Although Johnson & Johnson has lagged behind the other manufacturers, its technology holds great promise for mass production as it can deliver many more cans per lot.
Later this year, when Merck & Company is expected to begin manufacturing Johnson & Johnson's vaccine, it could produce 100 million doses per month – or as many as Pfizer and Moderna combined deliver each month. The White House welcomed the deal between Johnson & Johnson and Merck, but when production revs up, those cans may be tied up for a growing surplus or for export.
One option is to ship the frozen vaccine, which is made at Merck's overseas facility, where it can be bottled much cheaper. Of the $ 10 the federal government agreed to pay for a dose of Johnson & Johnson's vaccine, the drug substance itself only accounts for about 30 cents, federal officials said. The rest are the so-called fill-and-finish costs.
If AstraZeneca gets emergency clearance from US regulators, even more shots will be thrown into the mix. Officials expect around 50 million cans to be ready for delivery by May.
But Biden government officials are upset with AstraZeneca's vaccine. It seems about as effective as Johnson & Johnson's, but requires an extra shot, which means a more complicated rollout. Some health officials fear that the introduction of a fourth vaccine will only confuse people if enough doses are already in the pipeline to cover every adult who wants a shot.
On the other hand, if the government decides to donate the AstraZeneca cans without offering anything to their own citizens, other countries may conclude that the United States has no confidence in the safety or effectiveness of the vaccine.
"As we become more confident in the doses we have and the ability, or need or not, to increase them, we can make a more definitive statement about what role the AZ product will play in the US." Dr. Fauci said in an interview this week, "but right now I think it's too early to say anything."
Sheryl Gay Stolberg, Benjamin Mueller and Matina Stevis-Gridneff contributed to the coverage. Kitty Bennett contributed to the research.