The Daily - Why Did the U.S. Turn Down Vaccine Doses?

Episode Date: December 10, 2020

From the start of the pandemic, the Trump administration said it was committed to ordering and stockpiling enough potential vaccine doses to end the outbreak in the United States as quickly as possible.But new reporting from The Times has revealed that Pfizer, the maker of the first vaccine to show effectiveness against the coronavirus, tried unsuccessfully to get the government to lock in 100 million extra doses.Today, we investigate how the Trump administration missed that opportunity and what the repercussions might be.Guest: Sharon LaFraniere, an investigative reporter for The New York Times.For an exclusive look at how the biggest stories on our show come together, subscribe to our newsletter. You can read the latest edition here.Background reading: U.S. officials had the opportunity to secure enough doses of Pfizer’s coronavirus vaccine to inoculate most of the country — at no upfront cost to the government. Instead, they turned down the offer.With a smaller-than-expected order from the United States, Pfizer turned to fulfilling orders from other countries, like Britain, which began vaccinating people this week.

Hey, it's Michael. We know that 2020 has been a difficult year, but it's also been a year of small victories, personal milestones, and moments of joy. If something good happened to you, we want to hear about it. So write us an email, or better yet, send us a voice memo to thedailyatnytimes.com. That's thedailyatnytimes.com. That's thedailyatnytimes.com. And tell us your story of good news this year, large or small. And thank you. From New York Times, I'm Michael Barbaro. This is The Daily. Today. From the start of the pandemic, the Trump administration said it was committed to ordering and stockpiling enough vaccine to end the pandemic as quickly as possible. But new reporting from The Times raises questions about whether it has actually done that.

I spoke with my colleague, Sharon Lafreniere. It's Thursday, December 10th. Thursday, December 10th. So Sharon, tell me about this tip that you got. So it was on Saturday. I think I was playing bridge on my phone with the robots, which is how we spend Saturday nights now, right? Right. And I got a call from another New York Times reporter, mutual friend of ours, saying, I

have heard this about Pfizer. You need to call this guy. Here's his name. Here's his number. Tell him you know me. And so I called the guy. So I called the guy and basically the tip was that the administration had muffed a chance to buy more of Pfizer's vaccine. And now it couldn't get it until like the middle of next year. That's a very big tip.

It's a big tip because Pfizer's vaccine has been shown to be 95% effective, and it's the first one out of the gate, right? The Brits are already inoculating people with it. The Americans want it. And if we somehow missed out a chance to get twice as many doses as we had locked in, that would be a big deal. And I wonder what you thought when you heard this tip. I mean, it's one of those things you hear, you're sort of like,

wait, could that be right? My reaction was, if this is right, it's a big story. Mm-hmm. And so what did you do? So I called my editors and my colleagues and said, we need to chase this as hard as we can. And so all Sunday we were calling everybody and we were getting like, sorry, can't help you on this. Or I never heard about this or try some other people. or try some other people. And then finally, on Monday afternoon,

early Monday afternoon, we were able to confirm it, that in fact, Pfizer had tried to get the U.S. government to lock in 100 million extra doses, but the government had turned them down. So Sharon, what did you find out was the thinking behind this decision, which feels like a real head-scratcher on paper, not buying extra doses of a very effective vaccine from Pfizer? So to answer that, we really have to go back to the start of the administration's whole crash program to develop vaccines, all the way back to March when it starts this initiative called Operation Warp Speed and comes up with a strategy to develop vaccines in record-making time. Right. So the initial strategy was that the government would pick three different technologies, and each technology would be pursued by a pair of companies.

So six companies all together. Six horses, they actually called them horses. And the idea of having a pair of companies is one company fails, and you've still got one company standing to go after that technology. But nobody had any idea which of those vaccine technologies would work. So the government strategy was we'll back all six and we're going to pay this money even before we know whether their vaccines work or not. But Pfizer was alone among the group in saying, we don't want your money. And there's really three reasons for that. So the CEO, Albert Bourla,

