Here’s what Pfizer and Moderna say is next for their Covid vaccines

Three years and billions of Covid vaccines into the pandemic, Pfizer and Moderna say their work is far from done.

The two pharmaceutical companies, whose Covid vaccines have become household names, usher in a new era for their shots that will elevate the role they play in protecting public health, but also simplify what people need to do to live with the virus.

This includes developing new versions of vaccines that aim to provide broader, longer-lasting immunity against the virus, and combination vaccines that protect against Covid and other respiratory diseases in a single dose, among other efforts.

These plans coincide with a broader shift in the landscape of the Covid pandemic.

Both U.S. and global public health emergencies are over, vaccine uptake and sales growth have slowed, and both Pfizer and Moderna will sell their shots directly to health care providers for about $110 to $130 per dose once fall, when federal stockpiles are expected to run out of vaccines. Free vaccinations.

Neither company provided CNBC with an update on the exact private market price for their footage.

Many of Pfizer and Moderna’s vaccine plans may not reach the public for a few more years, and the success of those efforts will not be guaranteed.

“One of the great things about Moderna is the company’s willingness to bend over, even if it’s not clear exactly where things are going,” Dr. Jacqueline Miller, Moderna’s chief of infectious diseases, told CNBC.

That’s what Moderna and Pfizer say is next in their Covid shots.

Pfizer and Moderna aim to catch up with the shift in the US toward using annual Covid doses rather than frequent booster doses.

Regulators are moving toward a model similar to the flu vaccine for Covid vaccines, meaning people will get one shot each year that is updated annually to target the latest variant expected to circulate in the fall and winter. A panel of independent advisers to the US Food and Drug Administration will meet in June to choose which new vaccines for the Covid strain they should target when they are introduced later this year.

Moderna and Pfizer told CNBC that messenger RNA technology will allow them to keep up with new Covid variants each year.

The technology, which is used in both companies’ Covid shots, teaches human cells to produce a protein that initiates an immune response against a specific disease.

Miller, who helped lead the development of Moderna’s Covid vaccine in 2020, said the advantages of using mRNA became apparent earlier in the pandemic. This includes the ability to quickly scale shot manufacturing and easily change your target variables.

“The vaccine has become proof of the value of mRNA in an epidemic when you need to make something quickly,” Miller told CNBC. “The speed of that platform — it allows us to do things three times faster.”

Dr. Mikael Dolsten, Pfizer’s chief scientific officer, is hopeful that annual Covid vaccines will improve public sentiment about getting the vaccine. The public has become increasingly dissatisfied with health mandates during the early stages of the pandemic, he said, and “unfortunately, some people see vaccines as part of that.”

The annual schedule may help people see Covid shots as another “very normal part” of protecting their health and encourage more of them to get vaccinated each year, according to Dolsten.

“I think it’s like introducing seat belts to cars. People didn’t want to wear them at first, but over time they realized how protective seat belts are. Now everyone is using them today,” Dolsten told CNBC. “That’s kind of how the vaccine story needs to be reimagined.”

The Pfizer and Moderna Covid vaccines provide strong protection against the virus, but that immunity can start to wane after four to six months.

Part of Pfizer’s strategy to shift to an annual Covid vaccine schedule is to develop “next-generation” versions of the shot, which are intended to broaden and extend the protection people get for an entire year.

“The protection is still there but it’s gradually diminishing, and we’re working a couple of different ways to make it more like annual robustness for the majority of people,” Dolsten told CNBC.

Pfizer and its Covid vaccine partner BioNTech are working on a shot that would raise the level of antibodies a person gets after vaccination “many-fold,” according to Dolsten.

The vaccine wouldn’t work very differently from the company’s current shot, which teaches cells how to make harmless versions of the Covid spike protein. The immune system detects this protein and produces protective antibodies that help fend off the virus, but these decrease over time.

The main difference is that the next-generation dose will teach the cells how to make copies of an “improved” spike protein, which will generate a much higher level of antibody that can last an entire year.

“If we’re raising the antibodies, let’s say three-fold, that means they will last and protect for a year,” Dolsten said.

The company is working on a second vaccine aimed at boosting T cells, another form of protection that targets and destroys cells infected with the Covid virus.

In addition to the antibodies, Pfizer’s current injection stimulates the formation of T cells against the spike protein. T cells diminish more slowly than antibodies, which means they provide long-term protection against the virus.

Pfizer is adding another strain of mRNA in the new shot that will expand the T-cell response.

The strain will specifically trigger T cells to increase against other parts of the coronavirus called non-spicy proteins. These T cells, plus those generated against the spike protein, would provide protection against “all corners of the COVID viral landscape,” according to Doulston.

The non-spiky proteins also mutate more slowly than the spiked protein, meaning any T cells generated against them will likely protect against a wide range of Covid variants.

Moderna’s chief medical officer, Dr. Paul Burton, said the company has a “next-generation” Covid vaccine, which aims to improve how shots are stored and administered.

The company’s current shot should be kept in an extremely cold store. Once the vaccine is thawed, it can be stored in the refrigerator for up to 30 days, according to FDA guidelines.

Burton said Morderna’s new shot will be “refrigerator-stable,” which means it will have a longer shelf life in the freezer. The company will achieve this by shortening the length of the mRNA strand in the vaccine, according to Burton.

The shot could increase the number of vaccine providers around the world, especially in developing countries that may not have the freezing capabilities.

Burton said Moderna is considering the shot in a Phase 3 trial. The company’s current Covid shot is the only commercially available product.

Both Pfizer and Moderna are counting on a new list of combination vaccines, which are expected to provide strong protection against Covid and certain respiratory diseases in a single dose.

Dolsten said there is an increased need for this type of snapshot as certain shifts in society create a “more thriving environment” for infection.

Climate change is causing the Earth’s temperature to rise. Populations live longer but become more susceptible to disease as they age. An increasing number of people are moving within countries and across borders.

These factors contributed to the spread of different diseases, Dolsten said, sometimes at the same time. The United States, for example, experienced a so-called trio of Covid, respiratory syncytial virus and influenza last winter.

Dolsten said that people may not remember or even feel comfortable taking three different doses for those respiratory illnesses on a yearly basis. So making a shot that helps people fight off more than one of them at a time will “make life easier for them,” he says.

Pfizer and BioNTech are developing a vaccine that will target both Covid and influenza. The companies began trialing the first phase of the shot in November and said they expect to launch it in 2024 or later.

Dolsten said the drugmakers are also conducting clinical trials for another dose that targets Covid and RSV. He noted that Pfizer is first hoping to win FDA approval for its RSV vaccine for seniors later this month.

Meanwhile, Moderna’s shot, which targets Covid and influenza, is in early clinical trials. Another shot that protects against influenza and RSV is also in that early stage. Moderna is also developing a triple shot, which would target Covid, influenza, and RSV simultaneously.

Moderna’s combination vaccines could be available by 2025 at the earliest, Burton said, noting that the company still needs the Food and Drug Administration (FDA) to approve individual flu and RSV vaccines.

The public health benefit from combination vaccines would be “tremendous globally” because Covid, RSV and influenza can be fatal, according to Burton. He added that the convenience of those snapshots could encourage more people to take them.

“Having to get three different shots each and going to a drugstore chain multiple times, it can be stressful for people,” Burton told CNBC. “So to be able to have a single shot 3-in-1 or 2-in-1 – we know compliance and adherence are huge with one administration.”