Fauci: Don't expect Johnson & Johnson to have "front-loaded" doses when FDA approves vaccine

Wait, what? Wasn’t one of the aims of Operation Warp Speed to have companies mass-produce these vaccine candidates ahead of approval in case they succeeded in stopping COVID-19? Johnson & Johnson’s application for an emergency-use authorization will finally get attention this week, and the nation has anticipated a big influx of a late third vaccine to accelerate mass vaccination programs.

And it will … “by June, or so,” Anthony Fauci tells CNN’s Alisyn Camerota this morning, or maybe even July:

Why shouldn’t we expect front-loaded doses from Johnson & Johnson? Up until a couple of weeks ago, Fauci and both administrations clearly expected to see that kind of immediate distribution. That was clear from their initial projections of vaccinations on demand by April, which only changed after J&J’s application for the EUA. Earlier this month, those projections began to slide into the summer, a real concern now that we are seeing variants pop up that might limit the effectiveness of all these vaccines, including J&J’s.

Furthermore, the operational model of Operation Warp Speed was designed for “front loading” vaccine doses. J&J got paid $1 billion in predevelopment guaranteed purchases of 100 million doses in August, after getting over $400 million in development grants. Unlike Moderna, J&J already had extensive production facilities, which made the front-loading more reliable, or so it seemed at the time. The Warp Speed plan was to buy the doses whether they worked or not so that we could flood the zone ASAP to stop transmission of COVID-19 as rapidly as possible … not four months after the EUA got issued.

This may not be the most propitious time for a program review to find out where that process went wrong. However, at some point we will need to determine why those supplies didn’t materialize faster, given the guaranteed contracts for production paid up front.

Fortunately, we have better news from both Pfizer and Moderna this morning. They might make up for J&J’s absence — and then some:

Executives with Pfizer and Moderna said the companies are ramping up their supply of coronavirus vaccines, with shipments expected to double and possibly triple in the coming weeks, according to congressional testimony released Monday.

In a prepared statement to be made before a House subcommittee Tuesday, John Young, Pfizer’s chief business officer, is expected to say the company plans to increase its delivery capacity of 4 million to 5 million doses a week to more than 13 million by mid-March.

Moderna expects to double its monthly delivery capacity to 40 million doses by April, according to Dr. Stephen Hoge, the company’s president. Moderna has so far delivered 45 million doses, Hoge’s testimony says.

By June, the increased output from both pharmas will end up far exceeding J&J’s 100 million doses — perhaps even while requiring two doses per successful vaccination. That’s not to say that J&J’s vaccine won’t have an impact once it hits Fauci’s new projected arrival-in-strength date, but it might end up being much less than we had hoped … and paid for.

Update: Some of the reaction to this on social media blames Fauci for this situation. As far as I know, Fauci has no jurisdiction over production and procurement in Operation Warp Speed. There may be other valid criticisms of Fauci, but in this case he’s just the messenger.