Pfizer should be free to sell the vaccine to whomever it likes so long as it doesn’t compromise public health

Professor Jonathan Van Tam has emerged as one of the good eggs of the coronavirus crisis. Calm and patient, England’s deputy medical officer has always been cool under fire from an often baying press pack. His presentations of how the pandemic is developing and how the health services are dealing with the crisis have been analytical and logical, with little need for scary graphs.

Which is why the Professor’s performance at today’s virus press conference giving more details about who is eligible for the new Pfizer vaccine was disappointing on so many levels. When asked whether members of the public might be able to buy the vaccine privately, he dismissed out of hand the notion that people might be able to skip the queue and pay for their own vaccine.

This is what he said: “One of the things I like about the NHS is that it’s there for everybody, irrespective of their level of wealth or who they are in society. That’s a really important principle to me, personally.”

Van Tam went on to admit that the issue of whether the vaccine should be sold privately would be a “ministerial decision”. But he then added that, as a clinician: “I think these vaccines need to be prioritised to those who need them, not those who can afford to pay for them privately.”

Professor Van Tam is right to say those at risk must be prioritised. Yet he has strayed into dangerous, if not populist and authoritarian territory by suggesting that citizens should not be able to buy the vaccine if they were able to. He has confused the provision of an emergency vaccine being given free through a country’s national health service with the right of a privately owned company – such as Pfizer or any other – to sell the vaccine to other interested parties outside of national health services around the world, many of which are not free anyway.

Just as it would be unethical for the UK government to mandate that everyone in the country should be forced to have the new vaccine, so it is wrong to suggest that citizens do not have the right to buy the vaccine if it were offered by Pfizer, or by any other private company.

One can of course imagine exceptions to this argument. If the NHS did not order sufficient quantities of the drug, and those most at risk from the virus were not receiving the vaccine, then there might be a case for temporarily banning the private sale of the vaccine until supplies were back under control.

As it is, however, the UK has had the foresight to order 40 million doses of the vaccine, 10 million of which the government hopes to be giving out to the most vulnerable once the drug has been approved by the UK’s Medicines and Healthcare Products Regulatory Agency.

It is impossible to know what the future demand for Pfizer’s vaccine will be. As far as one can ascertain, Pfizer has so far only committed to sell to governments. To date, Pfizer and its vaccine partner BioNTech have agreed to distribute at least 100 million doses of their vaccine – when it has passed all the regulatory hopes – to the  U.S. government for nearly $2 billion. This is under Operation Warp Speed, President Trump’s Covid vaccine programme, pricing each dose at about $39.

Countries in South America and the Asia-Pacific region have also pre-ordered the vaccine while Pfizer plans to supply 50 million doses globally this year and a further 1.3 billion doses next year.

Pfizer and BioNTech have also agreed with the European Commission to provide 200 million vaccine doses for the EU, with the option to supply another 100 million doses at a later date.

How much more will need to be made? It is impossible to tell for certain, but what often happens when a pharma company creates a new blockbuster drug that is in high demand is that the creator then arranges strict proprietary licenses under which other manufacturers can make it.

There is absolutely no reason why Pfizer – if it does not have the capacity to make enough supplies to meet demand – could not also license its vaccine to other manufacturers, who in turn would sell to private health care companies as well as governments.

But Pfizer cannot be stopped by Prof Van Tam – or indeed the British government – from selling the vaccine privately. Over the 170 years since Pfizer was created, the pharma giant has been involved with discovering, developing and providing more than 170 different medicines and vaccines –from Viagra to smallpox – to millions of people around the world.

Founded by two German émigrés in New York in the 1840s, Pfizer is today publicly listed on the New York Stock Exchange where it is worth around $215 billion and employs around 88,000 people around the globe. It is the ingenuity of those early founders, who led the way on making vaccines for smallpox and pneumonia, that has allowed Pfizer to reinvest and to keep on discovering new drugs to the benefit of patients around the world. Yet the company also owes its accomplishments to the investors who support its work. And indirectly we may all be part of that success. Shareholders include some of the world’s biggest investors such as Black Rock and Norges Bank and most of us – in some way or other – may well benefit from our pension funds holding shares in the group.

Along with another 140 or so research labs around the world, by May this year Pfizer had thrown itself headlong into the race to find a vaccine to counter Covid. It had an early success: in July this year, Pfizer’s chief executive, Dr Albert Bourla announced his scientists and medics were testing four different coronavirus vaccine variations to help insulate people from the SARS-CoV-2 virus. Working together with BioNTech, the German drug maker based in Mainz, the research team had isolated two of the partners’ four mRNA vaccine candidates and won fast track designation from the FDA. (It’s a nice twist of fate that the couple behind the BioNTech discovery are brilliant Turkish doctors living in Germany).

By September Pfizer’s and BioNTech had started work on human trials with thousands of patients with one potential vaccine, BNT162.

Then, earlier this week, Pfizer and BioNTech announced that their vaccine was producing a 90% efficacy rate and they are ready to start manufacturing it en masse over the next few weeks.

All this research was carried out with Pfizer’s own capital – at least a $1 billion has been spent on the  project – money that has been earned over the years from other profitable drugs. Pfizer’s Bourla also revealed he had rejected all offers of money to help with vaccine research from the US government or any other outside body, because he believes that his scientists should be liberated from the bureaucracy which inevitably comes with government funding: “When you get money from someone, that always comes with strings.”

Now that Pfizer has taken the bold step of investing its own capital in this potentially groundbreaking vaccine, they should have the latitude to deploy it without being tied down by inappropriate or unnecessary government restrictions.