Illustration: Sarah Grillo/Axios

Moderna said Thursday that starting in 2021, it could manufacture "possibly up to 1 billion doses per year" of its experimental coronavirus vaccine with the help of a contract manufacturer.

Yes, but: 1 billion vaccine doses may sound like a lot, but government and public health leaders would inevitably still have to make hard choices about who should get the vaccine first.

By the numbers: 500 million people could get vaccinated from 1 billion vaccine doses, based on Moderna's tests of one person getting two 100-microgram shots.

  • There are 7.8 billion people on Earth, meaning Moderna's vaccine could initially cover 6% of the global population.

This scenario assumes the vaccine clears all clinical hurdles and is deemed safe and effective — which are major unknowns right now — and that it eventually gets FDA and other international governmental approvals.

  • This scenario also assumes 1 billion doses can actually be made within a year, which many experts believe is difficult to do.

The burning questions: That production level not only falls short of immediate need, but all 1 billion doses also will not come out at the same time. It's leading ethicists to consider the following:

  • Which clinics, hospitals and other facilities will get it?
  • Will health care workers, older people in places like nursing homes and others with compromised immune systems be prioritized? If so, who comes after?
  • If there are new coronavirus outbreaks, should those locales get an influx of the vaccine?
  • What if the vaccine costs a couple hundred dollars, like other vaccines? Will everyone be able to get it regardless of insurance coverage or ability to pay?
  • Since Moderna is based in the U.S., will the U.S. prioritize itself over other countries, and will it cut deals with other countries?

Between the lines: It's naive to think the most affluent people won't try to get it immediately.

  • "The very rich … will do anything to get it, and there will be a black market," said Arthur Caplan, a bioethicist at New York University, adding he's "200% sure" that would occur given what happened when ventilators were in short supply.

The bottom line: Even with other coronavirus vaccines rapidly moving through clinical trials, billions of people simply won't have access to a vaccine by 2021.

  • And if history is any indication, the poor and minorities will be at the back of the line unless equitable national and global policies are put into place.

Go deeper: How the U.S. might distribute a coronavirus vaccine

Go deeper

Updated 8 hours ago - Health

U.S. coronavirus updates

Data: The COVID Tracking Project; Note: Does not include probable deaths from New York City; Map: Andrew Witherspoon/Axios

Trump administration officials and Democratic congressional leaders remain at a stalemate in negotiations on the next coronavirus stimulus package.

The big picture: White House Chief of Staff Mark Meadows told CBS Sunday he's "not optimistic that there will be a solution in the very near term."

Scoop: White House launches regional media push to COVID hot spots

Photo: Drew Angerer/Getty Images

To show President Trump's "renewed focus" on combating COVID-19, the White House is launching a heavy regional media campaign in states that are coronavirus hot spots to educate the public on the importance of following mitigation measures, White House officials tell Axios.

Driving the news: The White House will be blanketing designated marketing areas throughout the Southwest and Midwest with White House doctors and administration officials on air.

Trump goes all in on vaccines and therapeutics

Photo Illustration: Sarah Grillo/Axios. Photo: Joe Raedle/Getty Images

Top Trump advisers and GOP leadership have told the president in recent weeks that he needs to switch gears on the coronavirus and go all in on messaging about progress on vaccines and therapeutics.

The big picture: The goal is to try to shift the focus of the election conversation to who would be better at reviving the economy. Administration officials say this is a key reason Trump restarted his briefings this week and that this rhetoric will only accelerate in the weeks to come.