Vaccines and the Covid-19 pandemic: lessons from failure and success

The losses from the global Covid-19 pandemic have been staggering-trillions in economic costs, on top of significant losses of life, health, and well-being. The world made significant and successful investments in vaccines to mitigate the pandemic, yet there were missed opportunities, as well. We review what has been learnt about the value of vaccines, the speed at which vaccines can be developed, and the optimal and ethical approaches to vaccine distribution, as well as other issues related to pandemic and emergency preparedness. Surprisingly, spending on vaccines remains far below that which would be justified by the social return. We remain poorly prepared for future pandemics and other emergencies.