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Allowing people to mix COVID-19 vaccines could cut into Pfizer and Moderna’s revenue next year

MarketWatch 06 October, 2021 - 12:06pm

There are two ways to think about the type of COVID-19 booster you can get: in one scenario, you get a homologous booster, which is the same shot you got for the initial series. A heterologous, or “mix-and-match” booster, lets you get a different vaccine based on availability or improved efficacy. 

This is an important scientific distinction that will likely be used to further inform how COVID-19 booster shots will be rolled out in the U.S. 

“There will be situations for one reason or another where a person may not have the availability to be boosted with the same product that they were originally vaccinated with,” Dr. Anthony Fauci, President Joe Biden’s chief medical adviser, told McClatchy last month.

But analysts say mixing COVID-19 shots could also dampen revenue projections for the vaccine market’s leaders.

“If ongoing mix-and-match trials show that the late entrants’ products are as effective at boosting as the original innovator vaccines themselves, then these companies stand to gain potentially meaningful near-term revenues and will almost certainly take significant share of whatever tail of future COVID vaccine revenue exists,” SVB Leerink analyst Geoffrey Porges told investors this week. 

Roughly $19 billion of the sales generated so far over the past year came from selling the initial doses of their shots. 

Those are considered homologous boosters.

But other research is under way assessing whether it’s okay to mix vaccines, and there are already some preliminary studies that indicate mixing vaccines is safe and could prompt a stronger immune response in some cases.

A U.S. study, which is being conducted by the National Institutes of Health and is testing a Moderna booster with other types of vaccines, is expected to make its findings public on Oct. 15 at a Food and Drug Administration advisory meeting assessing J&J’s booster application.

Results are also expected sometime this month from a U.K. trial called Cov-Boost.

A preprint published in June out of the U.K. found that mixing the BioNTech/Pfizer and AstraZeneca/University of Oxford vaccines triggered better immunity than using the AstraZeneca shots alone. Researchers in Germany said, also in June, that mixing the same vaccines as the U.K. could “improve immunogenicity and to mitigate potential intermittent supply shortages for individual vaccines.”

Depending on how the data shakes out, it could have a big impact on the market share held by the leading COVID-19 vaccine makers. 

If clinical data shows that it’s safe and effective to use a different type of COVID-19 booster, that could allow some of the smaller companies developing still-investigational shots to gain entry and a slice of market share, according to Porges.

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Jaimy Lee is a health-care reporter for MarketWatch. She is based in New York.

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