WEBVTT - Pfizer’s Fast and Lucrative Vaccine Distribution 0:00:00.040 --> 0:00:03.040 I'm Carol Masser and I'm Tim Stanovik. The cover story 0:00:03.200 --> 0:00:06.320 this week. The Fiser vaccine is a covid fighting wonder 0:00:06.400 --> 0:00:09.800 drug that's already helping tame the pandemic. The distribution of 0:00:09.800 --> 0:00:13.160 the vaccine is also generating some serious ethical dilemmas, though, 0:00:13.240 --> 0:00:16.880 and angering entire countries. Obviously, Fiser's first out of the 0:00:16.920 --> 0:00:20.400 gate status has offered chief executive officer Albert Borla a 0:00:20.480 --> 0:00:24.400 sales opportunity like no other that's put him in position 0:00:24.440 --> 0:00:27.640 to wield enormous power over who gets a shot, when, 0:00:27.760 --> 0:00:30.480 and how much to charge. Well. Fiser's drug is an 0:00:30.480 --> 0:00:35.160 extraordinary accomplishment, exceeding nearly everyone's hopes. The company is now 0:00:35.200 --> 0:00:38.279 doing what pharma does, mass marketing life saving products at 0:00:38.320 --> 0:00:41.080 prices that the market is willing to pay. The company 0:00:41.120 --> 0:00:44.520 expects the vaccine to generate at least fifteen billion dollars 0:00:44.560 --> 0:00:47.800 in revenue. And there's no rule book for how a 0:00:47.800 --> 0:00:51.199 global corporation should behave during a pandemic. Of course, we 0:00:51.280 --> 0:00:54.240 know that, but if there's ever an autopsy of the pandemic, 0:00:54.560 --> 0:00:57.600 essential question might be how a single company came to 0:00:57.640 --> 0:01:03.680 hold such power over so many. Vaccine capitalism Fyser deserves 0:01:03.720 --> 0:01:06.520 every bit of the credit its receiving, but should a 0:01:06.600 --> 0:01:10.520 drug company decide who gets a shot? By Stephanie Baker, 0:01:10.640 --> 0:01:15.920 Cynthia Coons and Vernon Silver, It's not every day that 0:01:15.959 --> 0:01:18.160 a head of government goes to the airport to greet 0:01:18.160 --> 0:01:22.319 a cargo shipment, but the pandemic has changed many things. 0:01:22.680 --> 0:01:26.800 On January tenth, Israeli Prime Minister Benjamin netann Yahoo motorcated 0:01:26.800 --> 0:01:30.480 to Ben Gurion International Airport, southeast of Tel Aviv to 0:01:30.520 --> 0:01:33.560 watch a shipment of seven hundred thousand vaccine doses from 0:01:33.640 --> 0:01:37.080 Fyser emerge from a blue and white allal bowing seven 0:01:37.160 --> 0:01:40.280 eighty seven nine. This is a great day for the 0:01:40.280 --> 0:01:43.200 State of Israel, with a huge shipment that has arrived, 0:01:43.400 --> 0:01:47.760 Netanyahoo said, exuding a confidence few world leaders have mustered 0:01:47.760 --> 0:01:51.640 since the crisis began. I agreed with my friend, Viser 0:01:51.720 --> 0:01:54.680 chairman and ce O, Albert Borla that we would bring 0:01:54.680 --> 0:01:57.560 shipment after shipment and complete the vaccination of the over 0:01:57.640 --> 0:02:02.000 sixteen population in Israel. During the month of March. Borla 0:02:02.080 --> 0:02:06.080 had thrown net Yahoo a political lifeline, faced with surging 0:02:06.160 --> 0:02:09.560 COVID nineteen cases and an election in March the Prime 0:02:09.560 --> 0:02:12.640 Minister latched onto Viser's vaccine as his best hope to 0:02:12.639 --> 0:02:16.200 stay in office. Standing on the tarmac, he bragged that 0:02:17.280 --> 0:02:20.559 Israelis over the age of sixty had already been vaccinated 0:02:20.760 --> 0:02:23.560 thanks to shipments that began in early December, and that 0:02:23.639 --> 0:02:26.800 more doses would come soon. That was because he'd struck 0:02:26.800 --> 0:02:29.160 a deal with Borla to use his country as a 0:02:29.200 --> 0:02:33.600 test case for Fiser's vaccine. Vaccine distribution still has the 0:02:33.639 --> 0:02:37.080 feel of a zero sum game. Five days after nettnya 0:02:37.120 --> 0:02:40.680 Who's victory lap, Fiser told other non US customers that 0:02:40.720 --> 0:02:43.920 it would cut near term supplies while it briefly closed 0:02:43.960 --> 0:02:48.640 its vaccine manufacturing facility in Belgium for an upgrade. Panic 0:02:48.680 --> 0:02:52.560 and anger rippled through world capitals, nowhere more so than 0:02:52.600 --> 0:02:55.840 in Rome. Italy, which has suffered one of the highest 0:02:55.919 --> 0:02:58.560 COVID death rates and which had successfully set up a 0:02:58.600 --> 0:03:02.119 mass vaccination program and inoculated more people than any other 0:03:02.200 --> 0:03:05.880 European Union country, was waiting for new doses when Fiser 0:03:05.919 --> 0:03:10.080 announced the cuts. The country's virus emergencies are at the time. 0:03:10.400 --> 0:03:14.239 Domenico our Coury lashed out, complaining that Fiser had cut 0:03:14.240 --> 0:03:17.400 its shipments by almost thirty percent, just as Italy was 0:03:17.440 --> 0:03:20.320 about to start vaccinating people older than eight on mass 0:03:20.880 --> 0:03:24.600 he warned that Italy could take unspecified action against the company. 