in their way, then turn around and claim ‘public funding.’ Then people use the evidence of the government not giving them more money as somehow evidence that more money wouldn’t have helped?

        I’ve talked about this *a lot* in previous columns, and will let others discuss from here.

        (I do agree that it’s a good way to tell who you’re dealing with and who is actually modeling the situation, to tell one half from the other half, but… hey.)

    • thechaostician says:

      On (3), I read “negotiations” to mean negotiations among governments in the WTO about how to coordinate waiving IP, not negotiations with the companies about what / how to waive. You want to make sure that the companies don’t have the option to sue the US in an international court.

  3. Robin Kulle says:

    Thanks Zvi. This leaves me poignantly satisfied, I’ve been struggling to put it into words, but you chose exactly the right combination of level-headed explanation and appropriately horrified incredulity.

  4. Adman says:

    Stanford is requiring not only students but also all faculty and staff to get vaccinated: https://healthalerts.stanford.edu/covid-19/2021/05/05/fall-vaccination-policy-for-faculty-staff-postdocs/

    Well, that’s their headline. The fine print says “Faculty, staff and postdoctoral scholars who are not fully vaccinated or who do not disclose their vaccination status will be required to continue regular COVID-19 testing and, possibly, additional requirements aimed at keeping our community safe.” So it sounds like it’s less “otherwise you’re fired” and more “otherwise we’ll make your life really annoying”.

    • TheZvi says:

      The power to tax is the power to destroy. Periodic testing sufficiently intense becomes one hell of a tax.

      • Dylan says:

        They’ve recently reduced the testing requirements for grad students to once a week, which is significantly less annoying than the twice a week (even after vaccination) program, but still annoying. They’ve stated that at some point in the future it will be possible to instead claim vaccination status, but as of today I still have to get tested once weekly.

  5. mattlashof says:

    Sorry for the double-post if it occurs, commenting on mobile and but showing up.

    Thanks for the great post, as always. However, I take issue with your characterization of the patent issue as an essentially lawless and uncompensated taking.

    19 U.S. Code § 3511 states that the United States is a party to the WTO. Section (d)(15) specifically states that this applies to the TRIPS agreement that is part of the WTO. This law was passed by both houses of Congress, was signed by the President, and has never been adjudicated unconstitutional by any court of competent jurisdiction.

    In turn, the TRIPS agreement (https://www.wto.org/english/docs_e/legal_e/27-trips_04c_e.htm) states in article 31 the conditions under which countries may disregard patents. Section (b) of that article states the conditions under which nations are excused from making a good faith effort to license (which are met), and section (h) requires just compensation be paid to the patent holder, subject to judicial review under section (i).

    I have not seen anyone say specifically that they won’t pay compensation under article 31, and i highly doubt the US trade negotiators would allow it.

    Maybe you don’t like these laws, but that’s a totally different kettle of fish than the notion that using this duly-enacted authority is somehow lawless.

    • Eigengrau says:

      Thank you for this! I took issue with the “lawless” comment as well but lacked the mental wherewithal to look up the terms.

      Also, according to Canada’s ambassador to the US, all 164 WTO members have to agree before it’s put into action. That seems plausibly untrue though — looking at you, CTV fact checkers. Have you any insight?

    • TheZvi says:

      This is definitely a motte/bailey situation of some kind, plausibly in *both directions* – for the half who think that IP is theft, you claim you’re waiving it but letting others veto it for you, for those who think theft is theft, you claim it will get vetoed but give clear permission for other countries to disregard and know they won’t face consequences.

      • mattlashof says:

        I mean, I wasn’t even trying to make an argument one way or the other on the wisdom of patent waivers. I understand you think they are very unwise. I was only taking issue with your characterization of such waivers as *lawless*.

        Like, if a duly enacted law, passed by both houses of Congress (with large majorities btw) and signed by the president provides conditions under which waiver is permissible, and the current government is acting within the scope of those conditions (which they are AFAIK), then please explain how this action is lawless.

        You made a pretty strong statement here: “I like being a nation of laws, where the executive doesn’t just take stuff when he feels like it.”
        Please justify. If acting in accordance with duly enacted legislation is “lawless”, then clearly you mean something different than I do by the word “law.” I do think that people of all ideological stripes use the word “law” to mean “what I think the law should be” rather than “legislation enacted through duly prescribed democratic processes” — I certainly feel that temptation as well! But I’m not trying to make a claim about IP being theft, or the disregarding of IP being theft — I’m merely trying to make a claim about the actual legal content of United States law.

