Today's the day! Vaccine for Covid day! V-C Day! This morning trucks left the Pfizer factory in Kalamazoo, Michigan, packed with the first authorized Covid-19 vaccine. They headed to airports where the doses will be parted out nationwide to first responders starting tomorrow.

A month from now, all of our medical workers will be vaccinated, the front line will be protected. Those heroes who have spent the last year risking their lives and dying, saving the rest of us will finally get the protection they deserve. With the surge that is coming in January, we'll need every nurse and doctor we have.

It's been 336 days since the genetic sequence was released. This effort sets the record for vaccine development by years!

It's popular in some circles to lament the "lack of advancement" in tech in the last twenty years. We are only here today because of the incredible technological progress in the previous 20 years.

Twenty years ago, simple things like compute capacity and internet bandwidths weren't good enough to have created the models and communicated the needed information.

Twenty years ago, we hadn't even finished the Human Genome Project. Genetic sequencing was orders of magnitude more expensive, and modeling software for proteins was still in its' infancy.

Twenty years ago, mRNA vaccines were still just an intellectual curiosity. Dr. Katalin Karikó and Dr. Drew Weissman wouldn't publish their breakthrough till 2005. What's more remarkable is that Dr. Karikó had been on a tenure track at Penn and, due to lack of interest in mRNA, was demoted in 1995. Still, she believed in the promise of mRNA, and she persevered.

We live in the peak of human history to date. The rollout of this vaccine is one of the most incredible things we'll see in our lifetimes.

The Black Death hit Europe in waves over 200 years. We will eradicate Covid from the earth in two.

Let's dig into the details.

This week the FDA met and approved an Emergency Use Authorization for the Pfizer / BioNTech mRNA-based Covid vaccine. The FDA did so on the advice of a panel of outside experts called the Vaccines and Related Biological Products Advisory Committee. They for 17-4 in favor of approval for everyone older than 16. The four dissents wanted to only approve it for people over 18 since 16-year-olds weren't included in the study. Based on what I've read, it seems they were being pedantic, and the consensus is that it's fine for 16 and older.

Sometime in the next week, the same panel is expected to meet to approve Moderna's mRNA vaccine. It'll be a bit before any other ones get approved. As a reminder, both of the mRNA vaccines need two doses, about a month apart, to be most effective.

J&J's single-dose adenovirus vaccine is on track to hit its test threshold in mid to late January. The other adenovirus vaccine is the AstraZeneca two-dose one, which has initial results in Europe that were middling. There are still outstanding questions on if the AZ vaccine can get to 90% efficacy by changing the dose regimen, but that will take time. If approved, I wouldn't expect AZ's rollout for months, which is tragic because it's easier to distribute and has the largest production capacity.

Novavax is the last of the first five, and they're expecting results by the end of March. The US has preordered 100 million doses of that one. Based on its similarity to the mRNA, people seem pretty excited about it.

There was a bit of a scandal this week when it came out that Pfizer offered the US the opportunity to buy 100 million extra doses [we have 100 million reserved with an option for more], and the US declined repeatedly. Now Pfizer says that after the first 100 million, the US won't get more till possibly June. Obviously, this isn't great, but I'm not convinced it's as catastrophic as some suggest.

Currently, we have 100 million Pfizer doses, and as of this morning, 200 million Moderna doses. Assuming about 30 million people dosed every month, that would give us 5 months of supply. I also think we will get at least one more vaccine, another 100 million doses.

The projections I trust the most say that we should be at herd immunity by June / July. Herd immunity is a full return to normal, and we should expect that restrictions start to loosen significantly before that. Each additional vaccine probably brings it in by a month.

As vaccines roll out, it's important to remember that some people will die, some will get cancer, some will have strokes. Not because of the vaccine, but just because if you take a million people over a few weeks, some will get cancer/die / have a stroke. Correlation is not causation, don't buy into the fear-mongering. We have conducted the largest Phase III trials ever; the trials were 10x bigger than normal to make sure these shots are safe. The FDA and Pfizer did their jobs, and they're shipping out something they have the data to show that it's safe.

I want to say that I will 100% be taking the vaccine as soon as it's available to me. The vaccine designed on a computer in February, fabricated in a matter of weeks, tested widely in months, distributed across the world in under a year. That's the sci-fi future I want to live in; it's superhero level of impressive.

With all the good news, we can't let up our vigilance. There are more people hospitalized with Covid than at any point in the pandemic. A friend posted this week, "I am alive today because an ICU bed was available for me when I was 29." When hospitals are full, normally survivable conditions aren't. Don't travel, cancel your holiday plans, sit tight, and wait out this wave.

Bunker down, the calvary is coming, we just need to buy them a little time to arrive.

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