When will I get the Covid vaccine? Operation Warp Speed ​​and US Health-Care System

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Moncef Slaoui was called upon by the Trump administration in May to lead a Manhattan-style project to drastically cut the time it takes to develop a coronavirus vaccine and produce hundreds of millions of doses for the American people.

The well-known immunologist and former head of the vaccine division of GlaxoSmithKline Plc is somewhat of a celebrity in the pharmaceutical world. He assumed the role of Chief Scientific Advisor to Operation Warp Speed ​​with two conditions: “Full empowerment and no interference.”

Slaoui, 61, sees the rapid development of multiple vaccines and the production of millions of doses as an unprecedented success. However, a slow and confusing rollout has frustrated millions of Americans and prompted the Biden administration to pledge to speed up the pace. Slaoui said he has been bothered by the inability to shoot in the arms.

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

Speaking with Bloomberg earlier this month after resigning as an advisor to the U.S. pandemic response at the request of the Biden administration, Slaoui reflected on a broken health care system that he says is responsible for the dose delivery problems.

His comments have been edited for clarity and readability:

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

Moncef Slaoui: 100 million doses in 100 days is frankly among the plans we had. By then we had vaccinated 100 million people. That means two doses. At least in terms of production and delivery, absolutely 200 million doses will have been produced by the end of March or mid-April. So if the ambition is to use only half of it, then that is the ambition. I hope that goal has been achieved and far exceeded.

Bloomberg: Why is the gap between the divided vaccine doses and the doses administered so wide? Of the 39.8 doses delivered in the US, only 19.8 million injections have been administered so far, according to Bloomberg’s Vaccine Tracker.

Slaoui: Having lived in Europe and now the US, the health systems are clearly as dramatically different, as opposites. The problem in the US is that the system is so fragmented, there are so many healthcare providers, so many health insurers, so many systems, so many jurisdictions, and people move so much more between them than people in Europe. It’s really hard to get a coherent message to people, and it’s hard to mobilize everyone in health care to do something at the same time.

The way we go about it, and it clearly turned out to be a problem, was to say, because we can’t align all of these systems, let’s work through them, strengthen them. We were part of a government whose world view was based on less centralization.

BloombergWhy has the Trump administration’s approach to working through the states proved unsuccessful?

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

Every week a health system in New York or California would say send 200 doses to this zip code, 300 to the other one, and 500 or a thousand to this hospital, and so on. How is it possible that the health system would say so accurately that they want 200 here, 500 there, 700 here, and then if we send them to 99.9% accuracy, it turns out they can’t even immunize people?

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

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

Slaoui: I do not deny that this is by far less than our goal. That we missed it. In terms of vaccine discovery, development and production, we moved faster than ever before. But a vaccine is useless if left on the shelf. Obviously, it must end in people’s arm.

Maybe having a hundred stadiums where people could come and get vaccinated would have helped. Or with 200,000 army personnel to vaccinate people in tents. Maybe that’s the way you do it. The approach we have in our plan is that as soon as we get past phase 1a, that limited population, we go to the pharmacies. There is a pharmacy within 10 miles of 90% of Americans. If we get to those populations, which is happening now, the rate of immunization will increase. Right now we’re reaching a million people a day, and it will continue to increase based on the previous plan.

Bloomberg: In a In a previous interview with Bloomberg, you said that Pfizer Inc. turned to the US government get priority access to raw materials so that it can deliver 100 million doses in the second quarter of this year. The US government has it Defense Production Act for that purpose? And what would that mean for the relationship between the US government and Pfizer?