# Vaccine Rollout as Wheeled-Luggage Problem

According to [FiercePharma](https://www.fiercepharma.com/special-reports/vaccine-supply-chains-holding-line-against-covid-19), Pfizer, AstraZeneca, Moderna, Johnson & Johnson, and Novavax plan to produce a combined ~9 billion doses this year. They are collaborating with other companies to scale up production, and have facilities all over the world. They're licensing their product to nonprofit producers, and some have committed to providing the vaccines at cost.

The fact that these companies project to produce enough vaccine to vaccinate the entire world this year is great. Why didn't they have it ready to go earlier?

Note that this is a similar question to ["Why did it take so long to invent wheeled luggage?"](https://www.lesswrong.com/posts/DGoK3QeaXFu5Mvxh8/epistemic-standards-for-why-did-it-take-so-long-to-invent-x) Why has it taken so long to ramp up production, when the first mRNA vaccines were created in January 2020?

Jason Crawford proposes epistemic standards for this sort of question:

> On the other hand, if you want to argue that something *could* have been invented much earlier than it was, you have to do better than glancing at its high-level concepts or components. You need to rigorously examine every part, material, and manufacturing process, and rule them *all* out as gating technologies. Any detail, even a minor one, can become crucial—especially when we remember that inventions need not only to work but to be practical, which includes performance, reliability and cost.

We want to identify the fundamental bottleneck for ramping up vaccine supply. I've seen lots of attempts. They usually boil down to the idea that with better planning and less regulation, we could have spent a relative pittance for more production capacity early on, and might have been able to produce the billions of needed doses many months sooner.

That explanation does not meet the Crawford Standard. Instead, we need to rigorously examine every aspect of vaccine manufacturing and rule them *all* out as bottlenecks.

First, we need to consider planning and regulation failures prior to 2020. What failures of planning and regulation prevented us from setting up sufficient emergency vaccine production capacity before COVID-19 emerged? Could we have had a global network of pandemic vaccine factories on standby back in 2015?

Secondly, we need to consider the practical and material challenges producers must have faced once they'd developed their vaccines. If they'd had the money and governmental support, could they have ramped up production faster than they did? Or would they have faced problems sourcing labor, materials, transport, and storage capacity?

Are these 9 billion planned doses being produced in factories that already existed at the start of 2020? Or have these companies built or renovated additional facilities? How much delay was caused by planning failures and red tape, and how much was a practical problem?  Have these companies had to retrain workers? How hard was that?

By the Crawford Standard, while we can reasonably complain that planning failures and regulation probably slowed the ramping up of production, we need to do a lot more work to assign them the lion's share of the blame.

[FastCompany has an article](https://www.fastcompany.com/90588372/inside-one-of-the-new-quick-build-factories-making-the-moderna-vaccine) on how Lonza, a vaccine manufacturer, sped up the vaccine production spin-up process from 2+ years to about 8 months. They developed this concept about a month prior to the COVID-19 pandemic. The article is itself a look at some really innovative thinking by a manufacturing company that's actually trying. Good job, Lonza.

![](https://39669.cdn.cke-cs.com/rQvD3VnunXZu34m86e5f/images/a2cc03517f26408468907d131f3b38dadaed6ff46254a038.png)

Their approach involved building adaptable buildings in advance, which can then be pre-approved and repurposed when they have a specific vaccine production need. My impression is that it still takes a long time to build the adaptable buildings. Once built, though, it only takes 8 months to set up manufacturing within them. Even starting in late January, though, they wouldn't have been ready to go until September 2020.

This is as fast as a company capitalizing on a whole new approach to vaccine factory construction could go. It seems reasonable to expect that repurposing existing infrastructure *not* specifically designed for adaptability would take even longer.

I have no idea how complicated the work of manufacturing vaccine is. But given that we've seen a [major batch failure in the J&J vaccine](https://www.industryweek.com/covid19/article/21159916/jj-disposes-15-million-vaccine-doses-after-partners-batch-fails-quality-check) after a quality control failure, it's not exactly flipping hamburgers. So on top of the time and labor it takes to build a factory,  with all the complex equipment that also needs to be manufactured (perhaps requiring additional factories to build that!), there's also the challenge of finding or training a high-skill workforce on a global scale to operate a bevy of new vaccine factories. You can't buy this stuff at Target.

We can cynically assert that in fact, governments are acting to actively harm vaccine production as some sort of signalling game. What about the more obvious-seeming explanation that they would want to take credit for a strong pandemic response? That vaccine manufacturers want to make money and help those bureaucrats get some credit for success?

It seems like a more reasonable explanation to expect that regulatory and other governance failures are responsible for only a part of the rollout. Practical issues must be a big part of the explanation as well.

If true, this helps explain why human challenge trials might not have helped as much as you'd expect. If even Lonza wasn't going to be ready to produce vaccine at scale until September, then an HCT wouldn't speed things up, at least not by much.

By the Crawford Standard, the burden of proof is not on me to demonstrate that we couldn't have gone much faster in producing vaccine.

To claim we could have gone much faster, if it weren't for X, is to claim that there was *no* *other factor Y* that was a more fundamental bottleneck than X. The burden of proof is on people making arguments of this kind. They need to investigate the details of the manufacturing process make a careful case that this could have been accomplished faster. Alternatively, they need to supply a better epistemic standard than Jason Crawford's.

This would undoubtedly produce useful insights, and I think it's a more productive way to steer the conversation than complaints about political blame-mongering. That blame-mongering might just be a reaction by politicians who are fundamentally not able to make things go faster, yet who are expected to do so and are unfairly blamed for not having a magic wand. I would be much more interested to learn about what goes into building a new vaccine factory.