        With regard to the “without compensation” point, I also haven’t seen anything to suggest that there will be no compensation. Ambassador Tai’s statement clearly does not say that, and it’s contrary to Article 31 of the TRIPS agreement, which is the legal authority for this waiver. Do you have a basis for that?

      • Eye Beams says:

        “Like, if a duly enacted law, passed by both houses of Congress (with large majorities btw) and signed by the president provides conditions under which waiver is permissible, and the current government is acting within the scope of those conditions (which they are AFAIK), then please explain how this action is lawless.”

        Bastiat would like a word with you. In The Law he delineates the difference between True Law (capitol letters because Enlightenment!) and legalized plunder. Here’s one of many quotes, but the book is short and easy to read given it’s age. And free of IP entanglements, so you can download it no problem!

        “When a politician views society from the seclusion of his office he is struck by the spectacle of inequality that he sees. He deplores the deprivations, which are the lot of so many of our brothers, deprivations, which appear to be even sadder when contrasted with luxury and wealth. Perhaps the politician should ask himself whether this state of affairs has not been caused by old conquests and lootings, and by more recent legal plunder. . . But the politician never gives this a thought. His mind turns to organizations, combinations, and arrangements – legal or apparently legal. He attempts to remedy the evil by increasing and perpetuating the very thing that caused the evil in the first place: legal plunder.”

      • mattlashof says:

        @Eye Beams

        I don’t recall the election where Batistat gained the authority to decide what the law, or The Law, for that matter, is.

      • Erik says:

        @mattlashof I read Bastiat as claiming the ability to recognize Law as a generalized abstraction over laws, not the authority to determine what the abstraction is. Let me try with a more concrete example.

        1) “Anyone earning more than a bazillion dollars a year shall pay umpty-ump percent tax on their income.”
        2) “Anyone earning more than a bazillion dollars a year shall pay umpty-ump percent tax on their income, except for the Michael E. Smithers born and baptised by that name in 1962, who shall pay [twice|half] as much.”

        Either of these might be written into the legal code of a particular country, but the second is more lawless, because regardless of what the law-as-legal-code says, we see it exempts Smithers from the law-as-common-practice. Without any opinion on the exact amount of tax Smithers should be paying, I can say it’s lawless that he be singled out to pay a different amount from everyone else.

    • Anonymous Bosch says:

      Echoing everyone else’s thanks for this reply. The administration is basically announcing an aspirational approach to WTO negotiations which is entirely within the current rules. Domestically, this changes nothing. Internationally, WTO waivers are hardly unprecedented. In fact least developed countries have been under a fairly broad TRIPS waiver since 2002 that is set to last until 2033:
      https://www.ip-watch.org/2015/11/06/ldc-pharma-ip-waiver-until-2033-approved-by-wto-trips-council/

      Moderna, for one, voluntarily waived their patent rights six months ago and their CEO seemed pretty confident this would not affect their bottom line. I consider this position to be more compelling than Pfizer or J&J, since Moderna is a startup 100% focused on mRNA vaccines while Pfizer/J&J are megacorps with many streams of revenue:
      https://www.businessinsider.com/coronavirus-vaccine-waiver-moderna-ceo-says-didnt-lose-sleep-2021-5

      • Chris says:

        I wrote a reply to your last paragraph, but it appeared quite far down the page, in what I think should be a different thread?

        The point was – the company behind the “Pfizer” vaccine, who owns the patent, is also a “startup 100% focused on mRNA vaccines”/therapies, just like Moderna. Definitely not a megacorp.
        Their CEO (and vaccine inventor/patent holder) is unwilling to completely waive the patent though. Apparently he wants to do licensing instead.

  6. Worried says:

    Thank you for the continuous high quality explanations. Would you be able to explain why you are not concerned with possible long term effects of the vaccines? My understanding, from listening to people like Bret Weinstein, is that the mRNA technology is new and poorly understood, and that there is a chance of long term effects that we would have no way of knowing about yet. Is that not worth worrying about?

    • TheZvi says:

      Bret seems to be making a business of finding people making claims in this reference class, since this is the 3rd distinct such claim I’ve heard out of him vs. less than 3 similar total ones from other named non-direct sources total.

