How drugmakers are still making money from COVID‑19 vaccines three years on

COVID‑19 has not gone away and continues to claim lives. Manufacturers must update their vaccines to match new strains, while the United States – which has sharply cut spending on everything from vaccination to research – is forced to change course and act largely on guesswork. Despite all the challenges in the US market, vaccine makers do not want to lose it: although profits are nowhere near pandemic levels, they are still earning substantial revenue.

The FDA recommended using vaccines targeting the LP.8.1 strain for the 2025‑2026 season. Last week, it called for updating COVID‑19 vaccines for the 2026‑2027 immunisation campaign to target the dominant XFG variant – despite concerns from some staff about limited data on currently circulating strains.

According to the US Centers for Disease Control and Prevention, up‑to‑date information is currently unavailable due to a low number of samples available for sequencing. The latest update, just one month old, showed that XFG strains already accounted for more than half of US cases in the four weeks ending April 11.

CDC data show that only about 18% of Americans received a COVID‑19 booster in the 2025‑2026 season, even though the virus continues to kill tens of thousands of people each year – including between 8,000 and 12,000 adults aged 50 to 64.

Vaccine sceptic Health Secretary Robert F. Kennedy Jr. kept the VRBPAC committee intact, but disease monitoring was scaled back. In 2025, the FDA tightened requirements for COVID‑19 vaccine use, including demanding large‑scale, placebo‑controlled trials in the 50‑64 age group before recommending the vaccine.

Four COVID‑19 vaccines are approved for use in the United States: Moderna’s NEXSPIKE and Spikevax, Pfizer‑BioNTech’s Comirnaty, and the Novavax‑Sanofi vaccine.

Pfizer and BioNTech suspended a large‑scale trial of their updated COVID‑19 vaccine in April this year, saying that the number of participants – approximately 25,000‑30,000 – was too low to generate the necessary data.

Moderna is conducting a similar study in the United States, needing to recruit 30,000 volunteers, and is also struggling with enrolment. The trial is expected to be completed in June 2027.

Comirnaty generated more than $140 billion in revenue for the companies during the pandemic years of 2021‑2023. The drug became the world’s best‑selling medicine. Pfizer reported record revenue of $37.8 billion in 2022, while BioNTech’s revenue for the same year was €17.3 billion. By 2025, their vaccine revenue had fallen sharply.

Moderna earned $43.6 billion from its vaccine in 2021‑2023. Spikevax sales fell to $3.1 billion in 2024 and to $1.9 billion in 2025. Having lost a significant share of the US market due to health department actions, Moderna pivoted to Europe. In the first quarter of 2026, the company beat Wall Street revenue forecasts thanks to overseas COVID‑19 vaccine sales. Moderna’s revenue more than tripled year‑on‑year to $389 million, with nearly 80% coming from international sales, including Britain, Canada and Australia.

Moderna confirmed its 2026 revenue growth forecast of up to 10%, with about half coming from the United States – down from 62% last year. However, for the second quarter of this year, the company expects $50‑100 million, evenly split between the US and international markets, below analyst expectations of $130.6 million.

Moderna is betting on its respiratory disease vaccines, including a combined COVID‑19 shot, as well as a personalised cancer vaccine being developed with Merck.

In April, Moderna received European approval for its COVID‑19 vaccine mCombriax for adults aged 50 and over. Europe also plans to update its vaccines for the 2026‑2027 season to target the XFG variant within the existing Omicron‑related family.

COVID‑19 vaccines still help prevent severe disease and death, but updating them to better match circulating variants could increase protection as the virus evolves, the European Medicines Agency said.

In Russia, according to RNC Pharma, 2.59 million doses of domestic COVID‑19 vaccines were released into circulation in 2025, compared with 5.88 million doses in 2024 and 13.23 million doses in 2023. By comparison, at the peak in 2021, the figure was 292.88 million doses.

According to RNC Pharma development director Nikolai Bespalov, only two vaccines were produced in 2025, with Convacel accounting for 95% of all doses and Sputnik Light the remaining 5%. In 2026, there has been just one delivery of Sputnik V – 65,400 doses.

In total, 21,700 packs of domestic coronavirus vaccines were sold in 2025 for nearly 97 million roubles, according to data from analytics firm Headway Company.