told us, number one, it doesn't need the money. Number two, it doesn't want the government oversight. I mean, he actually felt that having government oversight over their vaccine project would not speed them up, but it would slow them down. And number three, he was fearful about getting involved in the whole political drama that was starting to unfold with the White House pressuring the health agencies to act in one way or another. He just wanted to stay out of the political fray. one way or another. He just wanted to stay out of the political fray. And he thought, you know, if he takes the money, the money will come with strings attached and he doesn't want to be dragged into this. Got it. So what exactly is the arrangement with Pfizer? Because it sounds very different from the other five. What's the eventual terms of it? So the contract called for Pfizer to deliver 100 million doses to the U.S. government at a cost of $19.50 per dose by the end of the first quarter of 2021. But the U.S. government

didn't pay any money up front. In other words, only if this vaccine clears all the hurdles, Only if this vaccine clears all the hurdles, gets approved by the FDA, and Pfizer is able to manufacture it, only in that case will the U.S. government than its arrangement with the five other companies, doesn't have to put any money down, and it seems like Pfizer is assuming most, if not all, of the risk. Exactly. So it's just a very good deal if you're the United States government. Right. You get to lock in 100 million doses and you don't have to pay up front. And so the U.S. takes that deal. Right. And when exactly was this? So the contract is signed in late July. But even at that time, we're told Pfizer is asking Operation Warp Speed officials, don't you want more? Like, don't you want to lock in an extra 100 million doses or 200 million doses? Because you don't have to pay for them unless it

works. And the answer was, no, we're hedging our bets. We've got six candidates here. We're not, you know, playing favorites among any of them. And Pfizer is saying basically, yeah, but with us, it's a free bet. But the government is saying, no, you know, we're sticking with our strategy. They don't want to bet too heavily on any one of the six, even if the bet is free. And Sharon, as the U.S. government is turning down this offer from Pfizer, what does it actually know about Pfizer's vaccine and how effective it may actually be? Well, remember, this is July. And at this point, the government really doesn't know very much, if anything, about which of these vaccines is going to work. But as time went on, it looks like suddenly that Pfizer is going to be the first over the finish line. But the problem is a lot of other countries were also getting interested in Pfizer's vaccine. They have a vaccine that is attracting so much

attention that their executives are getting messages over LinkedIn from other countries, like we want some, you know, can we lock this in? And in early October, the U.S. government also gets interested in some extra doses and talks resume. But it's no longer the same situation because while the U.S. was hesitating, other countries were moving in. So in October, they don't actually come to any agreement on a second contract because the U.S. is like, we need it sooner than it sounds like you're delivering it or you're not promising us that we're going to get it in time. Anyway, the talks are inconclusive. And then comes the big day of November 8th. This is CNN breaking news.

Pharmaceutical giant Pfizer reportedly making an enormous breakthrough with its COVID-19 vaccine, announcing today... Pfizer gets the interim results of its clinical trials. Pharmaceutical giant Pfizer just announced moments ago that its coronavirus vaccine is 95% effective. 95% effective. 95% effective. And they say, with no serious side effects. And they are amazing. Pfizer CEO is calling it, quote, the greatest medical advancement in the last 100 years.

We will speak with... Right, I remember that, Sharon. The results were stunning, and it suggested that this vaccine was going to be a blockbuster, but the U.S. still hasn't ordered extra doses at this point. Right. And according to Scott Gottlieb, who is a member of Pfizer's board and the former commissioner of the Food and Drug Administration, Pfizer was still offering, after the results came out, more doses, but the U.S. did not seal a deal then.

So the Trump administration, the U.S. government, having missed this first chance back in July to lock in this deal for extra doses of this vaccine at no cost, is then told in October, and it sounds like even in November, we can't offer you the exact same timeline because months have gone by here. We've gotten other orders. And so as a result, despite how promising this vaccine turns out to be, the U.S. still decides not to order more. I just want to be clear. That seems to be the situation, yes. And then on November 11th, which is basically two days after Pfizer has announced these amazing results, it announces that it has a deal to sell 200 million doses to the European Union.

That was a contract that had been in negotiation for weeks and weeks. Nonetheless, in negotiation for, you know, weeks and weeks. Nonetheless, the European Union has locked in 200 million doses and the U.S. has locked in 100 million doses. So it very much looks like the European Union got 200 million doses of the vaccine that could have gone to the United States if the United States had wanted them. Yes, that's what it looks like. Sharon, do we know who exactly in the U.S. government made this decision repeatedly not to buy these vaccines? We're not sure.

