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Moderna COVID-19 Vaccine

Generic Name
Moderna COVID-19 Vaccine
Brand Names
Spikevax
Drug Type
Biotech
Unique Ingredient Identifier
EPK39PL4R4
Background

The Moderna COVID-19 Vaccine (mRNA-1273) is a novel mRNA-based vaccine encapsulated in a lipid nanoparticle that encodes for a full-length pre-fusion stabilized spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronavirus disease 2019 (COVID-19) is a highly contagious infectious disease caused by the novel coronavirus, SARS-CoV-2, leading to a respiratory illness alongside other complications. COVID-19 has high interpatient variability in symptoms, ranging from mild symptoms to severe illness. A phase I, open-label, dose-ranging clinical trial (NCT04283461) was initiated in March 2020 in which 45 subjects received two intramuscular doses (on days 1 and 29). This trial was later followed by phase II and III trials, where the Moderna COVID-19 Vaccine demonstrated vaccine efficacy of 94.1%.

On December 18, 2020, the FDA first issued an emergency use authorization (EUA) for the Moderna COVID-19 Vaccine as the second vaccine for the prevention of COVID-19 caused by SARS-CoV-2 in patients aged 18 years and older, after the EUA issued for the [Pfizer-BioNTech Covid-19 Vaccine] on December 11, 2020. The Moderna COVID-19 Vaccine is administered as a series of two intramuscular injections, one month (28 days) apart. In clinical trials, there were no differences in the safety profiles between younger and older (65 years of age and older) study participants. On December 23, 2020, Health Canada issued an expedited authorization for the Moderna COVID-19 Vaccine.

In November 2021, Health Canada and the EMA authorized the use of the Moderna COVID-19 vaccine as a booster shot to be given at least six months following the primary vaccination series and at half (50 mcg) of its regular strength. A similar booster dose is also available in the US for patients 18 years of age and older. The Moderna COVID-19 Vaccine was fully approved by the FDA on January 31, 2022 and Health Canada expanded the use of the Moderna COVID-19 Vaccine to include individuals aged six to 11. The Moderna COVID-19 vaccine is also approved for use as a fourth booster shot in adults 50 years of age and older.

Indication

The Moderna COVID-19 Vaccine is indicated for active immunization to prevent coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in individuals 18 years of age and older in the US and Europe, and in individuals 6 months of age and older in Canada. In the US, under the emergency use authorization, the Moderna COVID-19 Vaccine is used for the prevention of COVID-19 in children 6 months of age and older.[L42770]

It is administered in two doses, one month (28 days) apart. A booster dose of the vaccine, to be given at least 6 months following the initial vaccine series, is approved for use in all patients 18 years of age and older in Canada and the US. The Moderna COVID-19 vaccine is also approved for use as a fourth booster shot in adults 50 years of age and older.

A bivalent formulation of the Moderna vaccine which includes davesomeran - targeting the BA.4 and BA.5 Omicron variants - was approved in August 2022 by the FDA and in November 2022 by Health Canada. In Canada, an additional bivalent formulation which includes imelasomeran - targeting the BA.1 Omicron variant - was approved in September 2022, and may be used as a booster dose in individuals ≥6 years of age.

Associated Conditions
Coronavirus Disease 2019 (COVID‑19)

FDA Requests Additional Trial for Novavax COVID-19 Vaccine Before Full Approval

• The FDA has asked Novavax to conduct an additional randomized, controlled study of its COVID-19 vaccine NVX-CoV2601 before considering full approval, despite the vaccine having emergency use authorization since 2022. • Interim results from a phase 2/3 study showed Novavax's updated XBB.1.5 variant vaccine generated 5.8 times higher neutralizing antibody levels compared to the original formulation, with a favorable safety profile. • The FDA's request represents a significant setback for Novavax, which had expected approval based on prior conversations with regulators and had already passed its April 1 PDUFA date.

Pfizer and BioNTech Seek FDA Authorization for COVID-19 Vaccine in Young Children

• Pfizer and BioNTech have submitted an Emergency Use Authorization (EUA) to the FDA for their Omicron BA.4/BA.5-adapted bivalent COVID-19 vaccine for children aged 6 months to 4 years. • The application aims to address the recent surge in respiratory diseases among young children, with the updated vaccine potentially preventing severe illnesses and hospitalizations. • If authorized, the primary series for this age group would consist of two initial doses of the original vaccine, followed by a third dose of the Omicron BA.4/BA.5-adapted bivalent vaccine. • The bivalent vaccine is already authorized as a booster for individuals 5 years and older in the US and EU, offering broader protection against emerging variants.

