Yossi Sheffi - A Shot in the Arm: How Science, Engineering, and Supply Chains Converged to Vaccinate the World

A Shot in The Arm

How Science, Engineering, and Supply Chains Converged to Vaccinate the World

Yossi Sheffi

Cambridge, Mass.

Preface

When the Covid-19 pandemic struck in early 2020, I set aside a project on the history of innovation in supply chains to write a book analyzing what ultimately became perhaps the greatest global supply chain disruption since World War II. That book, The New (Ab)Normal: Reshaping Business and Supply Chain Strategy Beyond Covid-19 (MIT CTL Media, 2020) , focused on how Covid impacted the broader economy, having major disruptive effects on consumer goods, manufacturing, distribution, logistics, retailing, workplaces, and cities. In the same vein as two of my previous books dealing with risk and resilience The Resilient Enterprise: Overcoming Vulnerability for Competitive Advantage (MIT Press, 2005) and the Power of Resilience: How the Best Companies Manage the Unexpected (MIT Press, 2015) The New (Ab)Normal looked at how people and companies were handling, adapting to, and even benefiting from disruptive eventsboth Covid-related and in general.

In The New (Ab)Normal , I described how employees were working from home and consumers were battling to hoard toilet paper (detailing the origins of this and other shortages), as well as how companies were navigating the combined impacts of changing consumer demand, disrupted suppliers, fractured transportation links, and new workplace regulations. At the same time, I began watching another story unfolding in the laboratories of universities and pharmaceutical companies. Biomedical scientists and engineers around the world began a race to save civilization from the virus by developing a vaccine. Those scientists and engineers seemed to face very long odds of success in any reasonable timeframe given both the very long gestation periods typically required to create just the candidate vaccines for testing and the low rate of subsequent approvals of tested vaccines.

Many likened this massive vaccine development effort to the Apollo moonshot campaign of the 1960s. However, the moonshot was easier in several ways. The moonshot only needed to hand-build a dozen or so rockets to carry a select few dozen intrepid astronauts willing to risk it all to go into space and then to the moon. In contrast, the vaccine effort needed to mass-produce billions of units of a safe and effective product for use by billions of ordinary consumers and citizens, many of whom were risk-averse and hesitant. Whereas the moonshots rocket makers could deliver the rockets to a single location, the vaccine makers needed to reach everyone in the world wherever they lived. Finally, while US President John F. Kennedy gave NASA more than eight years to reach the moon, Covid began killing staggeringand increasingnumbers of people from day one.

This new book follows the global efforts to vaccinate the world and begins with a focused on the accumulated knowledge in the sciences of immunology, genetics, and cell biology that made the vaccines possible. Literally decades of science and more than a few Nobel Prizes went into understanding how viruses and vaccines work and creating the tools for making vaccines. Over time, scientists came to a fundamental understanding of how the cells of every living creature are really biological factories, how viruses hijack those cellular factories, and how the immune system learns to fight off the hijackers. One key innovation in the newest generation of vaccines (the mRNA vaccines of Moderna, PfizerBioNTech, and others) is in how they make the antigenthe Covid spike proteinthat the immune system learns to recognize and fight. The mRNA vaccines dont contain the antigen; rather, they contain a set of instructions, the equivalent of a business purchase order (PO), to a persons cells so that those cells manufacture this most important component of the vaccine. However, those innovative mRNA vaccines could not work without other innovative technologies that package the exceedingly fragile mRNA and deliver it to peoples cells.

Developing a safe and effective vaccine wasnt the end of the challenge; it was just a first step in what would become the greatest product launch in human history: mass-producing these vaccines, distributing them to vaccination sites around the world, and getting billions of people to come and get vaccinated (discussed in the following chapters).

The of this book focuses on the next step of the challenge: mass-producing an entirely new product from scratch and rapidly scaling production to millionsand then billionsof units within the shortest possible time. Mass-producing the vaccine meant creating all the supply chains needed to manufacture all the ingredients and raw materials required for the vaccine, many of which had been niche laboratory chemicals. Getting to scale entailed overcoming shortages of materials and industrial capacity.

After the vaccine makers produced and bottled all the doses, next came the challenge of getting the product to the people who needed it (described in ). This is analogous to the challenge of getting the hottest new toy out to retailers shelves for the holidays, but with the added pressure that impediments and delays in distribution would mean that more people would die. This task of consumer distribution was managed by governments with varying degrees of effectiveness. The mix of happy successes and woeful failures offer many lessons for how to handle new product launches, especially when product demand overwhelms supply.

As with any new product launch, product availability is one half of the distribution challenge with consumers. examines the other half: how of the vaccine providers had to convince, cajole, or incentivize people to go out and get the product. Although a great many people eagerly wanted the vaccine, detractors of vaccination arose as a serious threat to the prevention of death and disease. These so-called anti-vaxxers were a messy mix of those with heartfelt personal values, the sadly misinformed, and a rogues gallery of those who benefit from sowing social and political chaos. Vaccine makers and governments had to combat a never-ending stream of falsehoods and misrepresentations, some of which came from those governments own politicians.

The looks to the future and toward other opportunities for solving big challenges facing humanity. The mRNA vaccine technologies may hold the key to a new era of rapidly developed and effective vaccines for a wide range of diseases. Moreover, the ability to program a patients cells to make therapeutic substances could address a wider array of health problems such as cancer and organ failure. The combinations of genetic technologies and vaccine mass-production technologies can also be applied beyond medicine and agriculture to industrial processes. Finally, the deeper processes of accumulating scientific understanding, creating portfolios of engineering solutions, and building large-scale ecosystems of manufacturing and supply chains can combine to address other global problems such as climate change.

In summary, this book is a tale of bringing the full might of science, engineering, supply chain processes, and government resources to combat a critical global problem. Each of these four realms of human endeavor faced, and largely overcame, serious obstacles in pursuit of the goal of preventing more death, disease, and economic upheaval from Covid-19. Overall, the great race to vaccinate humanity holds many lessons about product development, manufacturing, creating new supply chains, distribution, and customer adoption of highly innovative, revolutionary products.