Alex Tabarrok on 'First Doses First'.

• Author: Reese, Isaac
• Position: Q&A

INTERVIEW BY ISAAC REESE

THE C0VID-19 VACCINES made by Moderna and Pfizer/BioNTech were developed and brought to market at a blistering pace, but their distribution has been hobbled by poor organization and rigid eligibility rules. The planned rollouts didn't give local officials and health care workers enough flexibility to adjust to the realities on the ground--or to make tradeoffs between treating as many people as possible and strictly adhering to the guidelines.

Alex Tabarrok, an economist at George Mason University who blogs at Marginal Revolution, has been promoting an idea called "First Doses First," which the United Kingdom recently adopted. This approach would allocate all available vaccines to be used as first doses, while pushing off second doses for weeks (or even months) until production can catch up. While U.S. regulators have so far resisted the strategy, they recently eased up on strict rules about the timing between doses.

Reason's Isaac Reese spoke to Tabarrok in January about the vaccine situation.

Q: You argued that the world's governments should collectively spend about $100 billion on vaccines. Where does that number come from?

A: The economics of this is actually incredibly simple: The world economy is losing $500 billion to $1 trillion a month. A month. So it's billions of dollars, invested in vaccines, to save trillions of dollars by accelerating the recovery.

Q: You consulted for the Trump administration, the World Bank, and other foreign governments about how to spur vaccine development. Can you talk about the advice you offered?

A: We initially approached it by thinking about an advanced market commitment, which is what [economist and Nobel laureate Michael] Kremer had used to increase the incentive to produce a pneumococcus vaccine. You set a high price, and then you just wait for firms to jump into the market to try and achieve, like a prize.

We quickly discovered that that might not be optimal in the current situation. The economic costs [of COVID-19] were so high that you wanted a lot of shots on goal, and you even wanted to take some shots with a...