Coronavirus Briefing: What Happened Today

Moderna sells its vaccine almost exclusively to wealthy countries.

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This is the Coronavirus Briefing, an informed guide to the pandemic. Sign up here to get this newsletter in your inbox.

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Daily reported coronavirus cases in the United States, seven-day average.Credit…The New York Times

Merck applied to the F.D.A. for emergency authorization of its antiviral pill to treat Covid-19.

The F.D.A.’s advisory panel will meet this week to consider booster shots for vaccines made by Moderna and Johnson & Johnson.

Sydney, Australia, celebrated the end of its lockdown, which lasted more than 100 days.

Get the latest updates here, as well as maps and a vaccine tracker.

Moderna opts for profits

Moderna has been supplying its coronavirus vaccine almost exclusively to wealthy nations, keeping poorer countries waiting while it earns billions in profit.

The company has shipped a greater share of its doses to wealthy countries than any other vaccine manufacturer, according to a data firm that tracks vaccine shipments.

Of the 22 countries, plus the E.U., to which Moderna and its distributors have reported selling the shots, none are low income. And most middle-income countries that have struck deals with Moderna have not received any doses. At least three others are paying higher prices.

Botswana, Thailand and Colombia have said they are paying $27 to $30 per dose, more than the U.S. (which paid $15 to $16.50 for each shot) or the E.U. (which paid $22.60 to $25.50).

“They are behaving as if they have absolutely no responsibility beyond maximizing the return on investment,” said Dr. Tom Frieden, a former head of the C.D.C.

The need is real: Dozens of poorer countries, mostly in Africa and the Middle East, had vaccinated less than 10 percent of their populations as of Sept. 30.

Moderna’s vaccine — the only product it makes — appears to be the world’s best defense against Covid-19. But the company is not delivering on its promises. In May, Moderna agreed to provide Covax with up to 34 million vaccine doses this year, plus up to 466 million doses in 2022. Covax says Moderna has not yet shipped any of those doses.

The Biden administration is increasingly frustrated.

The U.S. government provided the company with critical scientific assistance and $1.3 billion for research, and agreed to preorder $1.5 billion of the vaccine. Officials have been pressing Moderna executives to expand U.S. production or license its technology to overseas manufacturers. But administration officials say they have seen little cooperation from Moderna to expand global access.

The company has said it expects its vaccine to generate at least $20 billion in revenue this year, which would make its vaccine one of the most lucrative medical products in history. In 2019, Moderna reported total revenue of $60 million, and the company’s market value has nearly tripled this year to more than $120 billion.

Boosters complicate persuasion

One of the most frustrating problems facing U.S. public health officials at this stage of the pandemic is that the arrival of boosters is making it harder to coax the unvaccinated to get their first shots.

Our colleague Jan Hoffman reports that even as boosters are providing added protection for vulnerable populations, they are raising further doubts among the hesitant. Many who are wary of the vaccine say they have become more confused by what they see as mixed messages from federal health agencies and the White House. In a September survey from the Kaiser Family Foundation, 71 percent of unvaccinated respondents said the need for boosters indicated that the vaccines were not working.

Health officials also fear that when shots are approved for children ages 5 through 11, as is soon expected, the need for boosters will make skittish parents that much harder to persuade.

Experts fear that the country is bumping up against the ceiling of persuadable people, one that is significantly lower than the threshold needed for broad immunity.

With mass vaccine sites largely shuttered, the burden of persuading people to take vaccines has fallen increasingly to primary care providers. But at this point, many doctors and nurses say they are exhausted by putting in so much persuasive effort for relatively little return, even as they are treating very ill patients who had refused to get vaccinated.

“It is an uphill battle,” said Dr. Uzma Syed, an infectious disease specialist, who has been giving vaccine education talks to national and international groups. “I can’t say that these conversations don’t come with tremendous burnout. But you keep going in hopes that you reach even one person to change their mind, because that’s a life saved.”

Vaccines

Pfizer will vaccinate all people over 12 in a Brazilian city to study the effectiveness of its Covid-19 vaccine. The death toll from the virus in Brazil surpassed 600,000 people.

Vaccine technology used in Covid-19 shots may make flu shots more effective. In the meantime, public health experts say a flu shot is especially important this year.

Like police officers, many firefighters in the U.S. are also hesitant to get vaccinated.

About 86 percent of home health aides in New York met last week’s vaccination deadline.

Even with an 83 percent vaccination rate, Singapore is not opening up.

What else we’re following

A study found that one in five of England’s most critically ill Covid patients were unvaccinated pregnant women.

An emergency physician wrote about the fight to save patients during Australia’s latest outbreak.

Parents are smuggling carbon dioxide monitors into classrooms to check ventilation.

Cargo is piling up at ports as the pandemic continues to exacerbate chaos in global shipping.

A rare snow leopard at the Great Plains Zoo in South Dakota probably died from a coronavirus infection, Gizmodo reports.

What you’re doing

In the beginning of the pandemic before vaccines were available, I worried about getting the virus randomly and was fearful. Now, having had three shots, I feel like an observer, no longer too concerned about getting it myself. The unmasked and unvaccinated give it to each other, a bit like the movie “Idiocracy” in reverse.

— Patrick Whitaker, Gex, France

Let us know how you’re dealing with the pandemic. Send us a response here, and we may feature it in an upcoming newsletter.

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