Many vaccines have been approved for emergency use in adults and children across the world, with some gaining full, standard approval from 2022 onwards based on additional trial results and real-world evidence. While estimates of efficacy against symptomatic COVID-19 have varied from 50% to 95%, efficacy estimates against severe infection/hospitalization have been consistently high across all vaccine approaches investigated thus far. However, the emergence of the Omicron variant, the first variant to show meaningful immune evasion, led to a substantial reduction in vaccine efficacy. A booster dose largely restores efficacy, which is an important finding as severe/hospitalized COVID-19 infections represent the greatest social and economic disease burden, and the primary aim of vaccination campaigns is to reduce mortality and ease pressure on hospitals by reducing hospitalization rates. 

Importantly, pricing will become a more prominent factor post-pandemic as supply constraints have been resolved and companies seek to adopt more typical vaccine pricing to ensure longer-term profitability. Consequently, the shift to an endemic market has been marked with an announcement of list pricing for the three vaccines approved for US usage: Pfizer/BioNTech’s at $120 per dose, Moderna’s at $129 per dose, and Novavax’s at $130 per dose. The close pricing range of these vaccines highlights the competitive nature of the market as vaccine supply outstrips demand. Indeed, there has been significant pipeline attrition as minor players have reallocated resources to other, more profitable indications. The start of pipeline attrition was evidenced by Sanofi suspending development of its own mRNA vaccine despite reporting positive Phase I/II results, stating that the program was no longer commercially viable given the dominance of Comirnaty and Spikevax, and reallocating resources to its GSK-partnered VidPrevtyn Beta. 

This Datamonitor Healthcare report contains a Disease Analysis module.