With the first COVID-19 vaccinations expected to start in the coming weeks, 2021 is shaping up to be quite a year for the companies leading the vaccine race, with major blockbuster revenues on the line.
In fact, the top five players are set to divvy up about $38.5 billion in sales, Bernstein analysts figure, with the first-to-market companies reaping more than half of that. Pfizer, which just won U.K. approval Wednesday, is in line for $14.3 billion in COVID-19 vaccine sales next year, followed by $10.9 billion for Moderna, $6.4 billion for AstraZeneca, $3.9 billion for Novavax and $3 billion for Johnson & Johnson, according to the projections.
After a huge haul in 2021, the analysts predict the market will dwindle to around $6 billion in 2025, assuming vaccine recipients need a booster every three years. Along the way, the team of analysts project $23.1 billion in total COVID-19 vaccine sales in 2022, $12.6 billion in 2023 and $8.5 billion in 2024. But their model only accounts for those leading players right now.
Assuming “supply will flow to developed markets first with emerging markets given supply as demand ebbs in developed ones,” the analysts wrote, they expect the U.S. to reach herd immunity in June. Other developed markets such as the U.K., Canada, Japan and Europe should reach herd immunity in August or September, the Bernstein analysts wrote.
The latest figures are an update to the team's model based on Pfizer and Moderna’s recent success plus "lower confidence” in adeno-associated virus vaccines. That's due to a comparatively lower efficacy number for AstraZeneca’s vaccine and the company’s CEO Pascal Soriot recently commenting that it’ll need to conduct an “additional study” to win a U.S. nod.
The team is further factoring in expectations for December launches and the most recent company commentary around prices and dose availability.
The financial projections come at a time of remarkable success for COVID-19 vaccine research. On Wednesday, partners Pfizer and BioNTech scored the world’s first approval for a fully researched vaccine as the U.K. endorsed their shot. The partners plan to make around 800,000 doses available in the U.K. next week, The Guardian reports. The U.K. has placed an order for 40 million doses total.
Meanwhile, the partners are gearing up for a Dec. 10 meeting with independent FDA experts, and an FDA decision is expected to follow. The next closest player, Moderna, is set for a Dec. 17 meeting with the panel. The first vaccinations in the U.S. could start this month, officials have said.
While the Bernstein team expects U.S. herd immunity sometime next summer, Operation Warp Speed head Moncef Slaoui recently voiced even more ambitious expectations. Speaking with CNN last month, he said the U.S. could reach herd immunity by May based on the expected rate of vaccinations.
Shaun Griffin
doi: https://doi.org/10.1136/bmj.m4695
PDF: https://www.bmj.com/content/371/bmj.m4695.full.pdf
A mass screening programme of more than 10 million residents of Wuhan, China, performed after SARS-CoV-2 was brought under control, has identified 300 asymptomatic cases of covid-19, none of which was infectious.
The findings cannot be extrapolated to countries where outbreaks have not been brought under control successfully, said the authors of the report, which was published in Nature Communications.1
The researchers conducted a screening programme using PCR testing for viral RNA among the 10 million participants who were aged between 10 and 89. Trained staff interviewed participants on their history of covid-19. Asymptomatic positive cases were those who had a positive result on screening with neither a history of covid-19 diagnosis nor any clinical symptoms at the time of the nucleic acid testing. The researchers found no “viable virus” in cultures from asymptomatic samples.
The asymptomatic positive rate was lowest in participants aged under 17 and highest in those over 60. Further swab testing of 1174 close contacts of the 300 asymptomatic positive cases were all negative. The study population included 34 424 people with a history of covid-19, 107 of whom (0.310%) had been re-infected.
The researchers said that their findings did not show that the virus couldn’t be passed on by asymptomatic carriers, and they didn’t suggest that their findings were generalisable.
They said that strict measures—such as mask wearing, hand washing, social distancing, and lockdown—were successful in reducing the virulence of SARS-CoV-2 in Wuhan and that asymptomatic people in Wuhan may have low viral loads. This means that the finding cannot be applied to countries where outbreaks have not been successfully brought under control.
Fujian Song, from UEA’s Norwich Medical School, who collaborated with colleagues in Wuhan on the research, said: “The asymptomatic cases identified in the screening programme were truly asymptomatic, as none of them showed clinical symptoms before or during their follow-up isolation.” But, he added, “there is plenty of evidence elsewhere showing that people infected with covid-19 may be temporarily asymptomatic and infectious, before going on to develop symptoms.”
