Is Moderna really the leader in the race for COVID-19 vaccines?

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When Dr. Anthony Fauci speaks, people listen. The director of the National Institute of Allergies and Infectious Diseases (NIAID) quickly became one of the main spokespersons for US efforts to fight the COVID pandemic earlier this year.

There is one company that Fauci has chosen from among the many that are developing COVID-19 vaccine candidates. This pharmacist is Moderna (NASDAQ: MRNA).

And when The New York Times reported a few days ago that the Trump administration had chosen five COVID-19 vaccines to receive substantial financial support from the United States government, one company being mentioned first. You guessed it … Moderna.

Is Moderna really the de facto leader in the race for COVID-19 vaccines? It is complicated.

Image source: Getty Images.

First engine among many

On March 16, Moderna became the first to initiate a Phase 1 clinical study evaluating a candidate COVID-19 vaccine in humans. But he was followed a week later by a Chinese pharmacist CanSino Bio.

Inovio was not too far behind. Clinical biotechnology began a phase 1 study of its experimental COVID-19 vaccine on April 6.

The University of Oxford dosed the first patients in a phase 1 study of its COVID-19 vaccine candidate on April 23. In late April, a large British drug maker AstraZeneca (NYSE: AZN) announced its partnership with Oxford for the development and marketing of the vaccine.

Pfizer (NYSE: PFE) and his partner, BioNTech (NASDAQ: BNTX), were not far behind. The two companies launched phase 1 of a phase 1/2 clinical study of a COVID-19 vaccine candidate originally developed by BioNTech on May 5.

Novavax (NASDAQ: NVAX) jumped in the race on May 25. Clinical biotechnology has also launched phase 1 of a phase 1/2 clinical study.

Others are in pursuit. Johnson & Johnson plans to begin a clinical study of its COVID-19 vaccine candidate by September. Merck, Sanofi, and GlaxoSmithKline are preparing to begin clinical trials of their experimental vaccines.

A neck and neck race

Although Moderna was the first to start clinical testing of a COVID-19 vaccine candidate, is it still in first place? It’s a difficult call. It’s definitely a neck and neck race.

Moderna plans to start a phase 3 study of its COVID-19 vaccine in July. But Chinese drug maker CanSino could begin its advanced study around the same time.

The AstraZeneca-Oxford team is also in the running for the leading position. The partners began enrolling in a phase 2/3 clinical study in late May. They did not specify exactly when the clinical trials will end due to uncertainty about the time it will take for some participants to develop COVID-19. Results could be available within two months of the study launch or up to six months.

Gloved hand holding the COVID-19 vaccine syringe

Image source: Getty Images.

What is more difficult to determine

It is quite easy to compare the timescales of each of the companies developing COVID-19 vaccine candidates. What is much more difficult is trying to determine which of these vaccines has the best chance of success.

The White House has chosen the vaccines developed by Moderna, AstraZeneca-Oxford, Pfizer-BioNTech, J&J and Merck as the most promising candidates. Does this mean that these vaccines are really the most likely to succeed? Not necessarily. On the one hand, it is a mystery why the Trump administration chose J&J and Merck over others who are more advanced (namely, Novavax and Inovio).

Another organization that is trying to identify the most promising COVID-19 vaccine candidates is the Coalition for Epidemic Preparedness Innovations (CEPI). The nonprofit was founded by the Bill and Melinda Gates Foundation, the governments of India and Norway, the Wellcome Trust and the World Economic Forum. It is also funded by other governments around the world as well as by private sector companies.

CEPI has so far funded several COVID-19 candidate vaccines. But the organization has invested the most in vaccines developed by Novavax and AstraZeneca.

A delicate three-letter word

At least with regard to the race for the COVID-19 vaccine, referring to Moderna (or any other company) as the the leader is probably premature. “Le” is a delicate three-letter word in this case. It is better to see Moderna as a leader in the development of a COVID-19 vaccine.

But we must also consider many others as leaders in the development of COVID-19 vaccines. I would definitely put AstraZeneca and the University of Oxford, CanSino Bio and Novavax on the list. And I would not dismiss the Pfizer-BioNTech or Inovio partnership.

What about J&J, Merck, Sanofi and GlaxoSmithKline? These large pharmaceutical companies certainly have considerable vaccine expertise and the financial resources to rapidly advance their COVID-19 vaccine candidates. Since none of them have started clinical trials yet, I would hesitate to designate them as leaders at this point. However, this may change in the near future.

I expect there will ultimately be several vaccines that prove to be safe and effective. Moderna is getting the most attention right now, but I think biotechnology will have to share the spotlight.



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