Moderna, amid mounting pressure to address vaccine inequality, says it's working on new COVAX deal

Moderna manufacturing site
Moderna has pledged to provide 500 million doses of its COVID-19 vaccine to the worldwide relief effort COVAX. It also has agreed to deliver 110 million vaccine doses to the African Union. But critics say those initiatives are not enough. (Moderna)

The People’s Vaccine Alliance, a coalition of more than 80 public health, social justice and humanitarian organizations, has joined a growing list of those appealing to Moderna to provide COVID-19 vaccines to needy countries around the world.

In a letter addressed to Moderna CEO Stéphane Bancel, the group is calling on the mRNA specialist to “accelerate efforts to end the pandemic around the world.” In response, Moderna says it's working on a COVAX supply agreement.

In the letter, the coalition urges Moderna to account for how many vaccines it plans to produce next year. It's also calling on the Massachusetts-based company to transfer technology to help boost global supply.

“So far, only about one million doses of mRNA-1273 have gone to low-income countries and Moderna has shipped a greater share of doses to wealthy countries than any other COVID-19 vaccine manufacturer,” the coalition wrote.

Amid this appeal and others from the U.S. and other governments, Moderna is working behind the scenes on a plan to deliver millions of shots to countries in need, according to a report in Politico. A deal with Gavi/COVAX, the worldwide relief initiative designed to provide equitable global access to vaccines, is in the works, according to the report, which cited sources with knowledge of the negotiations.

Talks have been ongoing for months with the sides haggling over the size of the pledge, according to the publication. The negotiations have been protracted enough that the White House has stepped in to try to facilitate the deal, Politico reports.

"Moderna has been in direct discussion with Gavi concerning this amendment to our current agreement, all as part of our commitment to expand access for Moderna COVID-19 vaccine to the poorest countries of the world that have been hardest hit by the pandemic and where coverage rates are still low," the company said in an emailed statement.

In May, Gavi revealed that it had struck a deal with Moderna for the company to provide 500 million doses of its vaccine, with deliveries coming in the second half of 2021 and 2022. Additionally, three weeks ago, Moderna agreed to deliver 110 million vaccine doses to the African Union in 2022.

The administration is pushing drugmakers to pledge vaccines quickly. In September—during a virtual summit on COVID-19—President Joe Biden unveiled a goal of having 70% of the world’s population vaccinated by September 2022. Biden made the proclamation as he also revealed that the U.S. was buying 500 million doses of the Pfizer vaccine to donate to lower-income countries.

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Also at issue is what Moderna would charge for shots to poor countries. In its letter to the company, the People's Vaccine Alliance said that its analysis "suggests that at scale, a not-for-profit price" for the shot would be "no greater than $3 per dose." The coalition challenged the company to meet that price.

The price Moderna has settled on, according to Politico, is $7 per dose, still a considerable discount on what the company has regularly charged.

In June, when Moderna announced a deal to supply 200 million doses to the United States, the price came to $3.3 billion, or $16.50 per shot, according to the contract filed with the U.S. Department of Defense. But the haul also came on top of the $1.4 billion the government provided to the company to help develop the vaccine.

Meanwhile, the company also is in a battle with the U.S. government over rights to the technologies used to create the vaccine. In at least three of the patents the company has filed, there is no mention of three NIH scientists who participated in the early development of the shot. Moderna does credit the government scientists in at least one of its patent filings. Without a resolution soon, the issues could be decided in a courtroom.

The U.S. has urged companies, to no avail, to allow tech transfers that would permit foreign manufacturers to produce COVID-19 vaccines.

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On Tuesday, Pfizer revealed that it was entering a voluntary agreement with the Medicines Patent Pool to license the manufacture of its promising, but yet-to-be-approved COVID-19 pill as a generic in 95 countries accounting for 53% of the world’s population.

The move came three weeks after Merck and Ridgeback Biotherapeutics did the same with the MPP, licensing the production of its oral COVID-19 treatment candidate molnupiravir to 105 countries around the world.  

Now the call is out to Moderna. The People's Vaccine Alliance put it bluntly in its letter to Bancel.

"Humanity remains in a state of emergency," the coalition wrote. "Almost a year since the world’s first vaccine was administered, only four percent of people have received a vaccine in low-income countries, which have received less than half of one percent of vaccines globally. We are in no doubt that most COVID-19 deaths in low-income countries are now avoidable deaths: lives that could be saved were effective vaccines, none more than mRNA-1273, widely available to their populations."