0:03:24.880 --> 0:03:28.640 Days after our Cury aired his grievances, Fiser began shipping 0:03:28.680 --> 0:03:32.600 millions of doses to Israel. Within a week, Israel expanded 0:03:32.639 --> 0:03:36.160 its rollout to include sixteen to eighteen year olds. Look, 0:03:36.480 --> 0:03:41.200 we are very angry, Lucas Aiah, president of Italy's Veneto region, 0:03:41.520 --> 0:03:44.160 one of the areas most affected by COVID with more 0:03:44.200 --> 0:03:48.240 than dred deaths, told reporters sitting in front of EU 0:03:48.360 --> 0:03:52.200 and Italian flags, he'd recently learned that supplies to his 0:03:52.240 --> 0:03:55.720 region would be cut fifty for that week. I want 0:03:55.760 --> 0:03:58.840 to understand what Nobel Prize winner they paid to organize 0:03:58.880 --> 0:04:03.720 the distribution, or which principle or algorithm they used. It 0:04:03.800 --> 0:04:07.520 didn't come from some algorithm. The vaccine allocation was the 0:04:07.560 --> 0:04:10.920 product of a company struggling to apportion doses while demand 0:04:10.960 --> 0:04:14.760 far exceeded supply, using an opaque process that appears to 0:04:14.800 --> 0:04:18.000 involve a mix of order size, position in the queue. 0:04:18.320 --> 0:04:22.679 Production forecasts, calls from world leaders, the potential to advance 0:04:22.720 --> 0:04:25.640 the science, and of course, the desire to make a profit. 0:04:26.360 --> 0:04:29.559 Everybody wanted deliveries in the first quarter, and we tried 0:04:29.600 --> 0:04:33.200 to allow discussions and negotiations to spread things so everybody 0:04:33.200 --> 0:04:37.320 would get in an equitable base. Borla says the countries 0:04:37.360 --> 0:04:40.080 that hadn't placed orders wanted a place in line, and 0:04:40.120 --> 0:04:42.760 those that had placed early orders wanted to buy more. 0:04:43.440 --> 0:04:47.200 It was a constant negotiation, he says. Everybody wanted it, 0:04:47.240 --> 0:04:51.080 of course earlier. Feiser says the agreement with Israel didn't 0:04:51.080 --> 0:04:55.320 affect doses going elsewhere. Israel had two things going for it. 0:04:55.839 --> 0:04:58.400 Net and Yahoo had offered to pay roughly thirty dollars 0:04:58.400 --> 0:05:01.920 a dose about it, more than the US government, according 0:05:01.920 --> 0:05:04.760 to people familiar with the deal. He also agreed to 0:05:04.800 --> 0:05:08.279 share countrywide data on the vaccine, a two dose product 0:05:08.320 --> 0:05:12.680 based on an experimental platform called Messenger RNA or mr NA. 0:05:13.520 --> 0:05:17.120 It's being used almost exclusively in Israel in what amounts 0:05:17.120 --> 0:05:21.000 to a large scale effectiveness study. Fiser considered offering the 0:05:21.000 --> 0:05:23.719 same arrangement to Iceland, but the country didn't have enough 0:05:23.720 --> 0:05:28.480 COVID cases to make a study meaningful. By February, Israel 0:05:28.560 --> 0:05:32.239 had given first doses to of its nine million people, 0:05:32.800 --> 0:05:37.159 making it the world leader Italy meanwhile, had administered first 0:05:37.160 --> 0:05:40.840 shots to three point six percent of its citizens. Bore 0:05:40.960 --> 0:05:43.279 Less says the agreement with Israel will provide data that 0:05:43.320 --> 0:05:46.920 will transform the world's understanding of how to end the pandemic. 0:05:47.600 --> 0:05:50.560 They are trying to extract the scientific information that the 0:05:50.600 --> 0:05:53.719 whole world is waiting on right now, he says. We'll 0:05:53.760 --> 0:05:58.960 get data on symptomatic and asymptomatic transmission very quickly. Indeed, 0:05:59.080 --> 0:06:02.320 the news out of Israel on February twenty four was remarkable. 