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. 2023 Mar 1:380:e073747.
doi: 10.1136/bmj-2022-073747.

US public investment in development of mRNA covid-19 vaccines: retrospective cohort study

Hussain S Lalani  1   2 , Sarosh Nagar  3   4 , Ameet Sarpatwari  3   2 , Rachel E Barenie  3   5 , Jerry Avorn  3   2 , Benjamin N Rome  3   2 , Aaron S Kesselheim  3   2
Affiliations

US public investment in development of mRNA covid-19 vaccines: retrospective cohort study

Hussain S Lalani et al. BMJ. .

Erratum in

Abstract

Objective: To estimate US public investment in the development of mRNA covid-19 vaccines.

Design: Retrospective cohort study.

Setting: Publicly funded science from January 1985 to March 2022.

Data sources: National Institutes of Health (NIH) Report Portfolio Online Reporting Tool Expenditures and Results (RePORTER) and other public databases. Government funded grants were scored as directly, indirectly, or not likely related to four key innovations underlying mRNA covid-19 vaccines-lipid nanoparticle, mRNA synthesis or modification, prefusion spike protein structure, and mRNA vaccine biotechnology-on the basis of principal investigator, project title, and abstract.

Main outcome measure: Direct public investment in research and vaccine development, stratified by the rationale, government funding agency, and pre-pandemic (1985-2019) versus pandemic (1 January 2020 to 31 March 2022).

Results: 34 NIH funded research grants that were directly related to mRNA covid-19 vaccines were identified. These grants combined with other identified US government grants and contracts totaled $31.9bn (£26.3bn; €29.7bn), of which $337m was invested pre-pandemic. Pre-pandemic, the NIH invested $116m (35%) in basic and translational science related to mRNA vaccine technology, and the Biomedical Advanced Research and Development Authority (BARDA) ($148m; 44%) and the Department of Defense ($72m; 21%) invested in vaccine development. After the pandemic started, $29.2bn (92%) of US public funds purchased vaccines, $2.2bn (7%) supported clinical trials, and $108m (<1%) supported manufacturing plus basic and translational science.

Conclusions: The US government invested at least $31.9bn to develop, produce, and purchase mRNA covid-19 vaccines, including sizeable investments in the three decades before the pandemic through March 2022. These public investments translated into millions of lives saved and were crucial in developing the mRNA vaccine technology that also has the potential to tackle future pandemics and to treat diseases beyond covid-19. To maximize overall health impact, policy makers should ensure equitable global access to publicly funded health technologies.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/ and declare: grant support from Arnold Ventures, Commonwealth Fund, Anthem Public Policy Institute, National Institutes of Health, and Tennessee Department of Mental Health and Substance Abuse Services; HSL is a senior advisor to the Public Good Projects; AS and REB have received consulting fees from the Council for Informed Drug Spending Analysis and Alosa Health, respectively; HSL is a co-founder of ThisIsOurShot and VacunateYa, a national grassroots organization that empowers trusted messengers on social media to spread accurate health information and combat covid-19 vaccine misinformation (unpaid); no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig 1
Fig 1
NIH RePORTER search strategy to identify US government funded research for mRNA covid-19 vaccines. Figure outlines PubMed search strategy and analytic method to identify National Institutes of Health (NIH) funded research grants that were directly related to key inventions in mRNA covid-19 vaccines. By convention, NIH funded grants are listed in NIH RePORTER per fiscal year as core projects and subprojects. These NIH grants often receive consecutive years of funding, so NIH funded grants at fiscal year level (n=20 825) were consolidated into distinct NIH funded grants (n=2676) by matching grant title, principal investigator(s), and organization name. Duplicate NIH funded grants were removed. These duplicates include grants that were listed in more than one published research article in PubMed and subgrants (or subprojects), which are encompassed within grants at fiscal year level
Fig 2
Fig 2
National Institutes of Health (NIH) grants (top) and grant funding (bottom) at fiscal year level directly related to mRNA covid-19 vaccine development from 1985 to 2021 (top). Data obtained from NIH RePORTER analysis stratified by pre-pandemic (1985-2019) and pandemic (1 January 2020 to 31 March 2022). All directly related NIH funded grants at fiscal year level were included (n=165). This corresponds to 34 NIH funded grants after consolidation of fiscal years per grant. Two NIH grants in 2022 were excluded from figure, as study analysis period ended on 31 March 2022, and additional grants had not yet been awarded. This analysis does not include grants offered by Department of Defense or Biomedical Advanced Research and Development Authority
Fig 3
Fig 3
Timeline of selected key events in research and development of mRNA covid-19 vaccines. Summary of certain key events that led to invention of mRNA covid-19 vaccines based on analysis of government funded grants awarded by National Institutes of Health, Department of Defense, and Biomedical Advanced Research and Development Authority and adapted from historical literature review. RSV=respiratory syncytial virus
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Comment in

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