President Joe Biden recently reached his target of having 100 million shots administered in his first 100 days in office with six weeks to spare, thanks to a strategy he inherited from his predecessor.
The former administration wrote clauses into contracts with Wuhan coronavirus (COVID-19) vaccine manufacturers and used the Defense Production Act (DPA), which grants the president extraordinary powers over manufacturing in times of crisis.
Biden also took advantage of the provision under the DPA that allows the U.S. to include what's called a "priority rating" on contracts, which moves the government to the front of a line. In return, the manufacturers usually get better access to supplies they need.
Both administrations have been unapologetic for putting Americans first in the inoculation ladder.
Trump administration officials said American taxpayers deserved to have their orders prioritized because of the former president's multibillion-dollar "Operation Warp Speed" program that accelerated the development of the COVID-19 vaccines.
"We didn't want to put billions of dollars of taxpayers' money at risk only to find out we were third in line for the product we invested in," said Paul Mango, a former senior official in the Department of Health and Human Services (HHS) under Trump.
Government used DPA provision to secure shots for Americans
The U.S. applied priority ratings to its contracts with both Moderna and Johnson & Johnson a month after signing them in August last year, according to the HHS. The designation meant the companies had to fill their U.S. orders before those from other countries. AstraZeneca's U.S. contract also included a priority rating.
Officials with the Trump administration said Pfizer's initial contract did not include a DPA priority rating, but the contract language required the company to provide 20 million doses to the U.S. monthly beginning November last year. The deal also included a clause that said all timing estimates were "subject to change based on emerging data, regulatory guidance, and manufacturing and technical developments, among other risks."
The second contract the Trump administration signed with Pfizer raised the country's total order to 200 million doses. It included a priority rating that the company requested, an indication it was willing to put U.S. orders at the front of the line to benefit from the government's power to secure scarce supplies.
In other words, the Trump administration effectively bought all COVID-19 vaccines produced in the country by Pfizer and Moderna the moment the Food and Drug Administration (FDA) authorized their use. (Related: Moderna in talks with Biden administration to provide extra 100 million coronavirus vaccine doses.)
The America first approach taken by both Biden and Trump has been criticized by public health experts.
"It, depressingly, has gone pretty much exactly as predicted," said Thomas Bollyky, director of the global health program at the Council on Foreign Relations. "In every previous global health crisis where there has been a medical intervention that would make a difference, wealthy countries have hoarded it."
As of this writing, the U.S. has put nearly 130 million doses into arms – twice as many as the more-populous European Union.
Unlike the U.S., the EU has exported doses despite its own shortages and rollout failures. European Commission President Ursula von der Leyen claimed that the EU had exported 41 million doses of COVID-19 shots to 33 countries worldwide since January.
EU to restrict export of COVID-19 vaccines
The European Commission presented new plans on Wednesday, March 24, to restrict the export of COVID-19 vaccines from the 27-member bloc. The commission, the EU's executive arm, wants to ensure that member states will receive all the shots that have been promised for the second quarter.
"While our member states are facing the third wave of the pandemic and not every company is delivering on its contract, the EU is the only major OECD producer that continues to export vaccines at large scale to dozens of countries. But open roads should run in both directions," von der Leyen said in a statement.
The EU's tougher position was triggered by the setbacks in the number of vaccines delivered by AstraZeneca. (Related: EU IN CRISIS: Deadly rollout of AstraZeneca vaccine destroys EU’s reputation, shatters image of unity within bloc.)
Earlier this year, the Anglo-Swedish firm said it could only deliver 30 million doses of its vaccine in the first quarter instead of around 90 million doses. More recently, the pharmaceutical giant cut delivery expectations for the second quarter to less than half of what the bloc was initially expecting.
The EU member states will look at "reciprocity" and "proportionality" with their exports. They will now consider whether the destination country restricts its own vaccine exports or raw materials and whether the destination country is ahead or behind the EU with its vaccine rollout.
It could alarm those who are concerned that the EU is moving towards a protectionist approach to vaccine supply. The EU drew international criticisms when Italy blocked the export of 250,000 doses of the Oxford/AstraZeneca vaccine to Australia early this month.
In particular, the renewed stance could become an issue in the United Kingdom – by far the biggest recipient of COVID-19 shots produced in the EU. Data from the commission showed that the UK has imported more than 10 million doses from the EU. The next two biggest importers were Canada at 6.6 million and Japan at 5.4 million.
But Spain's Minister of Foreign Affairs Arancha Gonzalez Laya quickly brushed off the idea.
"It is not against the UK, it is to ensure AstraZeneca complies with the commitments it takes vis-à-vis with the European Union," Gonzalez Laya told CNBC's "Squawk Box Europe" on Wednesday.
"The export restrictions we have prepared for were never meant to be against countries. They were meant to be to ensure that pharmaceutical companies would comply with their commitments, with the contracts they have made with the European Commission."
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