Using antibody testing, the researchers found that almost two thirds of the asymptomatic cases had previously had covid-19. “With the centralised isolation and treatment of all covid-19 cases during the lockdown period in Wuhan, the risk of residents being infected in the community has been greatly reduced. When susceptible residents are exposed to a low dose of virus, they may tend to be asymptomatic as a result of their own immunity,” wrote the authors.
Song said, “It is very important to say that these asymptomatic cases were identified shortly after the relaxation of a very stringent lockdown in Wuhan that lasted more than 70 days. By then, the epidemic in Wuhan had been effectively brought under control. It is too early to be complacent, because of the existence of asymptomatic positive cases and high level of susceptibility in residents in Wuhan.”
Noting that mask wearing remains common in public places, he added that this and other public health measures, such as safe social distancing, should be sustained in Wuhan to control transmission, noting that “vulnerable populations with weakened immunity or comorbidities, or both, should continue to be appropriately shielded.”
https://www.bmj.com/content/371/bmj.m4695
A new study from researchers at Brigham Young University finds that alcohol-free hand sanitizer is just as effective at disinfecting surfaces from the COVID-19 virus as alcohol-based products.
The BYU scientists who conducted the study suspected that the CDC's preference for alcohol sanitizer stemmed from as-yet limited research on what really works to disinfect SARS-CoV-2. To explore other options, they treated samples of the novel coronavirus with benzalkonium chloride, which is commonly used in alcohol-free hand sanitizers, and several other quaternary ammonium compounds regularly found in disinfectants. In most of the test cases, the compounds wiped out at least 99.9% of the virus within 15 seconds.
"Our results indicate that alcohol-free hand sanitizer works just as well, so we could, maybe even should, be using it to control COVID," said lead study author Benjamin Ogilvie.
Alcohol-free hand sanitizers, which are also effective against common cold and flu viruses, have a number of advantages over their alcohol-based counterparts, Ogilvie explained.
"Benzalkonium chloride can be used in much lower concentrations and does not cause the familiar 'burn' feeling you might know from using alcohol hand sanitizer. It can make life easier for people who have to sanitize hands a lot, like healthcare workers, and maybe even increase compliance with sanitizing guidelines," he said.
In the face of shortages, "having more options to disinfect hospitals and public places is critical," added Ph.D. student Antonio Solis Leal, who conducted the study's experiments.
Switching to alcohol-free hand sanitizer is logistically simple as well.
"People were already using it before 2020," said BYU professor and coauthor Brad Berges. "It just seems like during this pandemic, the non-alcohol-based hand sanitizers have been thrown by the wayside because the government was saying, 'we don't know that these work,' due to the novelty of the virus and the unique lab conditions required to run tests on it."
Since benzalkonium chloride typically works well against viruses surrounded by lipids--like COVID--the researchers believed that it would be a good fit for disinfecting the coronavirus.
To test their hypothesis, they put COVID samples in test tubes and then mixed in different compounds, including .2% benzalkonium chloride solution and three commercially available disinfectants containing quaternary ammonium compounds, as well as soil loads and hard water.
Working fast to simulate real-world conditions--because hand sanitizer has to disinfect quickly to be effective--they neutralized the disinfecting compounds, extracted the virus from the tubes, and placed the virus particles on living cells. The virus failed to invade and kill the cells, indicating that it had been deactivated by the compounds.
"A couple of others have looked at using these compounds against COVID," said Berges, "but we're the first to actually look at it in a practical timeframe, using four different options, with the realistic circumstance of having dirt on your hands before you use it."
The team believes their findings "may actually provide a change in government directions about hand sanitizer," Berges said.
Ogilvie hopes that reintroducing alcohol-free sanitizers into the market can relieve the shortages--and reduce the chances of people encountering some potentially "sketchy" alcohol sanitizers that have cropped up in response to the demand.
"Hand sanitizer can play an especially important role in controlling COVID," he concluded. "This is information that could affect millions of people."
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The study is published online in the Journal of Hospital Infection.
https://www.eurekalert.org/pub_releases/2020-12/byu-ahs120120.php
Dr. Scott Gottlieb told CNBC on Wednesday the availability of coronavirus vaccine doses is likely to be limited in the next few months should U.S. regulators grant emergency approval later this month.