0:06:02.800 --> 0:06:07.200 The vaccine prevented of COVID cases in almost six hundred 0:06:07.200 --> 0:06:11.120 thousand vaccinated people. As the first company to develop an 0:06:11.160 --> 0:06:14.880 authorized COVID vaccine, which it did in partnership with Germany's 0:06:14.920 --> 0:06:19.960 bio intech Fiser, wields enormous power. Borla had been Fiser's 0:06:20.040 --> 0:06:23.119 chief executive officer only a year when the pandemic began, 0:06:23.560 --> 0:06:27.000 and almost immediately faced choices. No farma executive would normally 0:06:27.040 --> 0:06:32.359 be making government policy matters, as does the behavior of individuals, 0:06:32.360 --> 0:06:35.880 but to some degree, vaccine makers determine where infections will 0:06:35.920 --> 0:06:40.600 decrease and which economies will reopen first. Their customers are 0:06:40.640 --> 0:06:44.560 elected national leaders who have designed intricate vaccination programs with 0:06:44.600 --> 0:06:48.159 public health officials, but those leaders are learning that they're 0:06:48.160 --> 0:06:51.080 at the mercy of what manufacturers such as Fiser deliver. 0:06:51.800 --> 0:06:54.440 In the past few months, Borla has taken on an 0:06:54.480 --> 0:06:58.919 almost statesmanlike role, holding calls with heads of state, including 0:06:59.000 --> 0:07:03.960 former US President Donald Trump, European Commissioner President Ursula vonder Lyon, 0:07:04.400 --> 0:07:08.080 and Canadian Prime Minister Justin Trudeau. Net and Yah, who 0:07:08.200 --> 0:07:11.760 boasted in January that he'd spoken with Borla seventeen times, 0:07:12.200 --> 0:07:15.320 with the CEO even taking his calls at two am. 0:07:15.440 --> 0:07:18.440 Borla says he's taught to Netanyah who even more since then. 0:07:19.320 --> 0:07:22.320 Fiser's first out of the gate status has also offered 0:07:22.360 --> 0:07:25.920 Borla a sales opportunity like none other. He's locked in 0:07:26.040 --> 0:07:29.720 orders from more than sixty countries on undisclosed commercial terms. 0:07:30.520 --> 0:07:35.280 Fiser has supplied nine million doses globally. It's executing on 0:07:35.280 --> 0:07:38.240 one of the most ambitious scale ups in pharmaceutical history 0:07:38.480 --> 0:07:42.080 to meet the relentless demand, boosting production to two billion 0:07:42.160 --> 0:07:45.680 doses in one more than it has agreements to sell. 0:07:45.760 --> 0:07:48.960 At this stage, it expects the vaccine to generate at 0:07:49.040 --> 0:07:53.480 least fifteen billion dollars in revenue in putting it under 0:07:53.520 --> 0:07:57.600 the brand name Commernity, an ungainly blend of covid, m 0:07:57.720 --> 0:08:00.680 r n A and immunity on act to be one 0:08:00.720 --> 0:08:04.040 of the biggest selling drugs in the world. There's no 0:08:04.160 --> 0:08:07.560 rulebook for how a global corporation should behave during a pandemic. 0:08:08.280 --> 0:08:13.360 Feiser accomplished something extraordinary, exceeding nearly everyone's hopes, and is 0:08:13.400 --> 0:08:17.080 now doing what pharma does, mass marketing life saving products 0:08:17.080 --> 0:08:20.480 at prices the market is willing to pay. It's not 0:08:20.600 --> 0:08:24.760 bound to serve a global public health agenda. All that said, 0:08:25.000 --> 0:08:27.520 there will one day be an autopsy of the pandemic, 0:08:28.000 --> 0:08:30.560 and the central question might be how a single company 0:08:30.680 --> 0:08:38.400 came to hold such power over so many. In May, 0:08:38.520 --> 0:08:41.920 the Trump administration announced the launch of Operation Warp Speed. 0:08:42.559 --> 0:08:46.679 Monsef Slowie, a former Glaxo Smith client executive, joined as 0:08:46.760 --> 0:08:50.320 chief advisor to OWS to figure out which vaccines to back. 0:08:50.920 --> 0:08:54.280 He had an uncommon familiarity with mr and A technology 0:08:54.440 --> 0:08:56.920 from serving on the board of Maderna, which had spent 0:08:57.000 --> 0:09:01.280 years researching the platform. No drug using m RNA technology 0:09:01.360 --> 0:09:05.200 had ever been approved. Sloughy knew Fiser might be a 0:09:05.200 --> 0:09:08.720 contender after it announced its decision to collaborate with bio 0:09:08.840 --> 0:09:13.680 in Tech, another m RNA pioneer, but he didn't know Borla. 