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Pfizer Covid-19 vaccines arrive in an insulated box, tightly packed with dry ice, roughly double the size of a carry-on suitcase. Fully loaded, it weighs about 80 pounds.

Unremarkable as it may be, this rectangular package helps explain the considerable obstacles in rolling out Pfizer-BioNTech’s vaccine. The large box also represents how the pharma behemoth rebuffed the federal government, creating public health setbacks but greater profits.

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The odyssey of the boxes had its origins last summer, when Pfizer insisted it would deliver its own vaccine, taking full control of the complex ultra-cold transportation requirements. The company signed a deal with Operation Warp Speed in July, agreeing to ship the vaccine wherever the government wanted — but without specifying how many vaccines would be in each package.

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