Covid-19 prophylactic vaccines, preventative vaccines designed to immunise a population, continue to dominate the market, with Pfizer/BioNTech’s Comirnaty and Moderna’s mRNA-1273 in the top three marketed Covid-19 drugs by total forecast sales, and Johnson and Johnson’s (J&J’s) one-shot Covid-19 vaccine following them in third place.

Comirnaty remains the leading Covid-19 vaccine by total forecast sales, projected to reach $55bn between this year and 2027, where mRNA-1273 and J&J’s Covid-19 vaccine are forecast to make $38.9bn and $21.6bn respectively over the same time period. Comirnaty’s total sales are 41% greater than those of mRNA-1273 and 154% greater than those of J&J’s vaccine. It is also expected to lead by peak forecast sales, projected to reach $30.2bn this year, with mRNA-1273 forecast peak sales of $9.3bn this year, which is 3.2 times less than Comirnaty. J&J’s Covid-19 vaccine has the lowest forecast peak sales of $3.4bn next year, which is 8.9 times less than Comirnaty. Comirnaty is currently considered the gold-standard vaccine, with greater than 90% efficacy in preventing Covid-19. Its large, estimated sales, especially its peak forecast sales this year, are primarily driven by various vaccination programs occurring worldwide.

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Comirnaty’s main competitor by total forecast sales, mRNA-1273, also has an efficacy of over 90% in preventing Covid-19 and uses the same mRNA technology. It was awarded an emergency use authorisation (EUA) in the US on 18 December, a week after Comirnaty, making it the second Covid-19 vaccine approved worldwide. J&J’s Covid-19 vaccine, unlike the other two vaccines, uses recombinant vector technology and has a lower efficacy of 67% against Covid-19. It was awarded an EUA in the US on 27 February, almost three months after Comirnaty and mRNA-1273, and has since received full approval in the EU and South Korea. Unlike Comirnaty and mRNA-1273, J&J’s vaccine requires only one dose rather than two, allowing for a much quicker vaccination of a population, which is why it has displayed such strong sales despite its lower efficacy.

mRNA-1273 is projected to overtake Comirnaty by 2023 with forecast sales of $5.1bn, more than $1bn more than Comirnaty’s sales by 2023, and will take the first place in Covid-19 prophylactic vaccines by forecast sales between 2023 and 2027.  This is due to Comirnaty’s forecast sales declining at a faster rate than mRNA-1273’s from this year. In a similar fashion, J&J’s Covid-19 vaccine is projected to maintain its sales more than either of the other vaccines, with sales fluctuating by only $500m from its peak sales of $3.4bn between next year and 2027, allowing it to also overtake Comirnaty in sales from 2026 onwards.

Prophylactic vaccines currently dominate the market, with Comirnaty being the top vaccine by total forecast sales. Competition from other vaccines possibly entering the market in the future may, however, mean the leading drugs continue to change in future forecasts.