USA — Moderna, a US biotech firm has announced mixed findings from a large-scale trial of its mRNA flu shot, which employs the same technology as its effective Covid-19 vaccine.

The experimental mRNA-1010 flu shot by Moderna is a “quadrivalent” vaccine, targeting four strains of flu as suggested by the WHO: A/H1N1, A/H3N2, B/Yamagata, and B/Victoria.

Moderna’s flu shot produced an immune response against influenza A strains equivalent to or greater than that of already licensed vaccines, but it fell short of the already approved vaccines against strains of the less-common influenza B.

Moderna President Stephen Hoge described the results as an important step forward in the development of mRNA-based influenza vaccines.

The Phase 3 trial of the mRNA shot, which took place in Argentina, Australia, Colombia, Panama, and the Philippines during the Southern Hemisphere influenza season, involved 6,102 adults who received a single dose of mRNA-1010 or a licensed influenza vaccine.

Moderna is currently conducting an efficacy trial of its vaccine, with hopes that mRNA technology will quicken immunization development and production, and heighten efficacy for not only flu but also other viruses.

The WHO states that there are approximately three to five million severe influenza cases globally each year, resulting in between 290,000 and 650,000 deaths.

In a release, Moderna President Stephen Hoge attributed the “overwhelming majority of flu-related disease in older adults” to influenza A, which leads to over 95% of influenza-related hospitalizations in adults.

Meanwhile, influenza B has emerged as a threat, especially among pediatric populations, with studies indicating increased potency in causing severe illness and mortality.

Moderna has updated its agile mRNA platform to elicit a stronger response against influenza B, which is more common in younger populations.

The mRNA-based flu vaccine is considered well-tolerated, though adverse reactions to mRNA-1010 were more frequent than the comparator group.

Moderna is developing five influenza vaccine candidates, including some that target multiple proteins of the virus’ lifecycle for improved efficacy.

Pfizer is also working on an mRNA influenza vaccine, with a Phase III trial underway. mRNA technology is a flexible option for seasonal influenza waves, allowing for quick updates based on actual circulating strains.

It is a so-called quadrivalent vaccine, like those administered to the public today, targeting four different flu variants.

Moderna expects an interim analysis of efficacy to be reviewed by the Data and Safety Monitoring Board in Q1, determining whether more data is necessary for final analysis.

Pfizer and Moderna usually avoid early-stage research and development on flu vaccines due to their historically modest revenues.

The global influenza vaccine market was valued at US$6.59 billion in 2021 and is projected to reach US$10.73 billion in 2028 with a compound annual growth rate of 7.2%, according to Fortune Business Insights.

In contrast, the entire pharmaceutical industry’s global revenue in 2020 was US$1.27 trillion, according to Statista.

Although the seasonal flu runs from October to May and has its own deadly history, with four flu pandemics occurring in the past century (1918, 1957, 1968, 2009) and claiming at least a million lives during each, the public has shifted its focus away from it due to the Covid pandemic.

There is ample evidence to suggest that existing flu vaccines are often only partially effective at preventing influenza infection.

Limitations of existing flu vaccines

Existing flu vaccines are only 40% to 60% effective in preventing infection, and sometimes by a flu season’s end only 10% effective.

According to the Centers for Disease Control and Prevention (CDC), flu vaccine effectiveness can vary widely from year to year, depending on several factors, such as how well the vaccine is matched to the predominant circulating flu strains and the age and health of the vaccine recipient.

Part of the reason for this suboptimal efficacy is the fact that flu viruses are constantly mutating and evolving, making it difficult for vaccine manufacturers to predict which strains will be most prevalent in a given year.

Additionally, the vaccine must be administered well in advance of flu season, meaning that there is always a risk that the virus will change significantly in the months between vaccine development and distribution.

This lack of effectiveness can have serious consequences for public health, particularly for vulnerable populations such as the elderly, young children, and individuals with weakened immune systems.

Influenza is a serious illness that can lead to hospitalization, complications, and even death, and a vaccine that is only partially effective leaves many individuals at risk.

Therefore, the development of more effective flu vaccines is an urgent priority, particularly given the potential for global pandemics and the significant impact that even a mild flu season can have on public health and the economy.

mRNA-based vaccines, like those being developed by Moderna and Pfizer, hold promise for improving vaccine efficacy and responsiveness to changing flu strains, which could have significant benefits for public health.

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