Moderna Says It's "Wrestling" With This Question About Future Shots
The president of the company says there are still a lot of unknowns when it comes to boosters.
After months of speculation, President Joe Biden announced in August that COVID-19 boosters would be made available to the general public pending approval. The decision immediately sparked a debate among health experts and officials who claimed that the additional shots may not be necessary for everyone just yet. Ongoing research has provided some answers, including how those who are highly vulnerable might benefit from a booster if they received the Pfizer vaccine. But according to Stephen Hoge, president of vaccine manufacturer Moderna, there are still some questions that his company is "wrestling" with when it comes to future shots.
During an interview with Yahoo Finance on Sept. 16, Hoge addressed the ongoing uncertainty surrounding the need for a Moderna booster, admitting "we don't really know" if a third shot would be the final one needed or if subsequent doses would be required to shore up immunity. He went on to describe the quandary as the "key scientific question we're all wrestling with now."
The statements came as Hoge addressed a study released by Moderna on the same day. Findings showed that people who were vaccinated more recently, a median of eight months since their first shot, had a lower risk of breakthrough infection than those who were vaccinated last year, a median of 13 months since their first shot. The company subsequently said it believes the data supports the need for a booster shot.
Hoge explained that if it's found additional doses do prove to boost effectiveness, they will likely be needed about three months from now during the late fall and early winter. This is the time of year when there is typically a spike in respiratory diseases such as COVID-19, and breakthrough infections become more likely.
"It's important to note that there's a higher risk for those who are older and those who have comorbidities," he explained. "While we do see breakthrough cases across the whole adult population—and we ultimately do think there's a benefit to boosters for the whole adult population—it's clear the need is most acute in those over the age of 65 or those who have diabetes, obesity, or chronic pulmonary diseases; other things that put that at higher risk of severe disease if they ever do get COVID."
"The challenge is we won't know until we won't know until we provide that third dose booster and really follow people out for six or 12 months and see if immunity is actually holding up, and if it's not waning anymore after that third dose," he said. "It's one of those situations that we've been in multiple times over the past year where we need to follow the data and the science, but we do have to take action ahead of the virus," adding that finding out months later that strong immunity was holding would be a "bonus" to the 600,000 COVID-19 cases the company estimates boosters could help prevent.
However, other research has found that Moderna's vaccine may already provide particularly long-lasting protection compared to others. For example, a study published Aug. 30 in the Journal of the American Medical Association compared antibody response following vaccination with Pfizer and Moderna among 2,500 health care workers from Belgium, and found that Moderna's vaccine produces twice as many antibodies as possible Pfizer's. And another study published in the journal Science on Sept. 14 compared immune responses in patients who had recovered from COVID with those who had received a 25 microgram (mg) low dose of vaccine during Moderna's clinical trial, finding that immune memory remained strong six months later including patients aged 70 or older, even without the full 100 mg shots.
A separate study published by the Centers for Disease Control and Prevention (CDC) on Sept. 10 also seemed to indicate the vaccine outlasted others. After examining more than 32,000 medical encounters from 187 hospitals and 221 emergency departments and urgent care clinics across nine states from June to Aug. 2021, researchers found that Moderna maintained comparably better effectiveness—even in the face of the Delta variant. Moderna had a vaccine efficacy of 95 percent when protecting against hospitalization, while Pfizer's vaccine was 80 percent effective and Johnson & Johnson's was 60 percent. In terms of preventing emergency department and urgent care visits, Moderna was 92 percent effective, while Pfizer and Johnson & Johnson were 77 and 65 percent effective, respectively.
When asked about the concept of global equity and the need to distribute vaccines to countries that have not yet had access to them, Hoge explained that an increase in manufacturing capability would help the company meet demand. He also explained that the Moderna booster currently awaiting approval was a 50 mg dose, which is not only half of the primary dosage given during each of the initial two vaccine shots but also had the "bonus" of producing an even better antibody response than a stronger third shot in clinical studies. Hoge said this would give the company the ability to manufacture up to 1 billion more doses next year that could go to the rest of the world.
"We are making as much as we can, and have been for the better part of a year—and will be for the better part of the next year," Hoge said. "We are trying to scale up and invest in manufacturing to create more doses."