Impact of economies of scale for vaccines

We have benefited enormously from the vast economies of scale in the vaccine industry. Because childhood vaccines were mandated, the companies that made them could be confident that they’d be able to sell large numbers. That made it worth both doing the research and investing in capacity.

Even flu vaccines have benefited, because government agencies got a bunch of scientists to come together and produce their best guess as to what strains to vaccinate against each year, so that there only had to be one vaccine that everyone got, and mandating that insurance companies had to pay for it.

But with the current administration in the U.S. suggesting that vaccines are generally bad, I fear we’re going to see less of that: fewer mandates are going to mean fewer vaccines being administered. Obviously that’s going to mean more sick people, which is really bad. But almost as bad, it’s going to reduce the economies of scale, meaning that the per-shot cost of vaccines are likely to rise significantly.

This all got me to thinking, what would a post-mandated-vaccines world look like?

Well, only smart people would buy vaccines, and only rich people would be able to afford them.

How many people are both smart and rich? And how rich would you have to be? Depending on how much prices went up, maybe only the top 50% would be able to afford them, maybe the top 10%, maybe the top 1%.

One small upside might be that boutique vaccine shops could find it worthwhile to make better vaccines—modestly better effectiveness, modestly reduced side-effects—because there’d be vaccine competition.

Really, though, there was always a strong push for that stuff for mandated vaccines, because if you’re going to give out 300 million doses, even a tiny improvement is going to really matter.

Still, I read a year or so ago about a version of the Covid-19 vaccine that produced much longer-lasting immunity being discontinued because they couldn’t sell enough of it, because it wasn’t mandated. That’s the sort of thing that might get better in a post-mandate world.

Won’t be a net win for society. Probably not even a net win for the 1% who can afford whatever bespoke vaccines they want, because it costs billions to research and test a vaccine, and even the 1% can’t afford that, unless they all get together and fund joint projects.

These thoughts brought to you by me getting my Covid shot now rather than waiting until just a few weeks before I go visit my 92-year-old mother—because who knows if it’ll be available then?