WASHINGTON — Top White House officials spent Tuesday laying out a vision for a Covid vaccine utopia.
In the future they depicted, vaccines will be cheap and widely available. Instead of merely providing protection against hospitalization and death, they will stop infections from occurring in the first place. Instead of requiring a needle injection, they will be administered by nasal mist or skin patch.
Only on a few fleeting occasions, however, did President Biden’s top pandemic response advisers acknowledge the elephant in the room: money.
“Obviously, everyone has mentioned that investment is needed here,” Francis Collins, the former National Institutes of Health director and Biden’s acting science adviser, said, smiling, while moderating a panel about new methods of vaccine delivery. “It’s all going to come down to money.”
The cheery admission provided a brief reality check at the White House’s daylong “Summit on the Future of Covid-19 Vaccines.”
For the rest of the event, officials radiated optimism. Ashish Jha, Biden’s coronavirus response coordinator, began by setting forth a vision of vaccines that surpass the efficacy of those currently available.
“The vaccines we have are terrific,” he said. “We can do better than terrific.”
Other participants went further. Vaccines delivered as a skin patch — really a collection of microscopic needles “as long as a piece of paper is thick” — could provide immunity that’s stronger than any traditional vaccine injected into a muscle using a syringe.
Vaccines delivered as a nasal mist, other experts argued, could stop Covid transmission altogether, effectively bringing the pandemic to an end.
The tone remained upbeat throughout the event, and discussion often glossed over the enormous scientific challenges involved in the development of next-generation vaccines.
The audience at the event — likely the largest indoor gathering of U.S. public health leaders since the pandemic began in early 2020 — constituted a who’s-who of “Covid Twitter”: a collection of top academics and current or former Biden advisers, many of whom expressed delight at meeting each other in person for the first time.
Beyond Collins and Jha, attendees included former Food and Drug Administration official Luciana Borio; Baylor vaccinologist Peter Hotez; NYU’s Céline Gounder; Brown’s Megan Ranney; Penn’s Zeke Emanuel; and the Fred Hutchinson Cancer Center’s Trevor Bedford.
The White House itself was well-represented, too. Other officials present included David Kessler, the top science adviser to the Biden administration’s Covid-19 response; Alondra Nelson, the acting director of the White House science office; and Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases.
Notably, however, the event did not include lawmakers, or any government official with substantial control over federal spending.
That didn’t stop participants from addressing the question of funds entirely. The success of such a sweeping vaccine initiative, they argued, hinges almost entirely on a significant investment from the government.
Richard Hatchett, the CEO of the Coalition for Epidemic Preparedness and Innovation, asked wealthy nations to follow through on their pledge to help poorer governments buy vaccines.
Denise Octavia Smith, executive director of the National Association of Community Health Care Workers, warned that community health workers can’t be nearly as effective if they’re not paid fairly.
And Akiko Iwasaki, a Yale professor and co-founder of a company seeking to commercialize a vaccine booster delivered nasally, said she attended the event so that she could stress the need for government support.
“I’m really here to talk about the need for collaboration between the government, the private sector, and academia,” she said. “We need to move quickly to start testing these nasal vaccines, and that requires a significant U.S. government investment, both [financial] resources and help with the manufacturing.”
While it’s difficult to estimate the total cost of developing next-generation Covid vaccines, it will almost certainly require billions in federal funding to run large-scale clinical trials, scale up manufacturing capacity, and eventually purchase doses for distribution.
One official, who spoke on the condition of anonymity, said that a funding request to Congress, worth as much as $12 billion, is in the works.
Lawmakers, however, have proven largely unwilling to provide the Biden administration with new funds to bolster its Covid-19 response. A $10 billion funding proposal, cast as essential for purchasing vaccines, tests, and therapeutics ahead of a potential surge in the fall and winter, has stagnated for months. Last month, Sen. Mitt Romney (R-Utah) accused the White House of peddling “patently false” information after the administration insisted the funds were essential, only to later move $10 billion from another pool of funds to purchase the supplies.
The White House has also not aggressively pursued funding for the $65 billion “Apollo-style” pandemic-preparedness plan it unveiled in September — nor has it sought money for its redux of the Obama administration’s “Cancer Moonshot.”