Pat Benatar’s hit 1980 song “Hit Me With Your Best Shot” could have a very different meaning today. People around the world eagerly anticipate a new type of “best vaccine”: a safe and effective COVID-19 vaccine.
There are currently 166 new candidates for coronavirus vaccines in development, according to the World Health Organization (WHO). Twenty-four of those candidates are being evaluated in human clinical trials. Most of them are in early stage clinical studies. However, five COVID-19 vaccine candidates are currently in late-stage clinical trials or are scheduled to begin a phase 3 study in the coming days.
Sinopharm Group is developing two of the five late-stage candidates, one with the Wuhan Institute of
Biological products and another with the Beijing Institute of Biological Products. Another Chinese pharmacist, Sinovac Biotech, also claims to be a candidate for the COVID-19 vaccine in phase 3 testing.
AstraZeneca (NYSE: AZN) partnered with the University of Oxford to develop the vaccine candidate COVID-19 AZD1222. WHO chief scientist Soumya Swaminathan publicly stated in June that AZD1222 was “probably the leading candidate.”
There is also a COVID-19 vaccine candidate developed by an American biotechnology that will soon begin Phase 3 testing. Modern (NASDAQ: MRNA) He plans to begin his late-stage study of mRNA-1273 on July 27.
Which of these five late-stage COVID-19 vaccine candidates is likely to be the biggest winner? It’s complicated.
Image source: Getty Images.
Clinical results so far
As expected, all five COVID-19 vaccine candidates who reached phase 3 performed well in previous clinical studies. Unfortunately, there is no good way to tell which experimental vaccine appears to be safer and more effective than others.
Sinopharm and Sinovac reported preliminary results in June from previous clinical studies. Sinopharm claimed that all participants in the phase 1/2 studies for their two late-stage vaccine candidates had neutralizing antibodies (which have the potential to prevent infection with the new coronavirus). Sinovac said that more than 90% of the participants had neutralizing antibodies 14 days after receiving the second injection of their candidate vaccine, CoronaVac. Both Chinese drug makers also indicated that their respective COVID-19 vaccine candidates did not cause serious side effects.
AstraZeneca announced the interim results of a phase 1/2 clinical study of AZD1222 last week. Those results, published in the medical journal. The lancetrevealed that 91% of the participants demonstrated neutralizing antibodies after the first injection of the candidate vaccine. All participants who received a second dose of AZD1222 produced neutralizing antibodies. Furthermore, the vaccine candidate induced a T cell response in all participants, which could be key to providing a longer lasting immunity to SARS-CoV-2. AstraZeneca reported that there were no serious side effects in patients receiving AZD1222.
Moderna also reported tentative encouraging results from a phase 1 study of mRNA-1273 in May and followed up with more detailed data on July 14. Neutralizing antibodies and strong T-cell responses were found in all participants who received two doses of the experimental vaccine. Moderna also said that “mRNA-1273 was generally safe and well tolerated.”
Image source: Getty Images.
Capacity and contracts so far
There are other ways to get an idea of which COVID-19 vaccine candidates might be the biggest winners if they get regulatory approvals. We can evaluate the manufacturing capacity that each company has. We can also see the supply contracts that companies have in hand so far.
Sinopharm expects to be able to produce 200 million doses of its COVID-19 vaccines annually with its manufacturing facilities in Beijing and Wuhan. The company is owned by the Chinese government, so Sinopharm is assured of a large market if its vaccine candidates prove to be safe and effective in advanced-stage clinical trials.
Sinovac is building a manufacturing facility in China that could produce up to 100 million doses of CoronaVac annually. The Chinese government is providing financial support for this facility. The company has not announced any supply agreements. However, it seems likely that Sinovac will win contracts in China if CoronaVac gets regulatory approval.
AstraZeneca publicly stated in June that its “total manufacturing capacity is currently 2 billion doses.” This capability includes collaborations with third parties to produce AZD1222. And the big pharmaceutical company so far has commitments to the US, the UK, and other nations and nonprofits to supply more than 2 billion doses of AZD1222 if it gets approval.
Moderna says it is on track to produce around 500 million doses of mRNA-1273 per year starting in 2021. But biotechnology could increase that number to one billion doses annually. Moderna has yet to announce any supply agreements with the US or other countries, but those agreements are likely to be underway if mRNA-1273 succeeds in late-stage testing.
The best shot?
There is no way of knowing at this time which COVID-19 vaccines will navigate through the Phase 3 studies and which will have problems. My opinion is that any candidate in the final stage who proves to be safe and effective will be a great winner.
However, I think AstraZeneca probably has the best chance of becoming the biggest winner from a commercial point of view (assuming AZD1222 gets key regulatory approvals). Why?
The biggest commercial winners will surely be the vaccines that are marketed in the US and in major European countries because prices are likely to be higher in developed countries. China is not going to pay as much per dose to Sinopharm or SinoVac as AstraZeneca (and Moderna) could charge for their vaccines.
AstraZeneca has more aligned supply commitments and much greater production capacity than Moderna. In my opinion, that gives the great pharmacist a significant advantage. However, Moderna is much smaller than AstraZeneca. The biotech stock could be the biggest winner for investors if mRNA-1273 performs well in advanced-stage studies.
Please note that other COVID-19 vaccine candidates may also advance to Phase 3 testing in the near future. Some of the companies that make these vaccines, especially Pfizer and BioNTech, already have large supply agreements aligned. It is very possible that the “best shot” of all is not any of the current candidates in the final stage.
