If there was one pleasant surprise buried in last year’s pandemic havoc, it was that the flu season was remarkably muted. It turns out the measures to thwart COVID-19, like mask-wearing and social distancing, work wonders against the annual bug, too.
But the medical community's flu-fighters were equipped with another weapon that the COVID arsenal didn't have till December: a vaccine. Better equipped than ever, in fact. Flu shot makers delivered a record 194 million doses to the U.S. last season as public health experts warned against the dreaded overlap between the two pathogens. Flu vaccine demand skyrocketed.
And that delivered hefty sales for flu shot heavyweights Sanofi, GlaxoSmithKline and Seqirus at a time when other vaccine revenues sagged. Sanofi led the pack with $2.47 billion in flu shot sales, up 38% compared with 2019, while Seqirus raked in $1.7 billion, up an impressive 30%. England’s GSK raked in £733 million, up 35%.
This season, flu shot makers are again gearing up for another record year, with deliveries set to match the historic figures reported in 2020. Despite the widely deployed COVID-19 vaccines from Pfizer, Moderna and Johnson & Johnson, this flu season could prove just as precarious as society tries to roar back to pre-pandemic life, vaccine execs contend.
“A mild season one year may not signal what will occur the following year,” GlaxoSmithKline’s Leonard Friedland, M.D., vice president and director of scientific affairs and public health, told Fierce Pharma in an email.
Flu suppliers expect to ship more than 190 million doses during the upcoming season, indicating that “supply likely won’t be an issue,” Friedland said.
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GSK plans to send more than 50 million doses to the U.S.—about the same amount it produced in 2020. Fellow flu heavyweight, Seqirus, is gearing up to deliver about 60 million doses. That marks a slight drop—5%—from last year but still near all-time highs, said Seqirus' David Ross, VP of commercial operations in North America.
Sanofi, which set aside 80 million doses last year, wouldn’t divulge how many shots it is planning to ship this time around. In a midyear report, the company said it expects "record" flu sales in the second half of 2021. Like GSK, it doesn't expect supply to be a problem, said Dan DiVito, who heads the company’s respiratory portfolio.
“Whatever demand ends up being, we’ll deliver that and we’ll have some left over,” DiVito told FiercePharma.
‘Recipe for disaster’
As the health system battled a flood of COVID-19 patients last year, public health officials pleaded with Americans to get vaccinated against the flu. The goal was to prevent what was ominously termed a “twindemic,” or the simultaneous influx of flu and coronavirus patients into U.S. hospitals.
One year and three authorized COVID-19 jabs later, flu shot makers warn the twindemic isn’t merely a concern of the past. The delta variant has driven a wave of new infections and has sent hospitalizations rising, mostly among the unvaccinated.
That hasn’t stopped many businesses from returning employees to the office (albeit many with vaccine mandates). Nor has it stopped schools from calling students back to the classroom. But after a year spent largely at home, Americans are returning to society more susceptible to viruses they might have otherwise encountered, Sanofi's DiVito said.
Case in point: the recent rise of respiratory syncytial virus, or RSV, DiVito said. The virus, which can cause serious cases of pneumonia and bronchiolitis in infants, has made an uncharacteristically early return, triggering a CDC health advisory in June.
“None of us were exposed to things like flu and RSV that we normally would be each year,” DiVito said. A mix of the delta variant and flu among a naive population “could be a recipe for disaster.”
A potential boost(er)
With the White House planning to roll out COVID-19 boosters to the general population as early as September—pending an official nod from regulators—flu shot makers could be in for a tailwind.
That’s thanks to the CDC’s decision in early May to do away with its recommendation that people avoid getting another shot within two weeks of the coronavirus vaccine. Intended to bolster lagging routine immunizations among teens, the CDC move means that some Americans may be able to get their annual flu shots and COVID boosters during the same appointment.
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“The availability of vaccines, plus that important guidance from the CDC on coadministration, creates an environment where immunization rates for both flu and COVID should be boosted,” Seqirus’ Ross said in an interview.
Sanofi is now trying to push the double-shot method with extra safety evidence.
The company kickstarted a mid-stage study this summer that will test the safety of its Fluzone high-dose quadrivalent vaccine alongside a third dose of Moderna’s mRNA vaccine in people aged 65 and older.
But as flu vaccination season nears, it's not certain the data will be ready ahead of a wide deployment this fall. Regardless, Sanofi believes it's a good idea for healthcare providers to offer both shots simultaneously in the coming months.
"If you do these things at the same time, they're coming in anyway, that's ideal," DiVito said. "We just have to make sure healthcare providers, the immunizers, view it that way and not like an extra burden."