Picture: Cowen, Inc.

The road to recovery goes via vaccines and antibodies

If reopening the economy after the prolonged shutdown was the end of the beginning, then the successful development of vaccines and therapeutic antibodies has the potential to be the beginning of the end.

Consumer confidence to resume any semblance of a pre-virus level of activity will require vaccines or therapeutics that can be used prophylactically to prevent spread or at least mitigate disease severity. Vaccine development is in Hyperdrive and will have bumps.As biotech companies are progressing at a historic pace, including several with unproven technologies, there may likely be a high rate of failure among the over 150 vaccine candidates currently being studied. But that is ok and should in fact be expected and encouraged. The good news is that government and public funding in the U.S. and Europe and motivated regulatory agencies is expediting the time to market without sacrificing safety. More so, these funding sources are willing to partake in the risk associated with starting production months before final results are confirmed. Based on current progress, we expect at least one vaccine to be available for emergency use in Q4/20 and multiple vaccines available for high-risk populations in Q1/21. Inoculation of the general public will likely not begin until mid-’21, thereby giving us some roadmap as to when economic recovery will start.
A risk to the timing of the economic recovery pivots on the timelines for manufacturing scale up, but companies are making faster than expected progress on that front with more than a billion doses possible by the end of 2021 from Pfizer/BioNTech, Moderna, JNJ, AstraZeneca/Oxford University and GSK among others. Importantly, there could be a bottleneck in production if the raw materials become difficult to source. We estimate that hundreds of millions or even billions of doses will be needed since it is unlikely for the world to reach herd immunity in the next 1–2 years at the current infection rate.

Antibody therapy will be critical to bridge the gap before vaccines become widely available – antibody modalities are promising given historical successes.

Before a viable vaccine is developed, there will be a significant demand for a temporary solution that can protect people from the COVID-19. This will be especially true if the current trend of increasing hospitalizations continues. Antibody therapy should come in time to bridge the gap to vaccines since candidates are being developed by Regeneron using established technology that was used to develop therapies to treat other viral diseases. Other companies such as GSK/Vir, Lilly, Amgen, AbbVie, Abcella, Junshi and Celltrion have also joined the race. The market opportunity for antibody therapy appears larger than for vaccines, though both may disappoint.

The article was published in the European Biotechnology Magazine Summer Edition 2020..