“We’re going to be in this sort of rationing type of environment for this vaccine probably well into the spring,” the former Food and Drug Administration commissioner said on “Squawk Box.”
Gottlieb, a Pfizer board member, made his remarks shortly after the company’s Covid-19 vaccine received approval from the U.K. government. Britain’s rollout of the Pfizer vaccine, developed in partnership with German biotech firm BioNTech, is set to start next week for health-care workers and elderly people in long-term care facilities.
A day earlier, an advisory panel for the U.S. Centers for Disease Control and Prevention recommended that a similar group of Americans be the first to receive a Covid-19 vaccine after it receives regulatory clearance in America. In addition to Pfizer’s application with the FDA, Moderna also has submitted for the same limited authorization. The FDA could grant approval in just a few weeks, with distribution across the U.S. beginning shortly thereafter.
The U.S. expects about 40 million doses of vaccine will be available by the end of 2020, Health and Human Services Secretary Alex Azar told CNBC in mid-November. Since both Pfizer and Moderna’s vaccines require two doses, that would be enough for roughly 20 million Americans. There are approximately 21 million health-care workers in the U.S. and 3 million residents of long-term care facilities.
Most states and other localities expect the process of vaccinating all their health-care workers to take three weeks, according to Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, who spoke during Tuesday’s CDC panel meeting.
Gottlieb, who led the FDA from 2017 to 2019 during the Trump administration, touted the potential benefits of a vaccine to help turn the tide of the coronavirus pandemic. However, he stressed it will take time for widespread deployment.
“Really the biggest variable right now is that we’re going to have limited supply for the remainder of this year certainly and even into next year,” Gottlieb said. That means even when additional groups of Americans are cleared to receive the vaccine, “we’re going to be limited with those tranches,” he said.
“It’s going to be certain essential workers in the next waves of vaccination and also older individuals who are at higher risk of having a bad outcome for Covid. Those will be the groups that get vaccinated next,” he added.
Despite initial supply constraints, manufacturing capacity is expected to be ramped up throughout the next year. Pfizer and BioNTech have said they can make up to 1.3 billion doses in 2021. Last month, Massachusetts-based Moderna said it is still on pace to produce 500 million to 1 billion doses of its vaccine globally in 2021.
On Tuesday, the Trump administration’s vaccine chief, Dr. Moncef Slaoui, said he believes every American could be inoculated against Covid-19 by June. The country has almost 331 million people.
“Very quickly we’ll start having more than 150 million doses a month in March, April, May,” Slaoui told The Washington Post, should vaccines from companies beyond Pfizer and Moderna become available.
A number of other companies are in various stages of testing Covid-19 vaccines including U.K.-based AstraZeneca and U.S. drug giant Johnson & Johnson.
Gottlieb has said he expects the intensity of the U.S. coronavirus outbreak to be less severe in 2021, even when just portions of the population start to get vaccinated against Covid-19. That’s because up to 30% of Americans are likely to have been infected by year-end, he told CNBC earlier this week.
“You combine a lot of infection around the country with vaccinating 20% of the population [and] you’re getting to levels where this virus is not going to circulate as readily, once you get to those levels of prior immunity,” Gottlieb said Monday.
The U.S. has 13.7 million confirmed cases of coronavirus and at least 270,728 deaths, according to data compiled by Johns Hopkins University.
According to a news release from Governor Greg Abbott on Wednesday, about 1.4 million Texans will receive their first coronavirus vaccines beginning the week of December 14th.
Chris Van Duesen, spokesman for the Texas Department of State Health Services, said that the second dosage of vaccines for the same group will come in January. The vaccine developers applied for emergency authorization of the vaccines that require two dosages per individual, Statesman reported.
Abbot said, "The state of Texas is already prepared for the arrival of a COVID-19 vaccine, and will swiftly distribute these vaccines to Texans who voluntarily choose to be immunized. As we await the first shipment of these vaccines, we will work with communities to mitigate the spread of COVID-19."
Health care workers will be first in line for the vaccines.
"First tier" health care workers, which will receive the vaccine first, include hospital staff working directly with COVID-19 patients, long-term care staff working with vulnerable residents, emergency workers, and home health care workers.
According to Van Duesen, the initial distribution points will include hospitals, large clinics, doctors offices, and medical practices "that can vaccinate a large number of people initially."
