I know we are all applauding @JoeBiden for his response to India today, but, to be honest, I think Biden's response is actually really bad. And it shows that nearly 100 days into his administration, they still don't have a plan for ensuring global vaccination. 🧵
First, as @zainrizvi has pointed out, the WH was clear that the materials that would be sent to Serum Institute of India would be for Covishield (the SI version of AZ/Oxford). The only problem? There was NO materials shortage for Covishield that was inhibiting production.
Instead, @SerumInstIndia cannot access supplies for the OTHER COVID-19 vaccine it produces, Covovax, their version of @Novavax, *and not Covishield*. Serum Institute has been 100% explicit about this (once again h/t @zainrizvi):
Is this a mistake @JakeSullivan46? But regardless, we have seen nothing from the administration on how the US is going to scale manufacturing capacity for both raw materials and consumables (biorx bags, filters/columns etc,) necessary for scaling up vaccine production globally.
In fact, the administration has had US$10 BILLION, authorized by the COVID rescue package, to do exactly this since MARCH, and yet has to done nothing. congress.gov/bill/117th-con…
And the Bio E investment announced today is similarly unambitious -- 1 billion doses (enough to cover 700 million people) by end of 2022(!), is too little, too late. And remember 600 million doses of that capacity is for a vaccine that has yet to even enter phase 3 trials.
So we are scaling capacity for a vaccine that we don't even knows works, all while the Biden Administration has refused to explain why @Novavax candidate has still not even be authorized, despite posting excellent phase 3 results in January.

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More from @jbkrell

23 Mar
As the world reels this morning from the @AstraZeneca news, remember that this problem + the general difficulty of comparing different COVID-19 vaccines is due to a decision by the @NIH to not run head to head trials because pharma *didn't want them to*. 🧵
The problem is that each COVID-19 vaccine was evaluated in its own clinical trial(s), each with a different statistical design, end point definition, recruitment strategy etc. A better way would have been to compare each vaccine against each other in a "platform clinical trial".
This would of made direct comparison between each vaccine candidate far easier, because they would have been evaluated on a common trial design and critically, would have generated important info to guide policy makers on selecting candidates for further manufacturing scale up
Read 8 tweets
5 Feb
The @Dereklowe piece sort of misses the point. Yes, there is no idle mRNA vaccine production capacity in the pharma industry that could simply be repurposed to make more COVID-19 vaccines. But we could rapidly *build* more capacity, as we did across the world last year. 🧵
Before we get deep into the weeds, lets remember, in January/Feb, the world had basically no commercial scale mRNA vaccine production capacity. By December, private industry (with a lot of public funds) built 3 billion+ doses / year scale capacity
So what happened? Companies like @pfizer, @BioNTech_Group, and @LonzaGroup (which makes the bulk of finished drug substance for @moderna_tx ) rapidly built mRNA vaccine production capacity inside existing manufacturing facilities.
Read 19 tweets
3 Feb
I am a little confused by this @nytimes reporting by @MarcSantoraNYT and @RebeccaDRobbins on the new AZD1222 data. First of all, the claim that this data is the “first” to document evidence that a COVID vaccine can result in a reduction in transmission seems to be wrong. Image
In fact, just last week, Israeli researchers documented a 50% reduction in both symptomatic and asymptomatic infections in individuals who took a single dose of the Pfizer mRNA shot in a retrospective cohort study. medrxiv.org/content/10.110…
This is a preprint, but so is the new Astra data! Furthermore, the original AZD1222 publication in the Lancet in December *also* reported on preliminary PCR positivity in asymptomatic individuals in COV002 as well. thelancet.com/action/showPdf… Image
Read 5 tweets
2 Jul 20
When I was 22, I watched a friend become HIV+ cuz he couldn't afford Truvada PrEP which cost s$1,300/m but costs <$6 to make. CDC invented & patented PrEP, but they refused to stop Gilead's price gouging for yrs. Today, the the same thing is happening with remdesivir for COVID.
Last month, @cmorten2 & I showed that not only did (h/t @zainrizvi ) the US government spend >$70 million on developing & inventing the drug, the government is legally entitled to be co-owners of the patents for remdesivir. prep4all.org/news/remdesivir
This means that USG can license remdesivir to generic manufacturers while paying no (or very little) $ to Gilead. Remember remdesivir costs less than $1 to make a dose, yet Gilead charges over $350 a dose for it. Our government could stop this price gouging today, but will they?
Read 4 tweets
6 May 20
This is an important q from @mynameisjro. The convo around physical distancing reminds me a lot of the pre-PrEP conversations about HIV prevention. THREAD but tl;dr u can shame as much u want, but it doesn't change the fact that our methods of COVID control are not sustainable.
I am NOT saying we should stop physical distancing. But the idea that we can ask people to not see friends, lovers, family etc. for a basically unlimited period of time is BS. Let's not repeat the mistakes of the HIV epidemic in our response to this plague. 2/n
1 of the reasons the HIV epidemic was allowed to run out of control in US queers starting in the early 90s is because we were more focused on shaming queer ppl than finding effective ways to prevent HIV. And a lot of that had to do with the shame around "barebacking". 3/n
Read 11 tweets
15 Feb 19
@Surgeon_General @POTUS @NIAIDNews @HRSAgov @IHSgov @VP @gregggonsalves @fcraw4d Respectfully, that is bullshit. HIV epidemics in PWIDU are not "unprecedented" and interventions to bring them under control, like needle exchange, have been well understood since the 1980s. You and @VP could of implemented needle exchange sooner, but didn't, so Hoosiers suffered
@Surgeon_General @POTUS @NIAIDNews @HRSAgov @IHSgov @VP @gregggonsalves @fcraw4d 2. The idea that you did not know that SC was at risk for an HIV epidemic is also BS. Increases in overdoses had been happening in IN since 2004, local officials recommended needle exchange in 2008, there was a huge HCV outbreak in IN in 2010-11, but still no needle exchange.
@Surgeon_General @POTUS @NIAIDNews @HRSAgov @IHSgov @VP @gregggonsalves @fcraw4d Even in the midst of the peak of the epidemic, more than two months after it was identified @VP refused to allow needle exchanges, preferring to "pray", rather than understand science. This is not success.
Read 4 tweets

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