The COVID-19 pathogen led to a fast expanding pandemic because it proved lethal in certain populations but could be transmitted by persons who appeared healthy. As a result, researchers came under unprecedented time pressure to develop a vaccine. This case study focuses on the first COVID-19 vaccine, which was approved for use in humans, known as Comirnaty, the BioNTech-Pfizer COVID-19 vaccine or Vaccine BNT162b2. With the benefit of hindsight, we show how close collaboration with regulators and trust-based decisions meant (...) that the race for a COVID-19 vaccine was won without purposefully infecting healthy participants with an infectious agent that can cause severe illness or death and for which no rescue therapy had existed. (shrink)

The Pfizer-BioNTech coronavirus vaccine is 90 percent effective in protecting against COVID-19. It would not have been possible without the tireless effort of Professor Katalin Karikó, a scientific innovator fitting the mold of dynamic inventor Arthur Diamond presents in his book, Openness to Creative Destruction Sustaining Innovative Dynamism. Not only did Professor Karikó persist in her beliefs in the therapeutic potential of synthetic messenger RNA over the course of four decades, but she did so despite the criticisms of other (...) scientists and despite lack of financial backing for large parts of her career. Professor Karikó is a good example of the unconventional picture that Diamond paints of entrepreneurs in a specific version of market capitalism he terms, innovative dynamism. Specifically, she is an example of someone who does not hold prevailing academic theories in too high a regard and instead privileges her tacit knowledge (knowledge gained from years of working with mRNA in the lab) to persist believing in the potential of a therapy that now could quite literally save the world. Most surprisingly, she, like most of the entrepreneurs surveyed in the book, seem not primarily motivated by profit, though the money their projects eventually attract is integral to disseminating their creative ideas to the masses. -/- Are the many examples offered by Diamond that are similar to Professor Karikó’s story evidence against the long-standing suspicion that there is something morally damning in the self-interested motivations of innovative entrepreneurship? Is it the case that others would have inevitably pursued the cure that Karikó pursued, regardless of economic system? In light of COVID-19 and other high-pressure situations, ought we to care how we constrain the innovators who develop solutions? Diamond’s case for the economic system, innovative dynamism, seeks to answer these and other important questions concerning our political and cultural treatment of innovators and entrepreneurs. This review critically assesses his efforts. I make my case by first reviewing the major argumentative structure of the book, then I summarize and evaluate the three major themes Diamond presents in the book: (1) what is innovative dynamism and who are its competitors, (2) what are the major benefits of innovative dynamism, (3) who is the innovative entrepreneur and how do we support him or her? (shrink)

By 20 October 2021, the U.S. Food and Drug Administration (FDA) had amended its Emergency Use Authorizations for immunocompetent adults who previously received the Pfizer-BioNTech, Moderna, or Johnson & Johnson COVID-19 vaccines. For the 2-dose Pfizer-BioNTech and Moderna vaccines, the FDA permitted a single booster dose for adults aged 65 years or older and adults aged 18 to 64 years at high-risk for severe COVID-19 or at high risk for occupational or institutional COVID-19 exposure. For the single-dose Johnson (...) & Johnson vaccine, the FDA permitted a single booster dose for all adults aged 18 or older. These eligibility schemes were endorsed by the Centers for Disease Control and Prevention shortly after FDA approval. (shrink)

Can Covid-19 vaccines be used off-label? Should they be? These were questions on the minds of parents, pediatricians, and the media when the FDA fully approved the Pfizer-BioNTech Covid-19 vaccine for people aged 16 and up. Yet the American Academy of Pediatrics cautioned against pediatric off-label use of the vaccine, and the CDC Covid-19 Vaccine Provider Agreement appears to prohibit it. After briefly contextualizing ethical and legal precedents regarding off-label use, we offer an analysis of the ethical permissibility of (...) and considerations for pediatric off-label Covid-19 vaccination based on individual benefits, risks, and available alternatives. Our analysis challenges the ethics of a blanket prohibition on off-label pediatric Covid-19 vaccination, as it limits clinician ability to provide care they may determine to be clinically and ethically appropriate. At the same time, our analysis acknowledges that Covid-19 creates population-level ethical considerations that are at times in tension with individual health interests. (shrink)

Can you succeed without being a terrible person? We often think not: recognizing that, as the old saying has it, "nice guys finish last." But does that mean you have to go to the other extreme and be a bully or Machiavellian to get anything done? In The Art of Fairness, bestselling author David Bodanis uses thrilling case studies to show there's a better path, leading neatly in between. He reveals how it was fairness, applied with skill, that led to (...) the speedy development of the Pfizer-BioNTech vaccine, to construction ofthe Empire State Building to be constructed in barely a year, and to a quiet English debutante becoming an acclaimed jungle guerrilla fighter in World War II. In ten vivid profiles featuring pilots, filmmakers, baseball managers, and more, we see that the path to greatness doesn't require crushing displays of power or tyrannical ego. Simple fair decency can prevail. (shrink)