At the end of last week, for a short time, the pandemic felt that it might be about to be under control. Yes, the daily number of Covid-19 deaths was at almost record levels. But the vaccination rate was over a million photos a day, Dr. Fauci was coming back from the White House desk, and the new president had a new plan to defeat the virus.
Then came Monday and reality hit.
First came the news that
Merck
(ticker: MRK) gave up the two Covid-19 vaccines he had tested. Then
Modern
(MRNA) said its vaccine appears to be less effective against a new strain of the virus that causes Covid-19.
S&P 500
decreased by 1.2% Monday morning. And, although it was a smooth afternoon, the reality of the remaining fight against Covid-19 seemed even stronger.
In recent weeks, the launch of currently authorized Covid-19 vaccines has dominated discussions about the virus. Even with hundreds of thousands of people getting sick in the United States every day, the pandemic began to be felt everywhere; just a matter of getting a few hundred million shots in the arms.
Johnson & JohnsonS
The single-dose Covid-19 vaccine (JNJ) was the cavalry just above the hill, ready to inoculate 100 million people in the United States by spring, awaiting data from studies that are expected on any given day.
But the cracks in that hopeful vision had already begun to unfold. After weeks of assurances that current vaccines will protect against a new strain originating in the UK, Fauci warned on Thursday that a variant first identified in South Africa could to some extent go through high immune defenses against vaccines.
Now, the implications of this warning are clear. Moderna said Monday that its vaccine appears to be less effective against the South African strain and that it will develop a booster vaccine to protect it. This increases the spectrum of an infinitely more complex vaccine launch, adding the variable booster doses to an already challenging effort to vaccinate an entire population.
A few hours before the Moderna announcement,
Merck
(MRK), arguably the most successful vaccine developer in the industry, said it failed in its effort to develop a Covid-19 vaccine. The company said it was ending two Covid-19 vaccines after disappointing early studies.
The news puts additional pressure on the results of the phase 3 process of the Johnson & Johnson vaccine. Analysts were already expecting Johnson & Johnson data to move the stock market, depending on how the process turned out. Experts are looking for the vaccine to demonstrate the effectiveness of at least 80% with a single dose.
If the Johnson & Johnson vaccine disappoints, there are others underway, including a vaccine from
Novavax
(NVAX), also currently in Phase 3 studies. But Merck’s programs, although in an early stage of development, have been a comforting reserve from an experienced vaccine manufacturer with a history of development and manufacturing. of a large number of doses. It looked like a kind of drug safety net in case of unpleasant surprises.
It comes a month after the news that another more traditional vaccine from major vaccine manufacturers
Sanofi
(SNY) and
GlaxoSmithKline
(GSK) has experienced delays in early studies in elderly patients, that safety net feels slightly damaged.
Suddenly, it seems that it is much more important that the Johnson & Johnson vaccine works as well as expected.
Modern news, meanwhile, reminds that vaccination cannot be the light switch that stops the pandemic.
Two weeks ago, Pfizer’s chief scientific officer said Barron’s that Covid-19 mutations were expected to cause the loss of activity of all current vaccines within a year or two. This morning’s Moderna announcement suggests an even greater urgency.
In a paper that has not yet been evaluated by colleagues, published Monday, Moderna scientists found “a small but significant neutralization” of South African Covid-19 strain laboratory tests using blood taken from in people who have been vaccinated with the Moderna vaccine. The company said that, “out of an abundance of precautions”, it will test a new booster vaccine of its own vaccine, designed to protect against the South African strain. He will also try to use the third dose of the initial vaccine as a stimulant. The company said the new booster will be tested in a US phase 1 study
The idea of trying to deliver Covid-19 booster shots, however, in a country already struggling to achieve its initial vaccination goals, is enough to keep local public health officials up at night if they slept anyway.
The United States has administered 21.8 million doses of vaccine to 18.5 million people since December, according to the Centers for Disease Control and Prevention. A series of doses will be wasted as states, counties and the federal government struggle with huge logistical challenges, the product of decades of underinvestment in the nation’s public health infrastructure.
Talking to Barron’s two weeks ago. Dr. Ashish Jha, dean of the School of Public Health at Brown University, gave key advice to smooth the implementation: “We can come up with the most elegant plan in the world, but our national ability to do these things is not fantastic.” he said. “Simplicity, man. There is nothing like simplicity. ”
You know what’s not easy? Trying to balance the administration of booster shots to health workers, 90-year-olds and other vulnerable populations, while still competing for raw doses in the arms of 45-year-olds.
That doesn’t mean it’s all gloomy. Vaccination seems to work in the real world, as the Israeli experience seems to show.
But the road ahead looks a little rockier this afternoon than when the sun rose this morning.
Write to Josh Nathan-Kazis at [email protected]