Pfizer’s forecast for Covid-19 vaccine sales topping $33 billion this year cemented the shot’s status as an ultra-blockbuster and put a spotlight on the drugmaker’s plans to keep up the pace.
The vaccine, developed with partner BioNTech SE, has been the backbone of the US immunisation effort and is in increasing demand worldwide. But there are questions about how well it will hold up against the fast-spreading delta variant, whether boosters will be required to amplify its protection, and if new formulations are needed to fight evolving mutations.
Following Pfizer’s second-quarter earnings announcement Wednesday, Bloomberg spoke with Chief Executive Officer Albert Bourla and Chief Scientific Officer Mikael Dolsten to get a sense of how the drug giant is navigating the ever-changing state of the pandemic.
The questions and answers have been edited for clarity and length.
Bloomberg: There are indications that, in the face of the delta variant, the Pfizer-BioNTech vaccine’s efficacy is waning — even against severe disease and hospitalisation. We know delta is more transmissible, but what does this suggest about clinical impact?
Dolsten: The delta virus, through its transmissibility, replicates so much faster. That means you have more virus earlier in the disease, and it seems to faster penetrate the lower respiratory tract. It may cause more severe disease and seems more likely to lead to hospitalisation and even fatal outcome.
Fortunately, our vaccine retains the same immunological activity in the lab against delta, it’s just that you need to keep very high immunity given this is such a rapidly moving virus. That plus that the vaccine wanes — as any vaccine wanes over time — suggests a booster given within 6 to 8 months can give you back the very high immunity that you had at the outset.
We’ve learned in Israel today that even protection against severe disease may have waned from almost 100% [efficacy] to the 80s. We continue to monitor across the globe, as different countries are at different places as to how many people they’ve vaccinated, and how far out they are from vaccination. We expect to see the same trend.
This is a terrible virus, but the good news is with a boost, the vaccine gets stronger and stronger.
Bloomberg: Earlier today, Albert, you said that the company is developing vaccines to combat other variants that are likely never to be used. What variants are you focused on, beyond delta?
Bourla: The strategy is exactly that. Beta is the one we’ve developed a new vaccine for, and actually the studies are about to be completed. We’ll file with the Food and Drug Administration, but we’ll never use it because a booster from the same vaccine is performing extraordinarily well against beta. Delta is the same. We’re making a delta/delta-plus vaccine to address concerns. We don’t take chances, we do the work. But the likelihood we’ll need it is small.
Bloomberg: As governments now seek booster shots, how are you prioritising who gets supply? Will those doses be priced differently?
Bourla: Our standard policy is we have a price for high-income countries, middle-income countries, and a not-for-profit price for low-income countries. This year, we’re making 3 billion doses. And between now and the end of next year, we’ll have 6 billion doses. We hope to give to all. Right now, we don’t have to prioritize, because we have enough. But everyone needs to raise their hand and express interest.
Kids & boosters
Bloomberg: Children’s immune systems work somewhat differently than adults’. Do you anticipate they’ll need boosters, too?
Dolsten: Younger patients do get higher immune responses. But I think over time it’s reasonable to assume everyone gets a boost. There are two ways to do it: One is to be pragmatic, like the flu season, where you boost in the fall. Another is to take a quick diagnostic test and look at whether younger patients need them every three months or every two years: That’s how medical practice can evolve.
Bloomberg: The Pfizer-BioNTech vaccine is the only one currently cleared for use in the US for those age 12 through 17. As new entrants arrive, do you think you’ll be able to dominate that market?
Bourla: We will have the leadership, in general, because we have the preference of the people. And this comes from the trust of the company, and the track-record of delivery. So yes.
Bloomberg: What role do you see Pfizer playing in overcoming vaccine hesitancy, especially as the campaign shifts to reach younger children?
Bourla: Everyone needs to play a role: the press, teachers, community leaders, the Centers for Disease Control and Prevention and Pfizer. Our role will be way more effective if we’re very transparent. Our role is to state the science the way it is.
Bloomberg: You were peppered with a lot of questions about the vaccine today. Were there any questions you were surprised investors didn’t ask?
Bourla: There was a big surprise, that maybe was lost, about our RSV vaccine. Nobody even knew we were working on an adult RSV vaccine. RSV is the hottest topic among epidemiologists, and it’s an issue there’s no vaccine. We presented data it’s 100% effective. We’re getting close. The market is quite large.