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. No additional data available.

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美国对 mRNA covid-19 疫苗开发的公共投资：回顾性队列研究

目的 估算美国对 mRNA covid-19 疫苗开发的公共投资。设计回顾性队列研究。设置从 1985 年 1 月到 2022 年 3 月的公共资助科学。数据来源美国国立卫生研究院 (NIH) 报告组合在线报告工具支出和结果 (RePORTER) 和其他公共数据库。政府资助的拨款被评为直接、间接或不太可能与 mRNA covid-19 疫苗的四项关键创新相关——脂质纳米颗粒、mRNA 合成或修饰、预融合刺突蛋白结构和 mRNA 疫苗生物技术——基于主要研究者，项目名称和摘要。主要成果措施 对研究和疫苗开发的直接公共投资，按理由分层，政府资助机构，大流行前（1985-2019）与大流行（2020 年 1 月 1 日至 2022 年 3 月 31 日）。结果 确定了 34 项 NIH 资助的与 mRNA covid-19 疫苗直接相关的研究经费。这些赠款与其他确定的美国政府赠款和合同总计 319 亿美元（263 亿英镑；297 亿欧元），其中 3.37 亿美元是在大流行前投资的。大流行前，NIH 投资 1.16 亿美元 (35%) 用于与 mRNA 疫苗技术相关的基础和转化科学，生物医学高级研究与发展局 (BARDA) (1.48 亿美元；44%) 和国防部 (7200 万美元) ; 21%) 投资于疫苗开发。大流行开始后，292 亿美元（92%）的美国公共资金用于购买疫苗，22 亿美元（7%）用于支持临床试验，1.08 亿美元（<1%）用于支持制造以及基础和转化科学。结论 美国政府至少投资了 319 亿美元用于开发、生产和购买 mRNA covid-19 疫苗，包括在大流行之前的三十年到 2022 年 3 月的大量投资。这些公共投资挽救了数百万人的生命，对发展至关重要mRNA 疫苗技术也有可能应对未来的流行病和治疗 covid-19 以外的疾病。为了最大限度地提高整体健康影响，政策制定者应确保全球公平获得公共资助的卫生技术。没有可用的额外数据。这些公共投资挽救了数百万人的生命，并且对于开发 mRNA 疫苗技术至关重要，该技术也有可能应对未来的流行病和治疗 covid-19 以外的疾病。为了最大限度地提高整体健康影响，政策制定者应确保全球公平获得公共资助的卫生技术。没有可用的额外数据。这些公共投资挽救了数百万人的生命，并且对于开发 mRNA 疫苗技术至关重要，该技术也有可能应对未来的流行病和治疗 covid-19 以外的疾病。为了最大限度地提高整体健康影响，政策制定者应确保全球公平获得公共资助的卫生技术。没有可用的额外数据。