Moderna Begins Phase 3 COVE Study for COVID-19 mRNA Vaccine

Moderna, Inc. has initiated the Phase 3 COVE study of its mRNA vaccine candidate, mRNA-1273, against COVID-19, in collaboration with NIAID, NIH, and BARDA. The study aims to evaluate the vaccine's efficacy and safety, with plans to enroll approximately 30,000 participants in the U.S.

mRNA Delivery to CD34+ Cells via Lipid Nanoparticles Shows Promise in Rhesus Monkeys

• Researchers demonstrated successful mRNA delivery to CD34+ hematopoietic stem cells in rhesus monkeys using lipid nanoparticles (LNPs). • The study achieved efficient in vivo mRNA delivery without the need for prior stem cell isolation or transplantation. • Single-cell RNA sequencing validated mRNA expression in targeted CD34+ cells, indicating potential for gene therapies. • This approach could revolutionize treatment strategies for inherited blood disorders and immune deficiencies.

Autoantibodies to Protein S Linked to Coagulopathy Following COVID-19 Vaccination

• A new study identifies autoantibodies against protein S as a potential cause of coagulation-related adverse events following COVID-19 vaccination. • Researchers compared patients with coagulation issues post-vaccination to healthy controls and those with other adverse events. • The study utilized bead-based assays and ELISA to detect autoantibodies, confirming protein S autoantibodies in a subset of patients. • Functional assays suggest these autoantibodies impair protein S activity, potentially explaining the observed coagulopathy.

Moderna's mRNA Norovirus Vaccine Enters Phase 3 Trial

• Moderna's mRNA-1403 norovirus vaccine has entered a pivotal Phase 3 trial, evaluating its efficacy, safety, and immunogenicity in adults. • The global trial, named Nova 301, aims to enroll approximately 25,000 participants, focusing on adults aged 60 years and older. • mRNA-1403 is a trivalent vaccine designed to protect against multiple norovirus genotypes, addressing a significant public health concern. • Interim Phase 1/2 data showed promising safety and immunogenicity, supporting the Phase 3 trial's initiation and potential for regulatory submission in 2026.

FDA Approves Updated COVID-19 Vaccines Targeting Omicron Subvariants for 2024-2025 Season

• The FDA has approved updated mRNA COVID-19 vaccines from Moderna (Spikevax) and Pfizer-BioNTech (Comirnaty) targeting the Omicron KP.2 subvariant for the 2024-2025 season. • Novavax's updated protein-based COVID-19 vaccine, targeting the Omicron JN.1 subvariant, has also received emergency use authorization for individuals 12 years and older. • The updated vaccines are formulated to provide improved protection against currently circulating variants, addressing waning immunity from previous exposure or vaccination. • Health officials recommend that everyone aged 6 months and older receive a COVID-19 vaccine, particularly those at higher risk of severe illness.

Urticaria Emerges as Concern in Phase 1 Trial of HIV mRNA Vaccines

• Seven percent of participants in a phase 1 trial of experimental HIV-1 mRNA vaccines developed urticaria, with four cases remaining unresolved after 12 months of follow-up. • The study evaluated three investigational HIV-1 trimer mRNA vaccines at different doses in 108 healthy volunteers, with most adverse events being mild to moderate in severity. • All participants who developed urticaria had previously received Moderna COVID-19 vaccines, suggesting a potential correlation that warrants further investigation in future mRNA vaccine development.

Novavax COVID-19 Vaccine Targeting JN.1 Authorized for Emergency Use in the U.S.

• The FDA has granted Emergency Use Authorization (EUA) for Novavax's updated COVID-19 vaccine (NVX-CoV2705) for individuals aged 12 and older. • The updated vaccine targets the JN.1 variant and demonstrates cross-reactivity against JN.1 lineage viruses, including KP.2.3, KP.3 and LB.1. • The CDC has recommended the use of 2024-2025 COVID-19 vaccines, including Novavax's, for individuals six months and older, regardless of specific viral strains. • The Novavax vaccine will be available in pre-filled syringes at various locations nationwide, including pharmacies and grocery stores.