      I’ve answered the mRNA question before but essentially: There’s no plausible mechanism for this given what the vaccine physically is, and to the extent that there’s implausible ones or unknown unknowns, they would have shown up by now. The chance of ‘it is impossible to detect after 100mm+ vaccinations and months of time, plus the trials, in our paranoid state, but it’s gonna show up in the future!’ is not worth worrying about.

      • I’m a little disturbed by your confidence in dismissing unknown unknowns. Isn’t the whole point of unknown unknowns that you don’t know much about them?

        My understanding of the state of the art on (a) the immune system and (b) biochemical processes is “this is so complex that we have no idea what is going on most of the time”. The probability that the vaccine causes some negative long term effects is certainly not zero, especially given the fact that it’s whole point is to cause long term effects.

        Of course the probability of covid-19 doing the same is probably much larger. But “the vaccine is safer than covid with high probability” is imho much more honest than “the vaccine is safe”.

  7. Being a South Asian getting Pfizer, how much extra precautions do I need to take post vaccination? Only 4% of participants in Pfizer’s phase 3 trials and the efficacy rate for them was 75% rather than 95%. Since the category “Asian” includes everyone from Chinese to Indian to middle Easterners, it could be even lower for my subgroup. And on top of that, the newer strains have lower efficacy and anecdotally there are multiple reports of fully vaccinated South Asians dying from Covid.

    My family and I are still getting vaccinated of course because some protection is better than none but I am now worried about how useful it will even be.

    • TheZvi says:

      I wouldn’t be worried about any of this, it’s probably low sample size and random effects rather than something real, and protection vs. death/severe illness is much higher than protection vs. disease, so even if it’s real you’re still going to be high 90s-protected vs. death. You’re fine.

    • thechaostician says:

      The relevant data now would be from the mass vaccinations in the US. There are about 20 million Asians, including 5 million South Asians in the US, about half of whom have been vaccinated.
      If Pfizer is only 75% effective for Asians, then we should be seeing 5 times as many breakthrough cases among Asians as among the rest of the US population. I haven’t looked through the data myself to make sure this isn’t happening, but it seems like something we should have noticed by now.

  8. Anonymous says:

    > I strive not to use the word evil, I avoided using it in the previous section, but this is evil in its purest form:
    >
    > > NYC Public Schools will have remote learning instead of snow days next school year
    >
    > Anyone who doesn’t recognize this as such has lost their soul. Any parent or teacher who enforces this should be treated as the mustache-twirling villain they are. I am deeply sorry to any child who has been so absurd and tortured, or living in so much fear, that they are tempted to put up with this.
    >
    > If you do not think school’s primary nature is ‘child prison’ and/or that those running it are pro-children, then you have new data your model needs to somehow explain.

    Apparently I’ve lost my soul, since I fail to understand why this is so evil. I have fond memories of snow days, but I also have less fond memories of the school year being extended into summer break in exchange. It seems beneficial for families that there will be a reliable schedule for the school year.

    Admittedly I don’t know exactly how this worked in NYC before; if the school year always ended as originally scheduled then, okay, this is a little bit evil.

    • Eye Beams says:

      Serendipity + childhood is an innocently beautiful combination. Its why Christmas is a child’s holiday that the adults get to take part in, unlike so many other holidays. As a parent in a 2-working-parent house, yes, the predictability is nice, and on net is probably very valuable for people with uncertain employment prospects. But it comes at the cost of this innocence and beauty, which even if its a rational trade off, should be lamented like the loss of any innocence and beauty.

    • Chris says:

      The patent for the “Pfizer vaccine” is owned by German company Biontech, the actual *developers* of the vaccine (their CEO is first on the list of inventors in the US patent listing).

      They simply partnered with Pfizer to organize and fund the clinical trials and production, because they are… “a startup 100% focused on mRNA vaccines”.
      That’s not entirely true, they’re focused on mRNA therapies more generally, also working on cancer, rare diseases etc. But the Covid vaccine probably makes up over 99% of their revenue stream since it got approved.

      Another thing: Biontech is working on producing and distributing their “Pfizer vaccine” in China, without Pfizer though. They’re partnering with a different company.