0:09:13.840 --> 0:09:17.679 When they first spoke in June. Borla made it clear 0:09:17.760 --> 0:09:20.679 he wasn't interested in taking money for research and development 0:09:21.000 --> 0:09:24.920 as the other companies of WS was evaluating were. Instead, 0:09:25.080 --> 0:09:28.760 he wanted an advanced purchase order from OWS to guarantee 0:09:28.760 --> 0:09:32.600 a buyer. If Fiser succeeded. The company's fifty billion dollars 0:09:32.600 --> 0:09:35.560 in annual revenue meant it could afford to take a flyer. 0:09:36.520 --> 0:09:39.240 Borla has said it wasn't an easy decision, but he 0:09:39.280 --> 0:09:43.160 felt it liberated scientists from bureaucracy to get faster results. 0:09:43.679 --> 0:09:46.199 Albert was very clear that they had what it takes 0:09:46.200 --> 0:09:51.320 to deliver. Sloughy says Fiser's confidence showed early on. It 0:09:51.400 --> 0:09:54.599 began marketing the vaccine globally in May, soon after it 0:09:54.679 --> 0:09:58.439 started safety testing. The process started in the very early 0:09:58.559 --> 0:10:02.360 days when we reached out to every single country. Borla says. 0:10:02.640 --> 0:10:06.080 We started discussions in all continents of the world. The 0:10:06.240 --> 0:10:08.840 UK was the first country to do a deal, agreeing 0:10:08.840 --> 0:10:12.240 on July twenty to buy thirty million doses, later up 0:10:12.320 --> 0:10:16.400 to forty million to be delivered in twenty twenty one. 0:10:16.760 --> 0:10:19.800 As with most of Viser's deals with individual countries, the 0:10:19.920 --> 0:10:23.920 terms were not disclosed. Two days later, Fiser announced a 0:10:24.000 --> 0:10:27.640 one point nine billion dollar order from Operation Warp Speed 0:10:28.000 --> 0:10:31.760 for one hundred million doses, pending authorization of its vaccine 0:10:31.800 --> 0:10:35.560 from the Food and Drug Administration. The straight advanced purchase 0:10:35.679 --> 0:10:39.920 order set Fiser apart from all the other OWS candidates. Maderna, 0:10:39.960 --> 0:10:43.000 for example, got two point forty eight billion dollars from 0:10:43.000 --> 0:10:46.559 the US government, including nine and fifty five million dollars 0:10:46.559 --> 0:10:50.040 for clinical development and manufacturing, and payment for one hundred 0:10:50.080 --> 0:10:54.240 million doses. By contrast, Fiser has spent two billion dollars 0:10:54.280 --> 0:10:57.880 of its own money on development. Company executives came out 0:10:57.880 --> 0:10:59.920 of the gate asking for a higher price per dose 0:11:00.400 --> 0:11:03.360 than the nineteen dollars and fifty cents they eventually agreed on, 0:11:03.760 --> 0:11:07.080 According to former senior Administration officials who declined to be 0:11:07.160 --> 0:11:11.079 named because the discussions were confidential, higher prices were floated 0:11:11.120 --> 0:11:15.240 in Europe to last summer. Fiser and Biointech started off 0:11:15.280 --> 0:11:18.800 asking for fifty four euros about sixty five dollars a dose. 0:11:18.960 --> 0:11:22.800 In negotiations with the EU, A person familiar with the talks, says, 0:11:23.360 --> 0:11:28.720 Confirming German media reports, Biointech co founder Uger Shaheen told 0:11:28.760 --> 0:11:32.200 Build that initial ballpark figures were based on rough calculations 0:11:32.200 --> 0:11:35.440 of production costs before they figured out how the manufacturing 0:11:35.480 --> 0:11:38.640 would work. They later settled on a range of fifteen 0:11:38.640 --> 0:11:42.520 to thirty euros a dose for industrialized countries, depending on 0:11:42.679 --> 0:11:46.640 order size. Free from the strings attached by a government grant, 0:11:46.960 --> 0:11:50.240 Fiser could move faster. We made the early decision to 0:11:50.280 --> 0:11:53.360 begin clinical work and large scale manufacturing at our own 0:11:53.440 --> 0:11:56.520 risk to ensure that product would be available immediately if 0:11:56.520 --> 0:12:00.360 our clinical trials proved successful, Borla said, would anne the 0:12:00.440 --> 0:12:04.200 US deal. Less than a week after securing the US contract, 0:12:04.520 --> 0:12:07.880 Fiser started its final stage trial, saying it aimed to 0:12:07.960 --> 0:12:11.280 seek regulatory review by the FDA as early as October. 