In recent months, a large proportion of Americans are delaying or skipping new COVID-19 booster shots, and analysts and investors predict far fewer will be administered each year, bringing the total number of shots well below annual flu vaccinations.

With fewer shots required, vaccine makers such as Pfizer Inc, partner BioNTech SE, rival Moderna Inc, and Novavax Inc may need to raise prices by up to three times current levels if they want to meet Wall Street revenue forecasts for the shots in 2023 and beyond, according to several analysts.

Last year, many Wall Street analysts predicted that the number of COVID-19 shots would be comparable to the annual flu vaccine, which is the vaccine market leader, with more than 160 million shots administered annually in the United States and 600 million globally.

The slowing pace of the early COVID revaccination campaigns, particularly in the critical US market, is changing that perception. According to a recent Kaiser Family Foundation poll, two-thirds of American adults do not intend to get a COVID vaccine anytime soon. Analysts predict that the US market will be one-third the size it was before the flu.

“The fact that you have people saying the pandemic is over doesn’t motivate people to get vaccinated,” said Dr. Bruce Farber, chief of public health and epidemiology for New York hospital system Northwell Health.

He went on to say that cases of COVID infections in vaccinated people have raised concerns about the vaccine’s efficacy.

Bijan Salehizadeh of Navimed Capital, a healthcare investor, previously thought demand would likely mirror that of the flu, but now believes it will be much lower in the absence of significant evidence that updated shots are better.

“The average person is not going to jump to get it” without signs of improved efficacy, he said.

Approximately 14.8 million people received the updated COVID-19 booster shots, which target both the original coronavirus strain and the Omicron strain, during the first six weeks of the rollout. Over 22 million people received their third vaccination in the first six weeks of the 2021 vaccination campaign, despite the fact that only the elderly and immunocompromised were eligible at the time.

This year, after the release of new, updated shots that target Omicron, uptake of the boosters in the European Union did not increase as expected, remaining in the range of 1 million to 1.4 million doses per week.

Wall Street analysts and investors agreed that vaccine sales could improve if companies provide proof that new boosters protect people from mild illness, develop pan-coronavirus vaccines, or combine the shots with the flu vaccine in a single shot. A new wave of infections may also increase demand.

According to Refinitiv data, analysts expect Pfizer, Moderna, and Novavax to generate $16.3 billion, $7.9 billion, and $2.8 billion in sales from their COVID-19 vaccines in 2023, respectively.

Pfizer, BioNTech, and Moderna all declined to comment on their COVID sales projections.

Even though vaccine exhaustion and the faith that the pandemic is over are currently dampening demand, Novavax Chief Commercial Officer John Trizzino believes the COVID market will eventually be at least as large as the flu market. Increased infection rates, hospitalizations, and deaths, he claims, will drive people to seek booster shots.

“Unfortunately, the virus does that work for us,” Trizzino said.

Moderna has also stated on numerous occasions that it believes flu is a great analogy both in the United States and globally.

Prices could be raised to compensate for some of the lower demand. Moderna has stated that it may charge up to $100 per dose for shots that were originally priced at around $16.50.

Daina Graybosch, an analyst at SVB Leerink, is skeptical that the companies will be able to raise their prices that far.

However, Michael Yee of Jefferies believes that private health insurers and US government health plans could spend up to three times the current price of around $30 to avoid the significant costs of hospitalizations or long COVID.

Long-term revenue for a company like Moderna would be in the $3 billion to $5 billion range, he added.

Investors have already begun to lose faith in the COVID vaccine market’s promise, particularly for Moderna, BioNTech, and Novavax, three young companies that rely on the shots for nearly all of their profits. All three companies’ stocks have dropped by at least two-thirds in the last year. Pfizer, one of the world’s largest pharmaceutical companies, has dropped by roughly one-third.

(Adapted from Reuters.com)