Moderna tunes booster pitch ahead of potential shift to private COVID vaccine market this fall

To boost or not to boost, that is the question. The answer, according to executives at mRNA expert Moderna, is a resounding yes.

The meteoric rise and fall of the SARS-CoV-2 omicron variant this past winter “continues to demonstrate the remarkable evolutionary capacity of this virus,” Paul Burton, M.D., Ph.D., Moderna’s chief medical officer, said on the company’s earnings call Wednesday.

“The slowing of booster uptake now means there will be individuals who are under-vaccinated and under-protected as we move into late spring and summer, when we thought we would have declining case counts,” the biotech’s top scientist added.

With COVID-19's infectious potential considered, the company is arguing for a "variant adapted booster campaign this coming fall," Burton said.

Moderna is leveraging a mix of evidence showing its current shot continues to help after a first or second booster dose. For one, Burton flagged data from the U.K. that showed while protection against subvariants BA.1 And BA.2 wanes over time after receiving Moderna’s, Pfizer-BioNTech’s or AstraZeneca’s shot, a booster dose with Pfizer’s or Moderna’s mRNA vaccines “increases vaccine effectiveness and protection.”

Another study of more than 55,000 long-term care residents in Ontario, Canada, showed a second booster dose of Moderna’s shot increased vaccine effectiveness against infection with omicron, symptomatic disease and severe outcomes in the study’s high-risk population, Burton said.

Meanwhile, Moderna has a sense of who could benefit most from annual COVID-19 boosting, the exec said. Older adults above the age of 50, adults over 18 that have other health risk factors like kidney disease, cancer or HIV, plus first responders and people living in high-density conditions, such as students, military personnel and prisoners, could see the most benefits, the exec said.

The booster debate has continued to weigh on COVID-19 players this year, Jefferies analysts pointed out in a note to clients Wednesday.

"[L]ogically companies cannot make any bold prediction beyond 2022 other than a view there will be use of boosters, particularly for the elderly, high-risk, and others and as variants emerge,” the Jefferies team said.

Working under the assumption follow-up doses will be needed in the fall, Moderna is “working hard to make improvements to our available boosters,” the company's president, Stephen Hoge said.

To that end, Moderna’s primary R&D focus has been on development of a bivalent vaccine, of which the biotech has advanced three into clinical trials, the company’s president said. mRNA 1273.214, which covers 32 spike protein mutations, remains Moderna’s lead candidate for a booster campaign in the Northern Hemisphere this fall, Hoge added.

On Moderna’s expected Spikevax sales for the year, the company reiterated that it’s locked up roughly $21 billion in advanced purchase agreements. That said, there’s a potential downside “from the timing of COVAX deliveries, if COVAX is unable to confirm demand aligned to their contracted volume in the 2022 calendar year,” outgoing Chief Financial Officer David Meline explained on the call.

Moderna’s Spikevax sales forecast could increase, as well, if the company secures additional contracts for a fall booster dose, Meline said.

“In 2022, we believe that the SARS-CoV-2 virus will evolve into an endemic phase with a more seasonal sales pattern,” Meline said, adding that Moderna expects “the timing of sales to be larger in the second half of 2022” as a result.

At that time, Moderna would likely be able to sell its vaccine at a higher price, the CFO said.

“I think it’s fair to assume that to the extent that the market moves to a private market, typically you see higher prices in private markets based on the needs of the market, as opposed to when you’re addressing the government-acquired product in this pandemic context,” Meline added.

Overall, Moderna reported first-quarter 2022 revenues of $6.1 billion—a major increase over the $1.9 billion it earned over the same period in 2021. Product sales of the company’s COVID-19 vaccine accounted for $5.9 billion of that haul, the company noted in a release.

Moderna stood by its sales forecast of $21 billion in advanced purchase agreements for its shot this year.