0:12:11.960 --> 0:12:14.840 Maderna started its final trial the same day, but a 0:12:14.920 --> 0:12:18.800 longer interval between doses twenty eight days to Fiser's twenty one, 0:12:19.280 --> 0:12:22.640 meant that all other things being equal, Fiser was positioned 0:12:22.640 --> 0:12:26.840 to report results first. The orders kept rolling in a 0:12:26.880 --> 0:12:29.959 few days after the trial started. Japan ordered one and 0:12:30.000 --> 0:12:32.520 twenty million doses to be delivered in the first half 0:12:32.520 --> 0:12:37.000 of one in early August, Canada made a deal. In 0:12:37.120 --> 0:12:41.080 late August, Fiser shared early data showing that participants generated 0:12:41.120 --> 0:12:44.040 a strong immune response to the vaccine, and even more 0:12:44.080 --> 0:12:47.760 countries got in line. In early September, the company agreed 0:12:47.800 --> 0:12:50.600 to potentially supply the EU with as many as three 0:12:50.640 --> 0:12:53.680 hundred million doses, but the block dragged its feet on 0:12:53.760 --> 0:12:56.959 finalizing the deal. The Gulf state of cutter placed in 0:12:57.120 --> 0:13:00.839 order a few weeks later. Borla had been assistently saying 0:13:00.880 --> 0:13:03.920 the company expected to report results from the final stage 0:13:03.960 --> 0:13:07.160 trial by the end of October, which Trump seized on 0:13:07.280 --> 0:13:09.680 as he sagged in the polls in the home stretch 0:13:09.720 --> 0:13:12.920 of his reelection campaign. We're going to have a vaccine 0:13:13.040 --> 0:13:16.559 very soon, maybe even before a very special date, Trump 0:13:16.640 --> 0:13:20.320 said in early September, concerned that Fiser was rushing the 0:13:20.320 --> 0:13:23.960 trial at the expensive safety checks mounted. Pushing back at 0:13:23.960 --> 0:13:26.840 the perception that the Trump administration was pressuring the company, 0:13:27.040 --> 0:13:30.480 Borla promised to make safety paramount. I wanted to speak 0:13:30.480 --> 0:13:33.880 directly to the billions of people, millions of businesses, and 0:13:34.000 --> 0:13:36.800 hundreds of governments around the world that are investing their 0:13:36.840 --> 0:13:40.040 hopes in a safe and effective COVID nineteen vaccine. He 0:13:40.160 --> 0:13:43.960 said in an open letter, the vaccine must be proven safe. 0:13:44.840 --> 0:13:48.760 Fiser ruffled feathers with some inside operation warp speed. The 0:13:48.800 --> 0:13:51.080 company had been pushing for the US government to place 0:13:51.120 --> 0:13:55.040 an additional order of one million doses, but OWS officials 0:13:55.040 --> 0:13:57.960 were wary. The company was already failing to meet its 0:13:57.960 --> 0:14:00.920 production targets for November for re since that were unclear, 0:14:01.240 --> 0:14:05.200 according to the former senior administration officials. Fiser says it 0:14:05.280 --> 0:14:08.960 kept the government informed about production. When Fiser announced the 0:14:09.000 --> 0:14:12.200 results of its final stage trial six days after the election, 0:14:12.600 --> 0:14:16.840 the news was huge. The vaccine was more than effective 0:14:16.880 --> 0:14:20.960 at preventing COVID symptoms. Sloughy says, Borla called him right 0:14:21.000 --> 0:14:24.200 before Viser issued a news release at six am on 0:14:24.320 --> 0:14:27.120 November nine, and he was so excited that he had 0:14:27.160 --> 0:14:29.920 to refrain from shouting for fear of waking up other 0:14:30.000 --> 0:14:34.480 guests in his hotel in Washington. Nevertheless, amid the euphoria 0:14:34.640 --> 0:14:37.440 was some bad news, Viser warned that it would be 0:14:37.520 --> 0:14:40.760 able to produce only fifty million doses worldwide by the 0:14:40.840 --> 0:14:43.360 end of the year, instead of the one million it 0:14:43.360 --> 0:14:47.440 had projected. Fiser was running into major production problems at 0:14:47.440 --> 0:14:51.560 its Acre campus in Kalamazoo, Michigan, where the company set 0:14:51.600 --> 0:14:54.040 up a freezer farm the size of a football field 0:14:54.320 --> 0:14:58.120 to store doses at the required negative seventy five degrees celsius. 0:14:58.880 --> 0:15:01.280 Scaling up manufacture ring of a new product with a 0:15:01.320 --> 0:15:05.640 new technology required a steady flow of raw materials. It 0:15:05.680 --> 0:15:08.600 turned out Fiser needed the government's help after all. To 0:15:08.760 --> 0:15:12.440 clear supply chain hold ups. Company executives were pressing warp 0:15:12.520 --> 0:15:15.400 Speed for an order under the Defense Production Act, which 0:15:15.400 --> 0:15:19.720 would give it priority access to suppliers. Other OWS candidates 0:15:19.720 --> 0:15:21.880 had been taking advantage of the d PA for months. 