When Covid-19 vaccines first gained approval two years ago, Pfizer Inc. and Moderna Inc. didn’t have to worry about demand. Now, billions of dollars ride on a picture that is murkier than ever.
(Bloomberg) — When Covid-19 vaccines first gained approval two years ago, Pfizer Inc. and Moderna Inc. didn’t have to worry about demand. Now, billions of dollars ride on a picture that is murkier than ever.
People lined up overnight in the pandemic’s early stages for doses that companies couldn’t make fast enough. Almost 70% of Americans got vaccinated in the first inoculation drive. But uptake for booster shots has dropped in almost every cycle since, and just 16% got the latest round of shots targeting the omicron variant.
Health experts surveyed by Bloomberg are split on whether more Americans will get boosters this year. Among 13 specialists in public health, immunization and infectious disease who responded to queries, seven said they thought uptake would be about the same as it was in the last booster campaign, barring a major surge or potent variant. One said the rate may fall further, while the rest said it would increase.
Their responses show how much uncertainty now surrounds the shots that prompted the end of Covid restrictions. Along with financial consequences for Pfizer and Moderna, mixed interest in boosters is prompting warnings from some public health experts who say updated vaccinations are still the best way to protect against Covid and its more severe outcomes.
“People are at lower risk from acute Covid than they have ever been,” said Emily Landon, an associate professor of medicine at University of Chicago Medicine who responded to the survey. “But that won’t last if people don’t continue to get boosted.”
Companies are relying on that view to sustain demand. Pfizer expects about 24% of the US population will get either primary doses or boosters in 2023. Wall Street analysts estimate the company’s revenue from shots in 2023 will range from $12.5 billion to $13.9 billion, down about 60% from last year. For Moderna, whose Covid shot is its only product, the estimated range is much wider: $5 billion to $10.5 billion, down from $18.4 billion in 2022. Shares of both companies have shed about a fifth of their value since the year began.
If booster uptake this year follows trends from the previous campaign, 15% of the US population would receive a shot in 2023, according to Harry Cheeld, a senior analyst at health data firm Airfinity Ltd. Uptake could look more like Pfizer’s 24% estimate if populations began accepting Covid boosters as they have annual influenza vaccine, according to Cheeld, who wasn’t among those surveyed.
Meanwhile, experts identified a number of factors that might affect demand. Surges in infections, detection of a more lethal variant, Covid shots that could be co-administered with influenza vaccine and increased investment in messaging could all increase uptake. Increased out-of-pocket costs, vaccine fatigue and waning pandemic concern could cause it to falter.
“It’s going to depend a lot on what happens with coronavirus in the next year,” Landon said.
Sufficient Protection
Booster believers, though few, are likely to keep on getting shots. Some four out of five adults who got the updated booster believe it’s important to get another, and over half are waiting for the Centers for Disease Control and Prevention to update its guidelines, so they can be eligible for yet another booster, according to the latest Kaiser Family Foundation COVID-19 Vaccine Monitor.
“The people who are all in, are all in,” said Peter Hotez, a professor in the Departments of Pediatrics and Molecular Virology & Microbiology at the Baylor College of Medicine who answered survey questions. “I hear from them all the time, especially people who are immunocompromised. They want that second bivalent booster now.”
But a large chunk of adults in the US have had Covid by now and no longer see it as a threat.
“I just don’t think there’s a perception of risk right now to the same degree that there was in 2020,” said Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia who was surveyed.
Most vaccinated people think their shots — along with prior infections — provide sufficient protection against the virus, according to the Kaiser Vaccine Monitor. Others are wary of vaccine side effects or believe Covid is over. Vinay Prasad, a professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco who was surveyed, believes booster coverage will continue to drop as more people get Covid and recover from it.
Many of those surveyed recommended focusing efforts on raising booster coverage in the high-risk population. But even among the vulnerable elderly — who saw the highest number of Covid deaths — booster uptake hasn’t been that strong. About 41% of those 65 and older have received the updated booster so far, compared to 94% who completed the initial vaccine series.
One message survey respondents believe would be persuasive to this group is that the booster does prevent people from being hospitalized or becoming seriously ill. Messaging should also clarify guidance on vaccination schedules, show why Covid still poses a threat and to whom, and try to combat misinformation, public health experts said.
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