Preparing for a Pandemic: Accelerating Vaccine Availability

Each month, the COVID pandemic kills 300,000 people (as of Jan. 2021) and reduces global GDP by approximately $500 billion. The full cost, including losses to health and human capital is likely much larger. Cutler and Summers (2020) estimate total losses of $16 trillion (around $800 billion per month of the pandemic) for the US alone. Beyond the epidemiological externalities that motivate governments to play a central role in vaccination programs, new issues arise in a pandemic. Vaccine candidates face substantial risk of failure or delay in proving safety and efficacy. Normally firms wait to resolve this uncertainty before scaling up manufacturing, a risky and time-consuming process requiring specialized facilities and specific investments. However, in a pandemic the benefit of speed makes it socially valuable to invest in manufacturing capacity in parallel with testing. Social and political limits on vaccine prices during pandemics mean the social value far exceeds the commercial returns to vaccine manufacturers from installing capacity. In  a companion piece (Castillo et. al 2020), we estimate that increasing the total supply of vaccine capacity available in January 2021 from 2 billion to 3 billion courses per year generated $1.75 trillion in social value, while additional firm revenue was closer to $30bn assuming a price of $15 per dose. Additional profits would be smaller still. Since unprecedented acceleration of manufacturing involves substantial, risky investment, carefully crafted public intervention is needed to align social and private benefits. What magnitude and structure of public intervention is best? Early in the pandemic, we analyzed alternative approaches to procurement, arguing that buyers should directly fund manufacturing capacity and shoulder most of the risk of failure in exchange for the right to buy doses at close to marginal cost should the vaccine candidate be successful, while maintaining some direct incentives for speed. We analyzed the optimal portfolio of vaccine investments for countries with different characteristics as well as the implications for international cooperation. Our analysis, considered in light of the experience of 2020, suggests lessons for future pandemics.