      This issue – people thinking Pfizer developed the vaccine – bothered me before on here; when Zvi wrote about the CEO of Pfizer giving a statement that he wasn’t vaccinated yet because it wasn’t his turn yet according to official guidelines. Zvi wrote something roughly like “we should totally vaccinate the person *who has spearheaded vaccine development *”.

      …and it annoyed me much more than it ahould have. Maybe because generally, he’s careful and well-informed.
      This would seem like a good example of that peculiar perspective quite a few Americans seem to have, where anywhere outside the USA doesn’t seem to really exist in a meaningful way in its own right, and everything great is American – if Zvi’s perspective wouldn’t normally be a definite counterexample.

      (I have encountered the attitude a lot while living in Maryland for a year. I’ve met well-off, college-educated people who believed all kinds of things, from pizza to the car, were American inventions.)

  9. aliceryhl says:

    The government where I live just announced that you would be able to get a vaccine earlier if you opt-in to the AstraZeneca vaccine, which they had otherwise dropped using.

    • TheZvi says:

      I love the various levels of perversity involved here.

      • Chris says:

        This is basically what’s going on in Germany. Starting last Thursday, all prioritization has been lifted for the AstraZeneca vaccine. It’s almost exclusively used by doctors, not the official vaccination centres, but if you can find a doctor who vaccinates with AZ, they can give shots to anyone who wants them, no matter the age, profession, health etc.

        But what led to this in the first place is that the government has screwed up the messaging on the AZ vaccine so utterly and completely that a lot of people would rather not get vaccinated than get AZ.

        In a vaccination centre near me, some older man was yelling at staff, insulting them because they wouldn’t give him the Biontech vaccine (the one you Americans would know by its’ distributor as “Pfizer”) – the appointments clearly state which vaccine you’re going to get, so he knew before he went there, and was yelling because they refused to change it. In the end, he left without getting vaccinated.

        And now the EU has decided not to extend their contract with AstraZeneca beyond July… and the EU, as compared to the US, doesn’t have nearly enough doses yet

  10. Stefan says:

    In case you don’t know outbreak.info yet, I learned about it recently and it seems like a great source of data & visualization.

    See e.g. here for variants in the UK, one sees the exponential of B.1.617 taking over B.1.1.7:
    https://www.outbreak.info/location-reports?loc=GBR

    Credit to Ruby (LW) for linking the site in https://www.lesswrong.com/posts/63BsSJm65Ke3cpffG/the-case-for-extreme-vaccine-effectiveness

    • Lambert says:

      That doesn’t imply that community transmission of B.1.617.2 is exponential.
      Many of those 1,467 sequences will be from people who have just retuned from India, where they got infected. Assuming constant inflow etc, the number of cases arriving in the uk will grow exponentially with the Indian infection rate.

      And sequencing in the uk is a *very* non-random sample. They’re actively trying to find all the VUI and VOC infections. It’ll be disproportionately easy to find B.1.617.2 by sequencing any positive sample that comes from someone who has or lives with someone who has recently returned from India.

  11. Eye Beams says:

    NPR is banking on their listeners having no black or latino friends.

  12. freixa says:

    In regards to the IP, the most important note is, as you explained, that this is not going to affect vaccine production. There is an additional note about mRNA vaccines, is that the distribution is almost impossible outside high developed countries. I don’t see how India, Brazil or Tanzania can have enough freeze trucks to transport, storage and distribute the quantity of vaccine needed.

    Anyway, IP from Pfizer-BioNTech is from BioNTech, which is a German company and they’ve been working non-stop with rivals to increase its manufacturing capability. Without lifting the IP, US may be left without this technology, and unable to manufacture all critical medicines that in the future will use BioNTech technology.

    In summary, I see this as a Biden maneuver to ensure that the US leads this filed in the future.

    Or I can be wrong. The main point is that this movement will have strong implications way beyond this pandemic, so I doubt it is taken only for political advantage, specially taking into account that:
    1) Biden just won the election. He doesn’t need to do anything else of what is already doing until summer 2022 to be prepared for midterm election
    2) Long Live the King, but he is 78, I don’t think that he is worries on being reelected in 2024.

    • Humphrey_Appleby says:

      Moderna is also an mRNA vaccine and is entirely a US affair, so I don’t think your logic holds water.

    • Humphrey_Appleby says:

      Also, mRNA distribution to *rural* areas in India/Brazil/Tanzania is obviously a non-starter, but in major cities it shouldn’t be a problem. Particularly for Moderna, which has more forgiving logistics.

