On one hand, vaccines are an almost unbelievably remarkable scientific, engineering, and logistical achievement—from their development to getting them into people’s arms. On the other hand, we haven’t vaccinated the world fast enough.
Starting in spring 2020, a big team of researchers, which I joined that summer, were banging the drum at policy makers to go big on vaccines. Some of our exercises suggested that countries, even before knowing which vaccines would work, should throw a ton of money at the problem to increase production capacity.
To paraphrase something [Harvard’s] Larry Summers has said, if your family’s survival depended on getting a pizza in 30 minutes, you’d order from 20 different places in hopes of getting at least one on time. If we had done that with vaccines at the levels suggested by our calculations, we would’ve been able to vaccinate the United States by March 2021 and the world by October 2021.
Last February, when our Science paper came out, the world was vaccinating at a rate of about 1 billion people per year. Our model in that paper urged capacity for 7 billion people per year.
We also pointed out that society’s incentives and vaccine manufacturers’ incentives were misaligned. For manufacturers, especially early on, building out capacity was expensive and risky. But the capacity we wanted to create would have paid off many times over, and the early doses were especially valuable.
We estimated that the value for society of vaccine capacity is $5,800 per course, but Pfizer makes about $50. The gap between the social value of vaccines and the private incentives for producing them is vast. Pfizer’s making a lot of money but capturing a fraction of the social value.
The world hit our capacity goal around July 2021, and our Science model says the capacity built was worth about $17 trillion. That’s a lot! Still, every day that the pandemic has dragged on, there’s been a huge cost in terms of economics, education, health, and overall social well-being. There’s no perfect number, but our team used $1 trillion per month, which we think is pretty conservative, for our base-case analysis. That is, speeding up vaccination by one month is worth $1 trillion.
The cost-benefit analysis was to spend billions to save trillions. If we had built more sooner, we would have been done vaccinating earlier. In high-income countries, more than 600,000 people have died from COVID-19 since April. Worldwide, 200,000 to 300,000 people die each month.
Think of all the money the US government has spent in the pandemic response, and what a small fraction has actually gone into fighting the disease. There’s so much noise about vaccine inequity, but you eliminate the problem with capacity. The rich world should have coughed up for that. We’ll look back at that as a major missed opportunity.
Now the challenge is different. In the rich world, we have to overcome vaccine hesitancy, and we have to build up testing capacity. Globally, there are many countries that still need access to vaccines. All of this can be addressed with money. If you really want someone to do something, you can mandate it, or throw money at it, or both. You can see the glass as half empty, or half miracle. The science is so miraculous, but our institutions could’ve done such a better job with that science.
Eric Budish is Paul G. McDermott Professor of Economics and Entrepreneurship and Centel Foundation/Robert P. Reuss Faculty Scholar at Chicago Booth.
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