We know that Pfizer was dealing with the guy who is the scientific leader of Operation Warp Speed. His name is Dr. Mansaf Slaoui. His name is Dr. Mansaf Slaoui. But whether Dr. Slaoui was the one who was the final decision maker, or it was Alex Azar, the Health and Human Services Secretary, or whether the White House was involved or not, we really don't know now. So Sharon, if you could summarize it, what are the consequences of how the U.S. has approached these offers from Pfizer? So the consequence is that the U.S. has approached these offers from Pfizer? So the consequence is that the U.S. might have to

wait longer for as much supply of the Pfizer vaccine as it wants and needs. Because the state of play is that Pfizer is right on the brink of getting emergency approval from the Food and Drug Administration. It's going to be the first vaccine to get that in the U.S. And the U.S. government has locked in a commitment for 100 million doses, enough to cover 50 million people, and it wants more. But it looks very unlikely that it can get it as soon as it wants it. So how much time have we lost here when it comes to the Pfizer vaccine orders that we never placed? So what we're being told is that the U.S. government has now asked Pfizer for 100 million doses

and they want them starting in March. But Pfizer is saying, sorry, we cannot guarantee you these doses until June. So if that's how it all plays out, the way it's looking now, then we would have lost three months. Three months. Three months of not having tens of millions of doses that the U.S. could have had. If it works out that way, that would be three months in which the U.S. is waiting for a Pfizer vaccine because it didn't lock in more doses earlier. We'll be right back.

We'll be right back. Sharon, having made this decision, which in retrospect feels like a pretty strange and bad decision, what does the United States now do to correct for this? Could we just beg Pfizer to make extra doses for us? No, because it's not that Pfizer is not willing to make more doses for Americans. It's making every dose that it can possibly make right now. It doesn't have empty factories somewhere where it can go in and just flip on the lights and suddenly there's lots more doses. It has legal commitments to other countries to provide supply and those countries want it too. It's not a matter of begging Pfizer to make more. If they had more to give the Americans, they would give it to them. Pfizer has a very big motivation to put the U.S. first because Pfizer, number one, it's an American company.

Right. Number two, most of its customers are in the U.S. They do not want to be in this situation where their customers think what you're making deals, you know, to save the lives of Europeans and you're leaving Americans here waiting for life-saving vaccines. They don't want a consumer backlash. Mm-hmm. Could the U.S. – and here I'm just kind of exhausting American curiosity – could the U.S. kind of forcefully take vaccine from Pfizer if it wanted to be extremely nationalistic and say nobody gets doses outside the U.S. before we get doses?

I mean, that seems highly unlikely that the U.S. government is going to move into Pfizer's factories and, you know, rip up all its contracts and commandeer its doses. President Trump signed an executive order this week saying that Americans would get vaccine supplies first, but it seems pretty meaningless. It's hard to imagine what the government could do to force Pfizer to redirect vaccine that it's committed to other countries, to Americans. I mean, some people have speculated maybe could Pfizer team up with another pharmaceutical company like Merck, and then could there be some kind of partnership there that would allow it to increase production? But it cannot itself now just turn on a dime and create more production.

Okay, so with no great options for securing more doses from Pfizer right away, what can the U.S. do instead? How do we make up for those missing doses? I have to imagine the answer lies with these other companies that the U.S. has invested in. Exactly. Moderna is right behind Pfizer with a very similar vaccine that has proven to be equally effective. It's likely to win emergency approval from the FDA maybe a week after Pfizer does, later this month. It too has committed to provide the U.S.

with 100 million doses. Like Pfizer, it has to deliver those doses by the end of the first quarter of next year. It's easier to store than Pfizer's and it might be, you know, easier to ship. It's a much smaller company than Pfizer, right? It spent 10 years without bringing a product successfully to market, but it's done extremely well with this vaccine. So there's the Moderna option. So if I'm keeping count correctly, 50 million Americans would be inoculated through

Pfizer's vaccine. 50 million Americans would be inoculated through Moderna's vaccine. That still leaves a lot of Americans. So what about these other companies? So of the other four companies, two of them are sort of off the table right now because they haven't even started their phase three clinical trials. Another one, AstraZeneca, which has developed its vaccine with University of Oxford researchers, is about halfway enrolled in its clinical trial here. And there are some questions about its data, its transparency. are some questions about its data, its transparency. It's had somewhat rocky relations with the FDA. And its early results have shown basically that for the full two-dose regime, it was shown to be about 62% effective. So you have to ask yourself, are Americans going to want to take a vaccine

that's 62% effective when they have two vaccines out there that are 95% effective? Right. And I think we all know the answer to that is probably no, not really. So it's really kind of Moderna and Pfizer or bust for the moment. Well, there's also Johnson & Johnson, and it expects to have clinical trial results early next year. But we don't know if that vaccine worked or not. You know, if it works, that gives us a third. But at the moment, the U.S. government has got, as you said, commitments for 200 million doses, which will cover 100 million Americans.