0:15:22.440 --> 0:15:26.520 OWS hesitated the administration. Officials say they were worried that 0:15:26.560 --> 0:15:29.680 Fiser would use its size and market cloud to muscle 0:15:29.680 --> 0:15:32.440 out Maderna in the supply chain if it got equivalent 0:15:32.480 --> 0:15:35.680 status under the d p A. Fiser's production hold ups 0:15:35.720 --> 0:15:38.960 had a huge impact on the US vaccine rollout. Before 0:15:39.000 --> 0:15:42.640 the trial results were announced, OWS had been expecting twenty 0:15:42.640 --> 0:15:46.560 million doses in November and twenty million in December. Instead, 0:15:46.640 --> 0:15:49.960 it got nothing in December and twenty million doses in December, 0:15:50.480 --> 0:15:53.080 some of them flown in from Fiser's production site in 0:15:53.120 --> 0:15:56.880 Belgium to make up for the gaps. From Kalamazoo. The UK, 0:15:57.240 --> 0:16:00.080 which was the first country to authorize the vaccine on 0:16:00.120 --> 0:16:03.240 December two, had been expecting ten million doses by the 0:16:03.320 --> 0:16:06.400 end of the year, but got about half that. Despite 0:16:06.400 --> 0:16:09.640 the supply challenges, Fiser announced right before Christmas that it 0:16:09.680 --> 0:16:12.160 had agreed to supply the US with another one hundred 0:16:12.200 --> 0:16:16.360 million doses. At the same time, government officials finally agreed 0:16:16.400 --> 0:16:18.760 to provide the company with priority under the d p A. 0:16:19.720 --> 0:16:22.320 In late December, a flurry of news stories from the 0:16:22.320 --> 0:16:25.680 Middle East revealed that Fiser had contracted to sell millions 0:16:25.680 --> 0:16:29.920 of doses to countries in previously unreported deals. Dubai got 0:16:29.960 --> 0:16:32.680 its first doses blown in from Belgium and announced it 0:16:32.680 --> 0:16:35.520 would aim to inoculate seventy of its three point three 0:16:35.520 --> 0:16:39.920 million people with the Fiser vaccine. Officials in Saudi Arabia 0:16:40.000 --> 0:16:43.720 told TV broadcaster Al Arabia they were expecting three million 0:16:43.760 --> 0:16:46.560 Fiser doses, with a third of those to be delivered 0:16:46.560 --> 0:16:49.760 by the end of February. Oman ordered three hundred and 0:16:49.800 --> 0:16:53.360 seventy thousand, paying thirty dollars a shot for early supplies 0:16:53.440 --> 0:16:56.200 arriving in December and twenty four dollars a shot for 0:16:56.280 --> 0:16:59.440 later shipments. The Health Minister told a government news outlet 0:17:00.160 --> 0:17:03.239 this appeared to be one of the highest prices outside Israel, 0:17:03.240 --> 0:17:06.200 though lack of disclosure makes it impossible to say for sure. 0:17:06.960 --> 0:17:10.200 Fiser executives found a partial fix to their supply problem 0:17:10.320 --> 0:17:14.040 in the vaccine vials themselves. They just needed authorization to 0:17:14.160 --> 0:17:16.879 change the labels to say the vials contained six doses 0:17:16.920 --> 0:17:21.000 instead of five. Its standard practice in the pharmaceutical industry 0:17:21.040 --> 0:17:24.240 to overfill vials slightly to avoid running the risk of 0:17:24.359 --> 0:17:29.000 undershooting and violating FDA labeling laws. Fiser was overfilling each 0:17:29.080 --> 0:17:32.080 vial by just enough for an extra dose if vaccinators 0:17:32.160 --> 0:17:35.679 used what are called low dead volume syringes, but not 0:17:35.760 --> 0:17:40.400 all vaccination sites had the syringes. Moreover, the company's application 0:17:40.480 --> 0:17:43.520 to the f d A and other regulators specified five 0:17:43.560 --> 0:17:47.200 dose vials viser needed to generate data showing the extra 0:17:47.240 --> 0:17:51.399 shot could be reliably extracted. The company did that and 0:17:51.480 --> 0:17:54.720 then began pressing FDA officials to change the authorization to 0:17:54.760 --> 0:17:58.600 recognize the sixth dose. O w S officials were against 0:17:58.640 --> 0:18:02.520 the change, anticipate nightmare logistical implications, right when they were 0:18:02.560 --> 0:18:06.280 starting the biggest mass vaccination campaign in US history. The 0:18:06.320 --> 0:18:10.760 former senior administration officials say Viser's vaccine needed to be 0:18:10.840 --> 0:18:14.560 kept at subarctic temperatures. It was already difficult enough to 0:18:14.600 --> 0:18:18.919 distribute without last minute rejiggering. Recently, the