There are two noteworthy facts about the people who were allowed to participate in the Paxlovid trial, all of whom were both unvaccinated and had never previously had Covid-19. First, even when the Paxlovid trial began in July 2021, only a minority of Americans fit into the category of unvaccinated and Covid-naive, so the results of the trial have never been directly applicable to most Americans. Second, Paxlovid would be significantly more effective in people who have not been primed by vaccination or prior infection, so the trial supporting its use serves to exaggerate the benefit that most people would see from the medication.

Yes, Pfizer has begun a trial of Paxlovid in high-risk individuals who have been vaccinated, but this trial combines vaccinated and unvaccinated patients, potentially clouding the issue. More importantly, results of the trial will not be made available until November 2022.

I am not surprised that Pfizer’s first trial was designed to overstate the efficacy of Paxlovid because, as a pharmaceutical company, its goal is to maximize sales. But I am surprised that the federal government would buy $5 billion worth of Paxlovid without requiring that Pfizer move quickly to answer this essential question: How does Paxlovid perform in high-risk people who have been vaccinated or previously infected? A five-day course of Paxlovid costs about $500, but without the appropriate data it’s impossible to tell if this is a good buy or a rip-off.