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Pfizer, which was the first company to receive emergency use authorization in the United States for its coronavirus vaccine, is now looking to booster shots to boost its profits.
As the tragedy of the COVID-19 pandemic was beginning to unfold in April 2020, Pfizer launched one of its largest ad campaigns in history, copyrighting the motto “Science Will Win.” But late last week, another group declared that they would ultimately clinch victory: a group of protesters outside of Pfizer’s New York headquarters, chanting again and again, “I believe that we will win.” The protesters were there fighting for a global victory against the virus—not just one for the wealthy few.
As the first company to receive emergency use authorization in the United States for its vaccine, Pfizer has played an undeniable role in thwarting the pandemic, developing and distributing its two-phase mRNA shot at record speed. But in the excitement of the company’s obvious contribution to public health, it’s easy to forget that Pfizer is a company; and that means Pfizer’s endgame is profit. In the last few weeks, that bottom line has become readily apparent. The company’s pitch for COVID booster shots—without substantial evidence for their medical need—could maintain Pfizer’s record-high revenues for years to come.
CEO and Greek physician Albert Bourla has assured investors that the recent lag in U.S. vaccinations was only temporary. “Beyond ’22 and ’23, first of all, we believe, as we said multiple times, that there will be a need for boosters,” he told shareholders at the Q1 earnings meeting in May. He went on to say that he believes “annual vaccinations,” or at least regular vaccinations, would likely be required.
Last week, Israel became the first country on Earth to begin a booster shot campaign, offering a third Pfizer jab to at-risk adults to counteract the delta variant, which has complicated suppression of the virus worldwide. And Pfizer set its hopes for an annual booster shot in motion by submitting a request for emergency use authorization to the Food and Drug Administration (FDA). But rather quickly, the FDA pushed back. In a joint statement from the FDA and the Centers for Disease Control and Prevention (CDC), they rebuked Pfizer’s call for boosters. “Americans who have been fully vaccinated do not need a booster shot at this time,” the statement said.
While its public image has soared with the vaccine rollout, occasionally Pfizer’s profit-minded side reveals itself.
In a private meeting last week, the FDA officially shot down Pfizer’s pitch. But the company will get a second chance this Thursday, when the CDC’s Advisory Committee on Immunization Practices is set to consider the need for additional doses for immunocompromised individuals, following the playbook from Israel. Although immunocompromised patients would be a significantly smaller market than the prospects of a blanket third booster shot, it could open the floodgates for future boosters.
Meanwhile, epidemiologists remain skeptical. “It was clearly premature to be making a claim for booster shots, let alone booster shots annually,” says Dr. Michael Carome, the director of Public Citizen’s Health Research Group, of Bourla’s claim about boosters. “We need to have evidence to support public-health decision-making, and for whom.”
It’s no secret that Pfizer hugely benefited from the pandemic. On December 8 of last year, its stock price surged to an annual high of $42—increasing by 8 percent in the span of a week. This came immediately after Pfizer and its German vaccine partner BioNTech announced preliminary results that their vaccine was over 90 percent effective. Pfizer’s stock received a similar boost last week when it announced that a third shot may buoy a patient’s protection against the virus, especially after six months. The glimmering hope of boosters—and future rounds of revenue—delighted investors.
While its public image has soared with the vaccine rollout, occasionally, such as during a global health care conference hosted by Barclays, Pfizer’s profit-minded side reveals itself. There, Carter Lewis Gould, a senior analyst at the British bank, asked Pfizer’s CFO and executive VP of global supply, Frank D’Amelio, whether the pharmaceutical company still planned to pursue “higher pricing” as the pandemic recedes. D’Amelio responded that the pharmaceutical giant viewed the vaccine as a “significant opportunity … from a pricing perspective.”
As of now, Pfizer is locked into a government contract with the U.S. Biomedical Advanced Research and Development Authority (BARDA), which paid nearly $2 billion for 100 million doses before the vaccine was approved, eliminating risk for the pharmaceutical company. And last December, BARDA ordered another 100 million doses at the same price. The deal comes out to $19.50 per dose.
Health policy experts say that Pfizer’s argument regarding the delta variant is nonsensical.
But according to D’Amelio, that’s just “pandemic pricing.” Without stringent drug-pricing controls in the United States, vaccines can sometimes cost tenfold the fleeting government-fixed rate the pandemic produced. In a Q4 earnings call last year, D’Amelio said Pfizer usually gets $150 or $175 per dose for a normal vaccine. He assured investors that “obviously, we’re going to get more on price.”
As of now, Pfizer’s main argument for a booster shot is the delta variant. According to the company’s preliminary findings, an additional shot after six months can increase a patient’s neutralizing antibodies against the delta variant specifically. In a recent press release, Pfizer cites the level of antibody titers, which are the proteins generated by the vaccine to fight off the virus, as the main reason to authorize a third shot.
But according to Dr. William Moss, the executive director of the International Vaccine Access Center and a professor at Johns Hopkins Bloomberg School of Public Health, waning antibody levels alone is not a sufficient argument for booster shots. “The strongest evidence for the need of increased booster doses is if we were to see greater breakthrough cases among people who are immunized,” he says. “And we’re not seeing that yet.”
After reading Pfizer’s statement on boosters, Dr. Carome also disputes the company’s claim. “The vaccine after two doses seems to seriously protect patients, especially against severe disease, with which we’re primarily concerned,” he says. “So there’s nothing here that makes a strong argument at all.” Pfizer’s statement also references data from the Israel Ministry of Health, but Carome says that even Israel’s data doesn’t show there is a level of breakthrough infections that warrants a booster shot.
When asked for comment, Pfizer stated that it had “a productive meeting with U.S. public health officials” and that both “Pfizer and the U.S. government share a sense of urgency in staying ahead of the virus.” The company says it will publish more definitive, peer-reviewed data in the coming weeks.
Health policy experts say that Pfizer’s argument regarding the delta variant is nonsensical. Aggressive variants have developed by and large in countries where the vaccination rate remains low. Three of the four “variants of concern,” as classified by the World Health Organization, originated from Brazil, India, and South Africa—all countries with less than 15 percent of their population fully vaccinated. And the variant that Pfizer explicitly cites as a main driver for booster shots, delta, is from India, which has notoriously low vaccination rates; less than 6 percent of the country is fully vaccinated.
Devoting resources and production to a potential third shot, while most of the world hasn’t even received a first shot, is the most recent instance of Pfizer’s drive for profit. Dr. Tedros Adhanom Ghebreyesus, the director-general of WHO, didn’t hold back in his disgust.
“While many countries haven’t even started vaccinating, and another country has already vaccinated the majority of the population with two doses and now moving to a third dose, which is the booster, it doesn’t even make any sense,” he said in a video posted to Twitter last week. “If there is one word that can explain it, it’s greed.”