FDA announced that 0:18:18.960 --> 0:18:21.800 it can be kept at normal freezer temperatures for up 0:18:21.880 --> 0:18:26.720 to two weeks. The company's lobbying efforts succeeded. On January six, 0:18:26.880 --> 0:18:30.400 the FDA revised its fact sheet, allowing the sixth dose 0:18:30.480 --> 0:18:35.439 and effectively boosting Viser's production. By regulators in Europe, the 0:18:35.560 --> 0:18:38.800 UK and elsewhere followed suit. The US and the UK 0:18:39.040 --> 0:18:42.080 had managed to source the syringes, but other countries were 0:18:42.160 --> 0:18:45.680 left scrambling. Sweden and Japan complained they didn't have enough 0:18:45.720 --> 0:18:48.879 special syringes to extract the sixth dose, and warned it 0:18:48.880 --> 0:18:51.399 would likely mean millions of doses would be thrown away. 0:18:51.960 --> 0:18:56.160 Austria was also short of supplies. Borla defended the policy 0:18:56.240 --> 0:18:59.400 change by saying the company had validated thirty six syringe 0:18:59.440 --> 0:19:02.000 needle comb nations that could get the extra dose out. 0:19:02.520 --> 0:19:05.120 It would be criminal if we can use six doses 0:19:05.359 --> 0:19:07.680 and we are throwing away one vaccine that can save 0:19:07.720 --> 0:19:11.520 lives right now, he told Bloomberg in late January. The 0:19:11.560 --> 0:19:15.320 modification was a huge win for Fiser. The company had 0:19:15.320 --> 0:19:18.160 promised to supply the US with one dred million doses 0:19:18.200 --> 0:19:20.360 by the end of the first quarter, and it now 0:19:20.400 --> 0:19:24.240 says it can provide one twenty million because nations paid 0:19:24.320 --> 0:19:28.120 by the dose. The move also delivered an instant price 0:19:28.200 --> 0:19:35.080 hike per Vile. When Borla took the helm at Viser 0:19:35.160 --> 0:19:38.639 in January nine, his mission was to get the company 0:19:38.680 --> 0:19:41.480 to focus on blockbuster drugs and to fend off a 0:19:41.520 --> 0:19:45.280 potential battle with the Trump administration over drug pricing. The 0:19:45.320 --> 0:19:49.480 coronavirus immediately gave him a new focus. Viser's little known 0:19:49.520 --> 0:19:52.600 partnership with a German biotech turned it into a hero 0:19:52.760 --> 0:19:55.879 of the pandemic. There was considerable doubt that Mr and 0:19:56.000 --> 0:19:59.159 A vaccines would work, but Borla's willingness to gamble on 0:19:59.200 --> 0:20:02.680 the new technology you paid off. While Israel was swimming 0:20:02.720 --> 0:20:06.480 in Visor vaccines in late January, other countries were struggling 0:20:06.520 --> 0:20:10.120 to find out when their deliveries would resume. On January eight, 0:20:10.280 --> 0:20:12.760 the EU said it had doubled its order by securing 0:20:12.800 --> 0:20:16.320 the purchase of another three hundred million doses. A week later, 0:20:16.520 --> 0:20:20.800 Fiser announced the supply cut and the Belgian shutdown within days. 0:20:20.920 --> 0:20:24.280 It informed officials in Canada, which had recently doubled its 0:20:24.359 --> 0:20:27.280 order to forty million shots, that the country would receive 0:20:27.359 --> 0:20:31.040 no doses the following week. Prime Minister Trudeau spoke with 0:20:31.119 --> 0:20:34.679 boor Law on January one, but the call didn't unlock 0:20:34.720 --> 0:20:39.200 additional supplies. Desperate for doses, he agreed to take vaccines 0:20:39.240 --> 0:20:42.840 from KOVACS, the facility backed by the World Health Organization 0:20:43.119 --> 0:20:47.080 to provide two billion doses to low income countries. Canada 0:20:47.200 --> 0:20:49.440 was the only group of seven country to do so. 0:20:50.040 --> 0:20:53.760 Opposition politicians accused him of grabbing doses meant for countries 0:20:53.760 --> 0:20:58.480 that couldn't afford to do bilateral deals. Bahrain, Dubai, and 0:20:58.520 --> 0:21:03.159 Saudi Arabia also reported delays and shipments. Viser supply has 0:21:03.200 --> 0:21:07.080 been a global challenge. Amyor Sharif, head of Dubai's COVID 0:21:07.160 --> 0:21:11.080 nineteen Command and Control Center, told Bloomberg TV there have 0:21:11.160 --> 0:21:13.919 been a lot of discussions with visor representatives in the region. 