FDA says Dec 17 meeting to discuss. This contradicts some earlier opinions that the reason the FDA was taking so long to review Pfizer (Dec 10 scheduled date) was that they were planning to review 2-3 candidates together.
For context, scheduling the meeting to review the candidates is running at 5-10% of the development time for these vaccines. 20M vaccines represent about 1/3 the elderly population in the US, there are about 1,300 deaths a day right now, and most deaths are in the high risk category. So you can estimate the cost of the delay to be quite high (depending on your assumptions, but hard not to estimate the cost to be >1000 lives). I'm unsure of any vaccine side effect or release that could be considered worse. Pendemrix caused 1 in 18,000 narcolepsy, which for the 20M at risk who could get the vaccine seems like a good trade-off (if this was as bad as that).
Moderna entered phase 1 trials in March. Vaccines entering phase 1 trials have a 33% success rate overall, 85% successful for efficacy. So this is not a case of hindsight bias, this was always reasonably likely to work. And these numbers include issues like enrollment issues, or the diesease dying out (ebola).
So lets make some assumptions to see what it would look like to "just approve things for the high risk in a pandemic":
For example, let's say that a vaccine maker instead of pushing something 85% likely to be efective pushed through pushed through something 40% likely to work. And for safety, let's just assume it's going to be 2x worse than the worst vaccine ever, so maybe 1 in 10,000 get narcolepsy. But they still push it through.
This implies taking the untested vaccine has a 40% chance of protecting you and 0.1% chance of serious side effect.
For the elderly, who at the beginning of the pandemic has a conservative IFR of >10% and let's assume a 10% chance of getting it. Not taking the vaccine has something like a 1% chance of death.
For the elderly, taking the untested vaccine would in this example would reduce your chance of death by 0.6% but increase the chance of serious disease by 0.1%. For most people, this should be an obvious decision to vaccinate, even using the most pessimistic adaptions possible.
It almost sounds like a conspiracy theory, but in the real world Moderna had a working vaccine in March, and it was always statistically likely to work with low relative downside (for some population), and it has been banned the entire time until now.
The next pandemic could be completely prevented if we focus our efforts on how to approve vaccine candidates in days not months.
Note: I think the bar for requiring a vaccination can/should definitely be higher than the bar to lift a total ban on a vaccine.