Industry Updates Volume 10

Global Pandemic

• The world will pass 200 Million confirmed cases of Covid-19 by the end of July, with an average death rate of over 2% of confirmed cases.
• The ongoing pandemic is now driven by the Delta variant, ~83% of all new cases in the U.S.
• Research from the UK, Israel and elsewhere are recording 'breakthrough' infections, where someone already vaccinated with e.g., two Pfizer shots, nevertheless becomes infected, and in some cases is hospitalized and dies. 
  • Research shows a significant drop of effectiveness of the vaccines against Delta, but a range of results, from a drop of 12% to as high as nearly 50%.
  • Pfizer’s mRNA vaccine has been shown to be specifically less effective with older people.
• The CDC Director warned this week that while current vaccines still protect against severe COVID-19 in a majority of cases, “We are just a few mutations away from“ a further evolution of COVID-19, which will be capable of completely evading current vaccines - all of which are based on the original Wuhan strain, and not the current prevalent variants.
  • This view is shared by Prof Gupta of Cambridge University.
• Some research suggests the Delta variant creates up to 1,000 times greater viral load in infected people, and this occurs rapidly in the first few days, making testing, quarantine and tracing less effective in reducing transmission.
• Lancet reported a UCL study showing that the antibodies created by Pfizer and AstraZeneca vaccines start to wane after 6 weeks, and can reduce by more than 50% after 10 weeks.
• Current immediate answers to this challenge range from suggesting a third shot of an existing vaccine (e.g., 3rd Pfizer shot in Israel), to mixing different types of vaccines, which has been shown to generate a better immune response than more shots of the same.
• Long term solutions will likely be vaccines that will protect against Delta, future variants.

Vaccinations

• While Delta is a serious concern even in countries with high vaccination rates, it is absolutely devastating in less vaccinated populations.
• Although almost 4 billion vaccines have now been administered, the 'Vaccination Gap' has become ever wider.   The world is now clearly split into 4 categories with respect to vaccination rates:
  • 'RICH COUNTRIES' and CHINA: 54-64%; e.g., Canada 64%; UK 63%; Israel 61%; China 56%; EU 55%; USA 54%; also UAE 77% and surprisingly, Chile 56%.
    • There are a few 'laggards' in the rich countries, e.g., Saudi Arabia 37%; Japan 33%; South Korea 24%; Australia 22%.
  • 'MIDDLE INCOME': 19%-33%; e.g., Brazil 33%; Argentina 33%; Morocco 31%; Columbia 25%; Mexico 24%; Russia 19%.
  • 'FASTER LOWER INCOME’: 6-16%;  e.g., India 16%; Indonesia 12%; Thailand 12%; Ukraine 8%; Philippines 8%; South Africa 7%; Pakistan 6%; Iran 6%.
  • 'SLOW LOW INCOME': 1-3% e.g., Egypt 3%; Vietnam 3%; Bangladesh 3%; Angola 3%; Iraq 2%; Kenya 2%; Ghana 2%; Nigeria 1%; Ethiopia 1%; Algeria 0.1%.
• A unique risk of the "Pandemic of the Unvaccinated" exists in the U.S., given large geographical areas comprising almost one-third of the country with vaccination rates below 30%. 
  • U.S. new cases/day have increased 5X in the past month; now @ 57,000 per day.

Industry

• Market leader Pfizer, has recommended "more of the same" i.e., a 3rd shot of Pfizer to offset declining antibody levels; logic being that sufficiently high levels will largely protect against Delta. 
  • The profitability of selling 'more of the same' greatly exceeds the costs and potential loss of momentum of developing a new vaccine and going back through approvals.
  • They recently raised their annual sales forecast by almost a third to $33 Billion
• As expected from a commercial perspective, everyone else, except Pfizer, is emphasizing how the research shows better antibody response from mixing the types of vaccine so the second or third shot should NOT be the same as the first/second shot!
  • This implies that everyone who got Pfizer shots should now get something else!
• The 'something else' logic however does not help Moderna commercially, because it is too similar to Pfizer to be used as a different vaccine.
• Moderna announced they are working on new vaccines more targeted to the latest variants.
• Medically, there is no doubt that the best way to tackle the Delta challenge is a vaccine designed specifically to prevent Delta. 
• Sinovac has signed long-term agreements with UNICEF and Covax for an estimated 380 Million doses of CoronaVac WIV vaccine.

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