And the question is, what is going to happen at the end of March? Are we going to fall off some kind of vaccine cliff here? Or is there going to be an interval in of March? Are we going to fall off some kind of vaccine cliff here? Or is there going to be an interval in which people are not being vaccinated? Or are there going to be enough doses to fill in the gap? So what happens if we reach and go over a vaccine cliff? So the worst case scenario is that there is an interval in which Americans are waiting and that there's some sort of break in the inoculation program. But we don't know that's true.

We don't know for sure that that's going to happen. Moderna could fill in some of the gap. And at the moment, all we can say is that it kind of raises the anxiety level that we have two successful vaccines. kind of raises the anxiety level that we have two successful vaccines, and so far we have not locked in enough doses to cover more than 100 million Americans. Right. So no matter how you slice it, the chances of us going over a vaccine cliff, of suddenly having some period of some unknown duration where Americans are not being inoculated, which is not what we want, the chances that are higher, correct me if I'm wrong, because the United States did not order more of these doses from Pfizer.

Is that right? I think that's right. The administration says that is not going to happen. We're not going over this cliff, that there's going to be enough vaccine for everybody, that there are more supplies coming in, that there are negotiations going all the time, that they feel confident that they are going to have enough vaccine doses for every single American who wants it by spring or the middle of next year. But the government can't assure that. Not yet. Mm-hmm. But the government can't assure that?

Not yet. Sharon, it feels like the consequence of what the U.S. government, of what the Trump administration has done here, is time. You said that the decision-making here may have delayed this acquisition of vaccines by something like three months. Time is a very precious resource in this pandemic. Time is how we measure the number of people who get exposed to this virus, who get infected by it, who get killed by it. And so every single day matters. And so three months, 90 days, that really matters, right?

It means more people are likely to get this virus and potentially to die from it. I mean, I really, really hope that's not so. I mean, the whole story is such a roller coaster, right? We get these amazing results from Pfizer and Moderna and everybody is just ecstatic. And then we learn, whoa, we don't have enough. And are we going to get enough? And, you know, everybody would feel much more comfortable if we had all these doses in the bank.

I mean, what makes this feel especially confounding is that vaccines have been the U.S. government's approach to this pandemic, right? I mean, the Trump administration has not issued national lockdowns. It has not issued a national mask mandate. What it has said is that what will get us out of this pandemic is a vaccine. We are going all in on vaccines. It's pretty much our only solution to the pandemic.

So to have not done everything conceivably possible to get as many doses of the vaccine as we could, knowing that this is our solution, just becomes extremely hard to understand or explain. So in hindsight, some administration officials will say privately they wish that they had locked in more doses earlier, that this has exposed a kind of flaw in their strategy, and that now they're scrambling to figure out how can they compensate for it. And that is weighing heavily on them.

Sharon, thank you very much. We appreciate it. Thank you, Michael. On Wednesday afternoon, Canada became the latest country to approve Pfizer's vaccine, meaning that its citizens may start to receive it beginning next week. A few hours later, the Times reported that the United States had passed a grim new milestone on Wednesday. 3,000 deaths from the coronavirus in a single day.

We'll be right back. Here's what else you need to know today. No company should have this much unchecked power over our personal information and our social interactions. In a lawsuit filed on Wednesday, the Federal Trade Commission and attorneys general from 48 states called for breaking up Facebook. And that's why we are taking action today and standing up for the millions of consumers and many small businesses that have been harmed by Facebook's illegal behavior. The lawsuit accused the company of purchasing its rivals, including Instagram and WhatsApp, in order to eliminate potential competition

and, in the process, acting as an unlawful monopoly. In response, Facebook said that it would vigorously defend itself during what is expected to be a long and expensive legal battle. That's it for The Daily. I'm Michael Barbaro. See you tomorrow.