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Several vaccine manufacturers supplying the United States have recently made efforts to increase their manufacturing capacity, some with government assistance. The Biden administration used the Defense Production Act to secure some Pfizer supplies and claimed credit for engineering Johnson & Johnson’s deal with Merck for vaccine production aid later this year. Moderna this week announced a long-term deal with a contract manufacturer.

“The question is to what extent are companies doing at their own risk compared to what the government is supporting?” said Nicole Lurie, who led the Department of Health and Human Services’ emergency preparedness efforts during Obama’s presidency. Lurie is now a strategic advisor to the Coalition for Epidemic Preparedness Initiatives, one of the leading organizations in the global vaccine equity effort known as the COVAX Facility.

US authorities have already distributed billions of dollars to obtain hundreds of millions of doses of the first vaccines from Pfizer, Moderna, J&J, AstraZeneca and Novavax. Those manufacturers have pledged 700 million combined doses to the United States this year – a gargantuan task that they nevertheless promise to be able to accomplish in large part by this summer.

From there, the road becomes foggy. Scientists still do not know how long the protection against vaccines lasts and whether certain strains can overcome the immune protection of the initial vaccines. Booster shots may become a regular occurrence. And each of these manufacturers will have to continue producing initial doses in addition to any recalls.

“The good news is that existing vaccines generate neutralizing antibodies that work against the variants,” a senior administration official said. “We need more data to determine the sustainability of this response. It is likely – it is expected – that this response will diminish over time. “

The official added that there were three ways forward: boosting immunity with another dose of existing vaccines, increasing with a vaccine aimed at variants, or combining these into what’s called a bivalent vaccine.

Biden officials are betting the vast majority of Americans will be vaccinated before the variants spread so widely in the United States that more shots are needed – but this ship has sailed to other countries, such as South Africa. South, who jostle for shots protecting against variants like B.1.351 and P.1.

“I think as soon as there is a vaccine variant that has passed the appropriate trials, it may be prudent to just switch to that vaccine, certainly in countries where the variant is prevalent,” Lurie said.

All of this could constitute one of the biggest tests of vaccine diplomacy for US officials. While the Trump administration has largely resisted global cooperation on Covid-19, taking an “ America First ” approach to securing vaccines, the Biden team has taken early steps to join the international fray, returning at the World Health Organization and becoming a participant in COVAX Vaccine Equity Effort in Facilities.

But there is a careful balance for Biden to strike a balance between racing to protect Americans in a matter of weeks, as promised, and launching the global effort to defeat the virus before the variants become the biggest problem in the world. world.

“I’m talking to all of you about how we even have access to more vaccines than we need to care for all Americans. And we are helping other poor countries – countries around the world that don’t have the money, the time, the expertise, ”Biden said in an April 6 speech celebrating 150 million strokes administered to people. United States. the vaccine is available around the world and we are counterattacking the vaccine – the virus in other countries, we are not really completely sure. “



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