COVID-19 Bullets

•  AstraZeneca will miss its Q2 COVID-19 vaccine shipments by half, according to a Reuters report.
• Moderna and Pfizer both expect to double their current output, and possibly triple it. Pfizer will go from four million doses a week to 13 million doses by mid-March, and 100 million doses by the end of the first half. Moderna plans on doubling its output to 40 million doses per month by April.
  
• Johnson & Johnson expects to have 20 million doses of its single-shot vaccine available by the end of March, and 100 million doses at the end of Q2.
  
• The B.1.1.7 variant now constitutes 6.2% of all new COVID-19 cases in New York City, up from 2.7% in January.
• Michael Osterholm, et al., say that prioritizing elderly (65+) for vaccination (PDF) should minimize the healthcare system strain in the coming weeks with new variants gaining traction in the US. He also recommends
• Deferring second doses of mRNA vaccines until after the surge.
• Deferring the second dose of mRNA vaccines in people with confirmed COVID-19 infections.
• Authorizing and use of the half-dose regimen for the Moderna vaccine.
• Pfizer/BioNTech and AstraZeneca vaccines are slowing the pace of hospitalizations already in Scotland.
• Meanwhile in France, vaccination lags far behind shipments of vaccines, with 8 million delivered but only 3.5 million vaccinated.
• Derek Lowe's latest on mRNA vaccine manufacturing isn't exactly grim, but there are so many caveats you might swallow hard. A ton of interesting links there (and I especially recommend Jonas Neubert's look at supply chains), but the quote that really stuck with me was this:

  As you would imagine, everyone involved is having quite a time meeting demand. As the article says, though, it’s hard to get a clear picture of where the exact pinch points are, because the terms of the various contracts are not public, nor are even the identities of the raw material suppliers further up the chain. But anyone who’s had to source intermediates or starting materials in the drug business at any kind of scale will appreciate that the fastest way to find out what those weak points are is to place a Big Ol’ Order for something.

  Lowe is, as I am, "struck by how much we’ve been able to scale up these things" despite the many potential obstacles along the way. "I’d be willing to bet that if you’d called any of [the Acuitas Therapeutics people making lipid nanoparticles] up in (say) December 2019 and asked them if they could get to where they actually are by February 2021 they’d have been terrified."