Show Transcript
There’s been a flurry of vaccine news since the pandemic began, with a number of drug companies releasing a string of positive early stage results. Anthony Okolie speaks with Tarik Aeta, Healthcare Analyst, TD Asset Management, on the state of COVID-19 vaccine and therapeutics development.
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- Over the past few months, we've seen a flurry of vaccine news from pharmaceutical companies reporting positive early results. Joining me today is Tarik Aeta, health care analyst at TD Asset Management, to talk about some of the vaccine development news.
Tarik, you brought a chart here that has a lot of information. I see on the top the chart it shows five different vaccine approaches. Can you help us explain what these are?
- Yeah. So if you roll back the clock to early on in the pandemic, back to February and March, there was quite a bit of uncertainty regarding which vaccine technology would be most effective in our fight against COVID-19. But fast forwarding to today, the good news is, not only do we have 160 vaccines under development, but most of the major vaccine approaches are showing good data from their phase I clinical trials.
And as mentioned here, we have a chart of the five major approaches. And I'd like to focus your attention on the last two rows, which indicate whether the vaccines are neutralizing antibodies, as well as a T-cell response. And to have a successful vaccine, you need to have a good response on both counts.
So out of the five major ways you can make a vaccine, the first three have shown very promising data. This includes mRNA vaccines, such as Moderna's and Pfizer-BioNTech. We've also seen very good data from the viral vector vaccines, such as the AstraZeneca and Oxford partnership. And last but not least, protein subunit vaccines look promising, as well, with strong data from Novavax that we got last week. The caveat here is we've only gotten phase I data, and we still need larger phase III trials to prove out efficacy.
- And I think what's on everyone's mind is, how quickly can we get a vaccine, and will it work? On the chart, you have two categories that have a "fast" beside time to market.
- Yeah.
- So how fast is fast?
- Yeah, so when I put "fast" on this chart, it's about the vaccine technology. So mRNA and DNA plasmid-- in theory, these approaches should be the fastest, given you don't have to grow any viruses in a lab. But when we think about fast in terms of how fast we can actually have a vaccine to market, I would pay attention to just the ones that are furthest along in the clinical development.
So at the moment, this would be Moderna, Pfizer-BioNTech and AstraZeneca. All three of them are in their phase-III trial. All three are currently enrolling between 30,000 50,000 participants each. And those three vaccines-- we can have data as early as this October, And approval later in the fall is definitely in the cards.
- And, of course, there's been quite a bit of news about Moderna, which, in your chart, you have under the fast-tomarket category. And it also has yielded positive results in terms of producing antibodies. Would you say that they're the leading contender right now?
- Yeah. I wouldn't put Moderna as the absolute leading contender. You know, the CEO of Moderna has mentioned that they think that an 80% probability of success, so they are very confident in their vaccine. But I'd also put Pfizer-BioNTech's right up there as well, and AstraZeneca-Oxford as well.
So I think those three vaccines are, I would say, in many ways, neck and neck in terms of getting approved first. And all three have good data. There's some difference in data, one for the other, but they all have good data.
- And you mentioned AstraZeneca and Oxford, but you put them into the medium-to-speed category on the chart. Why's that?
- Yeah, so for AstraZeneca and Oxford, the method they're using to make a vaccine is a viral vector vaccine. For the category, in theory, it should take a bit longer to make a viral vector vaccine and develop it than an mRNA vaccine. But AstraZeneca is lucky because they can leverage a lot of the work Oxford did back in the past for other vaccines they've developed.
So because they've already had their adenovirus-- chimpanzee virus-- chimpanzee adenovirus made in the past, they were able to leverage that technology. So instead of actually being medium for AstraZeneca, in reality, they are fast to market just because they were able to leverage some of the previous work they've done in that space.
- But regardless of who's producing the positive results so far, there's still a long way to go, isn't there? I mean, how optimistic are you that the phase III trials will be ultimately successful?
- Yeah. So I'm quite optimistic. And it's driven not only by the phase I clinical trial, but also driven by the non-human primate challenge studies that we've seen in recent weeks. And this is basically where we give monkeys the vaccine and later give them the coronavirus to see how well the vaccine protects them.
So for example, for J&J's vaccine, 6 out of the 6 monkeys that got it had no trace of the virus in their lungs after being dosed with the coronavirus. And there's only one monkey with some traces of the virus in the upper-respiratory tract. Likewise, there's some encouraging data out of AstraZeneca and Moderna, with both vaccines protecting the lungs of all the monkeys.