0:21:14.359 --> 0:21:18.440 Oman was cut too, Do not panic, Ahmed bin Muhammad 0:21:18.480 --> 0:21:22.160 Al saidi Oman's health minister urged at a press conference 0:21:22.200 --> 0:21:25.840 on February one. We were assured that the next consignment 0:21:25.840 --> 0:21:28.359 will be here before the middle of this month. The 0:21:28.400 --> 0:21:32.160 Gulf States have weathered the delays without major consequences because 0:21:32.200 --> 0:21:36.360 their rates of infection are relatively low. Mexico, with surging 0:21:36.440 --> 0:21:39.440 cases in the world's third highest number of deaths, has 0:21:39.440 --> 0:21:43.280 felt Viser's supply cut more profoundly, having agreed in early 0:21:43.280 --> 0:21:46.520 December to buy thirty four million Visor doses. The nation 0:21:46.600 --> 0:21:49.840 started vaccinating in late December, the first country to do 0:21:49.920 --> 0:21:53.640 so in Latin America. Then Viser's shipments stopped for three 0:21:53.680 --> 0:21:57.879 weeks until roughly five thousand doses for healthcare workers arrived 0:21:57.880 --> 0:22:01.119 in mid February. It hadn't d and started vaccinating the 0:22:01.160 --> 0:22:06.520 elderly on February second. Mexican Foreign Minister Marcelo Ebrard criticized 0:22:06.520 --> 0:22:09.520 Fiser for holding back doses that are already signed and 0:22:09.560 --> 0:22:13.200 paid for. The world was waiting for Viser to retool 0:22:13.240 --> 0:22:17.040 its sprawling facility, the size of several sports stadiums on 0:22:17.080 --> 0:22:21.000 the outskirts of the tiny Belgian town of Purrs. Last year, 0:22:21.119 --> 0:22:24.720 Fiser hired several hundred more staff, bringing the total to 0:22:24.760 --> 0:22:27.320 more than three thousand, as it geared up for production. 0:22:28.040 --> 0:22:30.520 That wasn't enough to keep up with the crush of orders. 0:22:31.080 --> 0:22:34.160 The partial closure of the plant lasted almost two weeks. 0:22:34.800 --> 0:22:37.120 When there is a question of life and death, when 0:22:37.160 --> 0:22:39.760 there is a question of the global economy, the demand 0:22:39.760 --> 0:22:43.600 will always be bigger, Borla says, you will get complaints. 0:22:44.160 --> 0:22:48.119 Fiser wasn't alone in cutting supplies to Europe. Astra Zenica 0:22:48.280 --> 0:22:51.199 later also fell well short on its promised deliveries to 0:22:51.240 --> 0:22:54.240 the EU, but Europe was relying on the American company 0:22:54.280 --> 0:22:57.040 to start its rollout. There's no doubt in my mind 0:22:57.080 --> 0:23:00.280 that there is anxiety, there is stress, there is usher, 0:23:00.560 --> 0:23:03.880 Borla says. The voices are becoming louder and people will 0:23:03.920 --> 0:23:07.320 try to find the scapegoats. In the Rome region, the 0:23:07.440 --> 0:23:10.479 viser cuts delayed the vaccine campaign for people older than 0:23:10.520 --> 0:23:14.200 eighty by a week, with first shots administered on February eight. 0:23:14.720 --> 0:23:17.720 The knock on effect means some of the most vulnerable 0:23:17.760 --> 0:23:23.040 are waiting until spring to get their first doses. Salvatore Parisi, four, 0:23:23.440 --> 0:23:27.000 a retired Rome courthouse clerk, is sheltering at home until 0:23:27.040 --> 0:23:30.000 his April third appointment at a hospital for his first 0:23:30.119 --> 0:23:33.400 viser shot, with a second dose scheduled for April twenty four. 0:23:33.960 --> 0:23:36.760 He's holding out hope that doses might become available sooner 0:23:36.800 --> 0:23:40.600 at his family doctor's office. Every week we call. Is 0:23:40.640 --> 0:23:44.639 there something new? No, no, he says via telephone to 0:23:44.840 --> 0:23:48.440 questions relayed by his seventy nine year old wife, Maria Sinibaldi, 0:23:48.680 --> 0:23:51.680 because his hearing isn't what it once was. I'm a 0:23:51.720 --> 0:23:55.080 little scared, but not too angry. I'm just waiting for 0:23:55.119 --> 0:23:58.399 a call from my doctor. The EU had developed a 0:23:58.440 --> 0:24:02.399 strategy of pooling vaccine procurement across the twenty seven member states. 0:24:03.000 --> 0:24:06.880 It signed supply deals with six vaccine developers. With Fiser, 0:24:07.000 --> 0:24:10.520 the European Commission agreed to a framework for supplying countries quarterly, 0:24:11.000 --> 0:24:13.800 leaving week to week decisions to the company and each nation, 0:24:14.119 --> 0:24:18.440 says Stephen de Kersmacher, a commissioned spokesman. When Fiser made 0:24:18.440 --> 0:24:21.480 its cuts in January, that arrangement led to a patchwork 0:24:21.520 --> 0:24:24.520