Pfizer-BioNTech COVID-Flu Combo Vaccine Faces Setback Due to Influenza B Response

• Phase 3 trial of Pfizer-BioNTech's combined COVID-19 and influenza mRNA vaccine reveals suboptimal antibody response for influenza B component, necessitating formula adjustments. • The 8,000-subject study aimed to demonstrate non-inferiority to existing Comirnaty COVID-19 vaccine and standard flu vaccines, following promising phase 1/2 results. • Setback potentially opens opportunity for Moderna, whose competing COVID-flu combination vaccine showed superior immune responses in Phase 3 trials, targeting potential approval by 2025-2026.

Moderna's Combination Flu-COVID Vaccine Shows Superior Immune Response in Phase 3 Trial

• Moderna's mRNA-1083 combination vaccine demonstrated significantly higher immune responses against influenza strains and SARS-CoV-2 compared to standard vaccines in adults 50 years and older. • The Phase 3 trial met all primary endpoints with particularly strong results in adults 65+ where the combination vaccine outperformed Fluzone HD for influenza and Spikevax for COVID-19 protection. • The vaccine showed an acceptable safety profile with mostly mild to moderate side effects, positioning Moderna as the first company with positive Phase 3 data for a combination respiratory vaccine.

Advances in mRNA-Based Cancer Vaccines

Recent progress in mRNA-based cancer vaccines highlights their potential in cancer immunotherapy, leveraging the immune system to target and eliminate cancer cells. This review covers advancements in neoantigen discovery, adjuvant identification, delivery materials, and ongoing clinical trials, offering insights into future directions for mRNA vaccine applications in cancer treatment.

Moderna's Combo COVID-19 and Flu Vaccine Shows Promising Results in Early Trial

• Moderna announced positive data from an early-stage study of its mRNA-based combination vaccine for COVID-19 and influenza, showing similar or stronger immune responses compared to standalone vaccines in older adults. • The company plans to begin Phase 3 trials of the combination vaccine later this year, with regulatory approval targeted for 2025, potentially simplifying the complicated vaccination schedule for respiratory diseases. • This development aligns with Moderna's broader respiratory franchise strategy, which expects $8-15 billion in sales by 2027 and includes successful Phase 3 results for standalone flu vaccine mRNA-1010.

COVID-19 Vaccine Landscape: mRNA and DNA Vaccine Efficacy and Development

• mRNA vaccines like Pfizer-BioNTech's BNT162b2 and Moderna's mRNA-1273 have demonstrated high efficacy (72-95%) against moderate-to-severe COVID-19 in adults, with ongoing studies evaluating their effectiveness against emerging variants. • DNA vaccines, including Zydus Cadila's ZyCov-D, have shown promise with good safety profiles and the ability to induce neutralizing antibodies and cellular immune responses, offering a cost-effective alternative, especially in developing countries. • Studies indicate that extending the interval between doses of mRNA vaccines may enhance immune responses, particularly in previously uninfected individuals, although the recognition of variants like Omicron may decline more rapidly. • Booster doses of mRNA vaccines, such as BNT162b2, have been shown to significantly improve neutralizing titers against Omicron variants, supporting a three-dose regimen for enhanced protection.

Phase 2/3 Study Shows Robust Immunogenicity of NVX-CoV2601 in Vaccine-Naive Individuals with Prior SARS-CoV-2 Infection

A phase 2/3 open-label study demonstrates that a single dose of the monovalent XBB.1.5 vaccine, NVX-CoV2601, elicits robust immunogenicity in vaccine-naive individuals with prior SARS-CoV-2 infection, comparable to those previously vaccinated with mRNA vaccines. The study, involving participants across 30 US sites, found no new safety signals and supports the use of single doses of NVX-CoV2601 for immunity against SARS-CoV-2, regardless of prior vaccination history.

A Reflection on the COVID-19 Vaccine

The article reflects on the emotional journey of a healthcare professional receiving the COVID-19 vaccine, highlighting the mix of fear, guilt, admiration, and hope experienced during the pandemic. It also discusses the importance of vaccines in saving lives and the personal responsibility to lead by example in promoting vaccination.

mRNA Vaccines: How Moderna and Pfizer-BioNTech Revolutionized COVID-19 Immunization

• Moderna and Pfizer-BioNTech developed mRNA-based COVID-19 vaccines with efficacy rates exceeding 90%, representing a breakthrough in vaccine technology during the pandemic. • Both vaccines use lipid nanoparticle technology to deliver mRNA instructions that teach cells to produce the coronavirus spike protein, triggering a protective immune response without causing infection. • The vaccines require different storage conditions, with Pfizer's needing ultra-cold temperatures of -94°F (-70°C) while Moderna's remains stable at -4°F (-20°C), affecting global distribution logistics.
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