  13. SamChevre says:

    On the “I’m pregnant” objection (and I’ll add, “I’m breastfeeding”.) It would probably help if vaccination providers were clear on “yes, you can get vaccinated even if you are pregnant or breast-feeding.”

    I’ve heard anecdata from several women I know (including my sister) that they tried to schedule a vaccination/get vaccinated at a mass clinic and the people giving vaccinations weren’t sure they should get vaccinated because they were pregnant or breastfeeding. If the providers aren’t sure, I’m not surprised that the patients are not.

    I’ll reinforce the mask issue as well: if there were a firm commitment that once X% of adults are vaccinated the government will drop the mask requirements–indoors and out, at any venue–that would help a great deal. If the message is “you should get vaccinated, but none of the restrictions will change” that doens’t induce much confidence. (A vaccine passport system would be a good idea if it applied generally to employers asking for relevant-to-them medical information, but it is not going to survive legal challenge if it’s a carve-out to HIPAA.)

  14. bro says:

    That army survey of vaccine objections is the result of all kinds of incentives absolutely none of which is to accurately represent the most common vaccine objections.

    A truly vanishingly small proportion of people who were not otherwise going to get vaccinated are going to change their minds because the FDA grants full authorization instead of emergency authorization, for example. That is nakedly absurd if you have any more familiarity with the type than “I read about them in a $700 billion organization’s bureaucratic paper emission”.

    Lurk something like r/NoNewNormal for an afternoon for a more truly representative idea of what the common objections are.

  15. I really appreciate your takedown of the memo to the soldiers in Colorado Springs. I consider myself pro-covid vaccine, and even pro-making the vaccine mandatory, in some circumstances and depending on how the mandate is enforced. But I get very worried when I see efforts to bust the “myths” that the hesitant offer.

    Of course, I’m also writing from the cheap seats and don’t work in a public health field. So it is probably easier to criticize than to actually craft a good message.

  16. Lambert says:

    If the worry is that these waivers increase the general prior on valuable pharma patents getting waived, shouldn’t we be looking at the share prices of Bayer, GSK, Novartis and all the other big pharma companies who *aren’t* getting their ip expropriated right now?

  17. Bobboccio says:

    What would be the pros / cons of mixing first doses and second doses? eg.. Moderna as first dose, and Astrazeneca as the second. To me it seems like it would be extra effective? What about in other combinations?

  18. purple_guitar says:

    Zvi, besides getting vaccinated and wearing masks in indoor spaces, what can I do to further reduce the risks associated with severe infection and death?

    For example, I consider introducing a daily habit of nasal washing and gargling throat with salt water each evening; it may take less than 10 minutes, and the potential initial viral load should be significantly reduced. How effective could it be?

    • TheZvi says:

      It might help, I don’t know, but I find it odd that I’m being pitched such a thing post-vaccination. If you’re vaccinated I don’t see the need for such things unless e.g. you’re in India, in which case I guess? But no one’s ever tested such a thing. My guess would be little or no effect but it’s a weak guess.

  19. Humphrey_Appleby says:

    I see Pfizer is now approved for ages 12-15. I dare say in the not too distant future, it will also be approved all the way down to maybe 6 months plus. However, while I am highly enthusiastic about vaccination for adults, for young kids the actual risks from COVID seem low enough that I wonder whether COVID vaccination passes a cost benefit analysis for the recipient. Would be interested to hear your thoughts.

  20. Basil Marte says:

    With regards to schools replacing snow days, CGP Grey wholeheartedly agrees with you, here’s his new video/call to arms: https://www.youtube.com/watch?v=-FBwZtuJtMw

  21. Pingback: Covid 5/13: Moving On | Don't Worry About the Vase

  22. etheric42 says:

    OTC insulin exists. Wal-mart sells it in 49 states. It’s $25/vial. Humalog’s patent has expired and it’s available for $20-$50/vial. From what parents of diabetic (type 1) kids have told me is the kids had to go to the hospital or doctor about once a month in the 90s due to complications while now it is 1-2 times/year.

    Modern versions of insulin are different and better than classic insulin. They are also both on the market and available to buy (unless you are in Indiana for some reason). Why is Tresiba ($500 for 10 days) rent seeking but the Pfizer vaccine not?

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