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Biden Booster Shot Plan Collides With Global Production Strain

Aug. 18, 2021, 9:57 PM

The Biden administration says Covid-19 vaccine booster shots won’t threaten its efforts to expand global immunization, but health policy experts are skeptical that both fronts can be effectively tackled at once.

Health officials on Wednesday announced that starting Sept. 20, the U.S. will offer boosters to all vaccinated adults who received their second shot at least eight months earlier. The administration will also “do even more to lead global vaccination efforts,” particularly by escalating production capacity in the U.S. and abroad, White House coronavirus response coordinator Jeffrey Zients said.

“We have already shipped 115 million vaccine doses to 80 different countries,” Zients said at a Wednesday White House briefing. That’s “more vaccine doses than all the other countries in the world combined.”

President Joe Biden also weighed in later on Wednesday, noting that while “some world leaders say America shouldn’t get a third shot until other countries get their first shot,” he disagrees.

“We can take care of America and help the world at the same time,” Biden said.

But manufacturing challenges are likely to remain as limited facilities are already struggling to meet demand, and booster shots will only further strain the system, policy watchers say. Vaccine production hurdles include intellectual property protections, a lack of capable facilities, and shortages of manufacturing know-how.

“There is an incredible tension here given the supply remains constrained, and so far the U.S. efforts to expand global vaccine access have been woefully inadequate,” said Lisa Ouellette, a Stanford law professor who focuses on health law and the pandemic.

Global Interest

The U.S. has a strong domestic interest in expanding global access to Covid-19 vaccines, Ouellette said. But by further pushing boosters, “it will be harder to make the case to the public that it’s important to focus on global access,” she said.

In June, the administration announced it would donate 25 million vaccine doses abroad. Biden’s team earlier this month said it will begin shipping half a billion Pfizer vaccine doses that it pledged to buy and donate to low-income countries. Biden said Wednesday that in the fall and early winter, “the United States will donate more than 200 million additional doses to other countries.”

The administration has backed the idea of waiving global IP protections on Covid-19 vaccines to help increase production and distribution—an idea floated at the World Trade Organization that has yet to be solidified. It also announced it helped secure a deal between Merck & Co. and Johnson & Johnson to expand production of J&J’s vaccine.

Yet some observers say Biden’s efforts will inevitably fall short of hitting immunity rates that will curb further virus mutations or the spread of delta abroad—in part because the private sector is ultimately in control of its partnerships and production.

With “the manufacturers calling the shots in terms of how to do things” rather than letting outside parties produce their vaccines or have the government handle logistics, the world has seen “limited capacity” for manufacturing, said Ameet Sarpatwari, assistant professor of medicine at Harvard Medical School.

“With limited production and the knowledge that we are encouraging boosters for everyone now, it risks compounding the inequity we are already seeing,” he said.

And even if countries were to withhold enforcing patent and trade secret protections on Covid-19 vaccines, third-party manufacturers still may not have the knowledge to replicate quality doses without coordinating with major drugmakers, critics of waiving such protections say.

‘Supply and Demand’

Nearly 5 billion doses of Covid-19 vaccines have been administered across 183 countries—enough to fully vaccinate around 31% of the planet, according to Bloomberg’s vaccine tracker.

Wealthy countries have fared far better than their poorer counterparts in securing jabs for their citizens. In the U.S., so far 358 million doses have been administered, covering about 56% of the population. Canada, the U.K., and China find themselves in similar positions, with enough jabs for more than 60% of their respective populations.

Meanwhile, India and Bolivia have given enough doses for less than a quarter of their populations. Egypt and Venezuela have given doses that cover less than 10%.

Critics note that the current state of affairs favors wealthy nations as they purchase large quantities of vaccines without doing enough to support less fortunate ones.

“The rich countries are very clearly saying, through their actions if not necessarily through their words, that it’s rich countries first, everybody else later,” an approach that is even “more problematic” with booster shots, said Nicholson Price, a University of Michigan law professor focusing on health.

“It’s straight up supply and demand,” he said.

—With assistance from Lydia Wheeler

To contact the reporter on this story: Ian Lopez in Washington at

To contact the editors responsible for this story: Fawn Johnson at; Alexis Kramer at