Article

Vaccines for Pandemics: Lessons from COVID-19 for H5N1 and Beyond

Alison McCarthy

J.D. (Class of 2025), Saint Louis University School of Law.

Michael S. Sinha

M.D., J.D., M.P.H.. Associate Professor of Law, Saint Louis University School of Law and Associate Professor of Health Management and Policy (Secondary), Saint Louis University College for Public Health and Social Justice.

The COVID-19 pandemic brought unprecedented challenges to vaccine development and distribution. Never before has a vaccine been developed so quickly and distributed so rapidly. But compared to past pandemics and public health crises—like polio or even the more recent H1N1 pandemic—the United States government’s COVID-19 vaccine strategy depended greatly on the private sector.

COVID-19 vaccines were credited with saving millions of lives worldwide, but private companies reaped these rewards, retained their patent rights, and profited from the vast and pressing need for their vaccines. Now, five years later, not every company views its vaccine work as a success. Financial hits in the form of stock declines (Pfizer, Moderna) or inability to reach or to remain on the domestic market for vaccines (Johnson & Johnson, AstraZeneca) may make firms more reluctant to participate in a subsequent private sector “arms race” to develop a vaccine for the next novel pathogen. Vaccine distribution followed a similar pattern. The U.S. government, through the Pharmacy Partnership for Long-Term Care Program and the Federal Pharmacy Partnership, worked with private retail pharmacies like CVS and Walgreens to distribute vaccines. West Virginia, the only state to opt out of the program, sped through its vaccine distribution while CVS and Walgreens struggled to inoculate patients.

As the threat of an H5N1 pandemic looms, the United States is making many of the same mistakes that hindered its response to COVID-19. Private-public partnerships, which had mixed success during COVID-19, will still be critical to addressing H5N1 or a future disease outbreak. Yet the private sector has less incentive to enter a vaccine race than ever before, especially with vaccine skeptic Robert F. Kennedy, Jr. now at the helm of the U.S. Department of Health and Human Services (HHS). To be better prepared for future disease outbreaks, both the private and public sectors need to find a middle ground that will allow for expedient vaccine development without compromising on public interests and needs.

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