- Now, we also heard this week that Russia already has a vaccine that's being used. What's your assessment of that? And what should we be watching for?
- Yeah. So if we take a step back and look how Russia is developing their COVID-19 vaccine, scientifically, the vaccine makes sense in theory. So Russia is developing an adenovirus-based vaccine, quite similar to the approach that AstraZeneca and J&J are taking as well.
That said, in science, you need evidence. And Russia hasn't given us any disclosures on the data, be it the phase I trial. And they haven't even started a phase III trial yet. But given AstraZeneca and J&J have shown success using an adenovirus construct, by extension, the Russian vaccine could work. It's definitely possible.
However, until we get the data, we just simply don't know. So I wouldn't expect the Russian vaccine to get any traction outside of Russia until we have such data to disclose.
- That's very good insight there. So until there's a vaccine, it's really important that we get better treatments. Are there any promising developments in terms of therapeutic treatments?
Yeah. So on the therapeutic side-- there hasn't been a lot of press over here-- but I would be paying close attention to the antibody drug cocktails that Eli Lilly and Regeneron are looking to launch, potentially as early as this fall if they are successful. And here, these antibody drug cocktails can be used both to prevent COVID, as well as treatment-- so for those people that get hospitalized and need treatment.
I'd also be paying full attention to Merck's oral antiviral drug, and we we'll have more data on that candidate this fall. And these are important because these will help bridge the gap until a vaccine is ultimately available to the broader public and will help bring down mortality for those patients that do end up getting diagnosed with COVID-19.
- OK. We just have a few seconds left. But what are some of the upcoming milestones that you'll be watching for in the coming months to see if there's real development in either testing, treatment, or a vaccine?
- Right. So first and foremost, I'd be looking at the phase III data from Moderna, BioNTech, and AstraZeneca. And those, again, are set to come out as early as October.
Second, I'd also be looking at the phase I data from J&J and, later, Sanofi, as the fall progresses. And this is because they bring significant manufacturing capacity. So if they should be successful, along with AstraZeneca's and Moderna's and BioNTech, if you just simply add up the manufacturing promises from these companies, you get to 7 billion doses very quickly. And that doesn't include any optionality from the other 150-plus vaccines in development.
And then lastly, on the therapeutic side, as mentioned, I'd be paying close attention, again, to antibody drugs, as well as Merck's oral antiviral. And we'll have more data from those in the fall.
- Tarik, thank you very much for your insights.
- Yeah. Thanks, Anthony.
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Tarik, you brought a chart here that has a lot of information. I see on the top the chart it shows five different vaccine approaches. Can you help us explain what these are?
- Yeah. So if you roll back the clock to early on in the pandemic, back to February and March, there was quite a bit of uncertainty regarding which vaccine technology would be most effective in our fight against COVID-19. But fast forwarding to today, the good news is, not only do we have 160 vaccines under development, but most of the major vaccine approaches are showing good data from their phase I clinical trials.
And as mentioned here, we have a chart of the five major approaches. And I'd like to focus your attention on the last two rows, which indicate whether the vaccines are neutralizing antibodies, as well as a T-cell response. And to have a successful vaccine, you need to have a good response on both counts.
So out of the five major ways you can make a vaccine, the first three have shown very promising data. This includes mRNA vaccines, such as Moderna's and Pfizer-BioNTech. We've also seen very good data from the viral vector vaccines, such as the AstraZeneca and Oxford partnership. And last but not least, protein subunit vaccines look promising, as well, with strong data from Novavax that we got last week. The caveat here is we've only gotten phase I data, and we still need larger phase III trials to prove out efficacy.
- And I think what's on everyone's mind is, how quickly can we get a vaccine, and will it work? On the chart, you have two categories that have a "fast" beside time to market.
- Yeah.
- So how fast is fast?
- Yeah, so when I put "fast" on this chart, it's about the vaccine technology. So mRNA and DNA plasmid-- in theory, these approaches should be the fastest, given you don't have to grow any viruses in a lab. But when we think about fast in terms of how fast we can actually have a vaccine to market, I would pay attention to just the ones that are furthest along in the clinical development.
So at the moment, this would be Moderna, Pfizer-BioNTech and AstraZeneca. All three of them are in their phase-III trial. All three are currently enrolling between 30,000 50,000 participants each. And those three vaccines-- we can have data as early as this October, And approval later in the fall is definitely in the cards.
