“We Are Hoarding”: Why the U.S. Still Can’t Donate COVID-19 Vaccines to Countries in Need

By Katherine Eban

On the morning of March 31, roughly 25 Biden administration officials gathered at the White House, double-masked, for a meeting called on short notice by a member of the National Security Council. They were there, they believed, to debate how best to broaden the federal government’s COVID-19 response beyond U.S. borders, and reclaim America’s traditional role as the world’s public health leader.

The challenges they planned to address were daunting. The Trump administration had poisoned relations with the rest of the world, first severing ties with the World Health Organization and then politicizing the pandemic, referring to COVID-19 as the Wuhan virus and even “kung flu.” Into the vacuum rushed Russia and China, who began currying favor around the world by distributing their own vaccines—of possibly dubious quality.

Inside the U.S., all eyes have been focused on the chaotic rollout of vaccinations. But if current trends continue, it will be months if not weeks before every adult who wants a shot is able to get one. Very soon, the U.S. will be in possession of a vast COVID vaccine surplus. And that, global-health experts within the government agree, could quickly turn into a P.R. nightmare. “Can you imagine the condemnation of the world if America has vaccines sitting on warehouse shelves expiring with the rest of the world dying?” said one senior government official with knowledge of the meeting.

Unfortunately, sending doses overseas is no simple matter. To even begin planning in earnest how to do so, an essential document entitled The Framework for International Access needed to be greenlit. That was a goal of several officials in attendance at the meeting at the White House last Wednesday.

Instead, those in attendance heard a stark and dismaying message: The pandemic was spiraling out of control here at home. There was no capacity to deal with global donations, meaning that planning would come to a “screeching halt,” said the senior government official.

Two days earlier, CDC director Rochelle Walensky had veered off script in a press briefing to express her feeling of “impending doom” in the face of a deadly uptick in cases. Now, those gathered for the White House meeting discussed the alarming reversal of recent U.S. gains, driven in part by reckless reopenings and spring break travel: a surge of more infectious variants, a rising rate of hospitalizations for patients under 40, and a staggeringly high nationwide positivity rate of more than 13%. Roughly 2.9 million Americans were being vaccinated each day, and deaths had dipped below 900 per day, but every other indicator was bad. “They are going into full hunker-down mode to figure out what’s going wrong,” said the senior official.

The domestic situation was “so severe,” said the official, that every federal entity that might work on overseas donations had instead been tasked with vaccinating more Americans. The rest of the world would have to wait.

For all the well-documented failures of its pandemic response, the Trump administration exceeded expectations when it came to developing COVID-19 vaccines. Thanks in part to Operation Warp Speed, a multibillion-dollar joint venture of the Pentagon, the Department of Health and Human Services, and private pharmaceutical companies, a handful of manufacturers were able to gain approval for new vaccines in record time, accomplishing in under a year what might normally have taken a decade.

Still, given the nature of the Trump administration, this signal accomplishment came with some substantial asterisks. Upon taking office, the Biden team discovered that the previous administration’s plans for the distribution of vaccinations to individual citizens were woefully inadequate. And the Trump team’s unwillingness to enact a national testing plan, or even to clearly advocate for basic protective measures, allowed the virus to run rampant, leading the U.S. to suffer more deaths than any other country on earth.

For officials hoping to finally pivot from domestic to international vaccination strategy, there was another major catch, reported here for the first time.

The contracts the Trump administration signed with the vaccine manufacturers prohibit the U.S. from sharing its surplus doses with the rest of the world. According to contract language Vanity Fair has obtained, the agreements with Pfizer, Moderna, AstraZeneca, and Janssen state: “The Government may not use, or authorize the use of, any products or materials provided under this Project Agreement, unless such use occurs in the United States” or U.S. territories.

The clauses in question are designed to ensure that the manufacturers retain liability protection, but they have had the effect of projecting the Trump administration’s America First agenda into the Biden era. “That is what has completely and totally prohibited the U.S. from donating or reselling, because it would be in breach of contract,” said a senior administration official involved in the global planning effort. “It is a complete and total ban. Those legal parameters must change before we do anything to help the rest of the world.”

In a statement to Vanity Fair, a Defense Department spokesperson acknowledged the contract restrictions, saying: “DoD did attempt to negotiate terms that would allow the use of vaccine doses outside the U.S., but in some cases, the vaccine manufacturers refused.” Given the imperative to produce 300 million doses for the American public, said the spokesperson, Operation Warp Speed officials agreed that it was “more important to contract with the vaccine manufacturers for doses that could be used” by U.S. citizens “than walk away from the negotiations based on this single term.”

The impasse is especially frustrating because the Biden team’s global ambitions go beyond donating money or surplus vaccines. Vanity Fair has learned that the administration is quietly considering plans to have the U.S. serve as a major manufacturer of affordable, high-quality COVID vaccines for the entire world—a role typically reserved for lower-cost countries such as India. The effort began in plain sight on March 2, when the administration announced that, under the Defense Production Act, Merck would repurpose two of its U.S. manufacturing plants to begin producing the Johnson & Johnson vaccine. The partnership, pairing two traditional rivals, could yield as many as one billion doses a year.