With Novavax and Johnson & Johnson data now in hand, the world has efficacy numbers on at least five COVID-19 vaccine programs. That's plenty for analysts to parse—and they're busy doing not only that, but also sizing up the market as the field of top players grows.
The upshot? Blockbuster sales to go around, but Pfizer and Moderna will continue to lead the pack, partly thanks to their ability to quickly deploy mRNA against new variants. And for Moderna, at least, that means almost $14 billion in projected sales just this year from one team of analysts.
The efficacy data feed into those calculations, but there are caveats, SVB Leerink analyst Mani Foroohar, M.D., wrote in a Monday note to clients. Johnson & Johnson’s headline efficacy number of 66% was lower than its mRNA competitors—and Novavax’s 89% figure—but “a direct comparison can be misleading” because of differences in trial populations and the tough new variants circulating around the world.
J&J, for instance, ran part of its phase 3 trial in South Africa, and Novavax has phase 2b from the country, where a tough new variant is circulating widely. Both companies said their vaccines' results varied country to country. The variant eluded the full effects of the Pfizer and Moderna vaccines in lab studies, and, now, those companies are developing boosters.
In earlier studies, the Pfizer and Moderna programs were more than 90% effective against COVID-19 infections. AstraZeneca’s program was 70% effective in a phase 3 trial, but a dosing error raised questions that prompted a follow-up phase 3 set to read out this month. In AZ’s first phase 3 trial, the vaccine was 90% effective in participants who received a half-dose followed by a full dose.
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On an “apples to apples basis,” Foroohar wrote that J&J offers “a compelling one-dose profile with much more straightforward distribution and logistics than market leaders” Moderna and Pfizer, both of which are already distributing their respective mRNA shots. Those two-dose vaccines require storage at freezing temperatures, while J&J's shot can be refrigerated for up to three months.
Aside from J&J's top-line efficacy number, the vaccine was 85% effective against severe disease and offered "complete protection" against COVID-19 hospitalization and death in the massive phase 3 trial.
Meanwhile, analysts with ODDO BHF said after the latest data there’s “room for everyone” in the market, but that mRNA vaccines show “superior efficacy.” They’re projecting $13.7 billion in COVID-19 vaccine revenues for Moderna this year. Foroohar's team projects $9.5 billion in revenues for Moderna's program this year.
In the big picture, the recent results from J&J and Novavax are “heartening for humanity’s progress against the virus,” Foroohar wrote. Challenges from new variants remain, though, and there the mRNA programs hold a speed-of-development edge. The analyst predicts J&J and Novavax will start to capture global market share in the second half of this year and beyond, but, because of the strong data profile and head start for the Pfizer and Moderna programs, those companies will hold “dominant share."
As new variants circulate, the analyst’s team increased their projected "revaccination rate” for the coming years. They predict Pfizer-BioNTech and Moderna will capture the “dominant revaccination share.”
Aside from the data releases late last week, AstraZeneca’s vaccine scored an authorization in Europe. The company has been entangled in a supply controversy there, and, Sunday, officials said the company would boost supply by 9 million doses to 40 million doses overall in the first quarter. That’s half of the company’s original target.
In a note Monday, SVB Leerink analyst Andrew Berens and his team projected $1.9 billion in revenues for the AstraZeneca vaccine this year, followed by $3 billion next year. The revenues will be offset by expenses, though, as the company pledged to sell its vaccine on a not-for-profit basis during the pandemic.
In addition to the research work underway in Western countries, China's Sinopharm has touted efficacy results of 79% for its vaccine program.