- And, of course, there's been quite a bit of news about Moderna, which, in your chart, you have under the fast-tomarket category. And it also has yielded positive results in terms of producing antibodies. Would you say that they're the leading contender right now?
- Yeah. I wouldn't put Moderna as the absolute leading contender. You know, the CEO of Moderna has mentioned that they think that an 80% probability of success, so they are very confident in their vaccine. But I'd also put Pfizer-BioNTech's right up there as well, and AstraZeneca-Oxford as well.
So I think those three vaccines are, I would say, in many ways, neck and neck in terms of getting approved first. And all three have good data. There's some difference in data, one for the other, but they all have good data.
- And you mentioned AstraZeneca and Oxford, but you put them into the medium-to-speed category on the chart. Why's that?
- Yeah, so for AstraZeneca and Oxford, the method they're using to make a vaccine is a viral vector vaccine. For the category, in theory, it should take a bit longer to make a viral vector vaccine and develop it than an mRNA vaccine. But AstraZeneca is lucky because they can leverage a lot of the work Oxford did back in the past for other vaccines they've developed.
So because they've already had their adenovirus-- chimpanzee virus-- chimpanzee adenovirus made in the past, they were able to leverage that technology. So instead of actually being medium for AstraZeneca, in reality, they are fast to market just because they were able to leverage some of the previous work they've done in that space.
- But regardless of who's producing the positive results so far, there's still a long way to go, isn't there? I mean, how optimistic are you that the phase III trials will be ultimately successful?
- Yeah. So I'm quite optimistic. And it's driven not only by the phase I clinical trial, but also driven by the non-human primate challenge studies that we've seen in recent weeks. And this is basically where we give monkeys the vaccine and later give them the coronavirus to see how well the vaccine protects them.
So for example, for J&J's vaccine, 6 out of the 6 monkeys that got it had no trace of the virus in their lungs after being dosed with the coronavirus. And there's only one monkey with some traces of the virus in the upper-respiratory tract. Likewise, there's some encouraging data out of AstraZeneca and Moderna, with both vaccines protecting the lungs of all the monkeys.
- Now, we also heard this week that Russia already has a vaccine that's being used. What's your assessment of that? And what should we be watching for?
- Yeah. So if we take a step back and look how Russia is developing their COVID-19 vaccine, scientifically, the vaccine makes sense in theory. So Russia is developing an adenovirus-based vaccine, quite similar to the approach that AstraZeneca and J&J are taking as well.
That said, in science, you need evidence. And Russia hasn't given us any disclosures on the data, be it the phase I trial. And they haven't even started a phase III trial yet. But given AstraZeneca and J&J have shown success using an adenovirus construct, by extension, the Russian vaccine could work. It's definitely possible.
However, until we get the data, we just simply don't know. So I wouldn't expect the Russian vaccine to get any traction outside of Russia until we have such data to disclose.
- That's very good insight there. So until there's a vaccine, it's really important that we get better treatments. Are there any promising developments in terms of therapeutic treatments?
Yeah. So on the therapeutic side-- there hasn't been a lot of press over here-- but I would be paying close attention to the antibody drug cocktails that Eli Lilly and Regeneron are looking to launch, potentially as early as this fall if they are successful. And here, these antibody drug cocktails can be used both to prevent COVID, as well as treatment-- so for those people that get hospitalized and need treatment.
I'd also be paying full attention to Merck's oral antiviral drug, and we we'll have more data on that candidate this fall. And these are important because these will help bridge the gap until a vaccine is ultimately available to the broader public and will help bring down mortality for those patients that do end up getting diagnosed with COVID-19.
- OK. We just have a few seconds left. But what are some of the upcoming milestones that you'll be watching for in the coming months to see if there's real development in either testing, treatment, or a vaccine?
- Right. So first and foremost, I'd be looking at the phase III data from Moderna, BioNTech, and AstraZeneca. And those, again, are set to come out as early as October.
Second, I'd also be looking at the phase I data from J&J and, later, Sanofi, as the fall progresses. And this is because they bring significant manufacturing capacity. So if they should be successful, along with AstraZeneca's and Moderna's and BioNTech, if you just simply add up the manufacturing promises from these companies, you get to 7 billion doses very quickly. And that doesn't include any optionality from the other 150-plus vaccines in development.
And then lastly, on the therapeutic side, as mentioned, I'd be paying close attention, again, to antibody drugs, as well as Merck's oral antiviral. And we'll have more data from those in the fall.
- Tarik, thank you very much for your insights.
- Yeah. Thanks, Anthony.
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