If you want to create a new vaccine in super-quick time, don’t employ a specialist vaccine company.
That appears to be the takeaway from the pandemic after the three multinationals that make billions of dollars a year developing and selling jabs against hepatitis, mumps, chicken pox and pneumonia failed to land a punch in the fight against Covid.
GlaxoSmithKline PLC (LSE:GSK), Merck and Sanofi were outdone, despite their notable vaccine expertise, whilst the likes of Pfizer Inc, AstraZeneca PLC (LSE:AZN), Moderna Therapeutics Inc (NASDAQ:MRNA), Johnson & Johnson (NYSE:JNJ), BioNTech and Novavax became synonymous with vaccine success.
Why did three of the big four vaccine makers fail?
“You never really know why a big company failed – they’ve got no obligation to tell us,” says Proactive’s consultant healthcare analyst John Savin.
There are plenty of places where they could have gone wrong, including clinical or technical setbacks, problems with manufacturing or even commercial hiccups.
There is, however, one theme common to three of six successful Covid jab producers: Moderna and the Pfizer/BioNTech vaccines developed vaccines using messenger ribonucleic acid (mRNA).
Put simply, mRNA technology instructs the body to make part of the virus to provoke an immune response. It was a new and, at the time, untested means of tackling viruses.
AZ, J&J and Novavax were successful with a protein-based approach, the conventional method utilised in vaccine making that should have played to the strengths of our three failures.
So, how did less credentialed vaccine makers out-trump them with a similar approach?
One explanation may be that the unsuccessful trio didn't manage their respective trials very efficiently, according to Emma Ulker, director of institutional research at WH Ireland Capital Markets.
The vaccine winners, generally, overlapped study stages, which reduced risk and propelled them warp-speed to success.
Ulker, meanwhile, noted that the three vaccine laggards had “slow-moving processes of development”, and any holdups in the clinical trial timeline took longer to rectify.
Therefore, more time-consuming redevelopment phases became increasingly detrimental as setbacks piled up.
A third reason for the failed programmes was an “over-reliance on existing technology” and reluctance to outsource research and trials.
“The ones who rushed into this were not the big vaccine companies. They were companies that were interested in accelerating their technology,” said Peter Hotez, vaccine expert at the Baylor College of Medicine in the US.
It’s difficult for some of these colossal companies to innovate internally, Savin explained. Instead, they acquire knowledge to bridge the gap.
For Pfizer this bet paid off in spades after it shelled out to collaborate with Germany's BioNTech and invest in the latter's considerable expertise in the mRNA space.
“That's why you find these big companies paying a lot of money for start-up or established biotech companies that have got a good position in the marketplace because it's a way for them acquire lots of expertise,” Proactive's Savin said.
GSK, Merck and Sanofi didn't have that sort of foresight or corporate self-awareness and relied instead on proven trusted technologies “that perhaps simply were not adaptable to coronavirus,” Ulker said.
“Companies tend to rely on their proprietary technologies because they think they can trust them — and don’t want to infringe on rivals’ intellectual property,” added Mansoor Amiji, professor of pharmaceutical sciences at Northeastern University.
Will GSK, Merck and Sanofi ever succeed and why would they want to continue trying?
Merck last year decided it would stop developing formulations of Covid vaccines, but GSK and Sanofi are still trying.
The duo gave up the RNA approach and are now working in tandem to focus on protein-based vaccines.
GSK and Sanofi decided to think longer term, Savin said, as the virus will always need to be treated and the RNA vaccines are unsuitable for third world countries where a transferrable, effective and robust method is required.
“There’s a huge world out there that does need the Covid vaccine, so if you want a vaccine programme in Africa, a stable robust protein vaccine could be a lot more suited than the very hard to handle RNA vaccine,” the vaccine expert added.
Although the longer it takes to develop the harder it is likely to become. Clinical trials are harder to conduct as most people have already been exposed to Covid and the results must be outstanding to beat current data.
“It is now impossible to run vaccine trials as there is herd immunity in the unvaccinated, high and boosted vaccination levels in most people, low serious hospitalisation rates, reinfections, variations and then flu and RSV [respiratory syncytial virus] to complicate matters further,” Savin explained.
So, what did we learn?
GlaxoSmithKline, Merck and Sanofi were late to the party in experimenting with RNA, which turned out to be the most effective vaccine.
The unsuccessful trio also failed to innovate and outsource due to an over-reliance on existing technologies, while their procedures adopted were slower.
Who knows if GSK and Sanofi will ever succeed but they failed to finish the first race and that leaves them at the back of the pack frantically trying to develop an approvable vaccine for third world countries.