mRNA-3927

导读：新冠疫苗巨头之一——Moderna（莫德纳）的发展离不开Flagship Pioneering（旗舰先锋）这家独特眼光的投资公司的大力支持。Moderna的突然崛起也让Flagship再次走进大家的视野。 Flagship Pioneering是一家生物技术投资公司，以鼓励创新项目的落地和转化。自2000年成立以来，Flagship通过旗下的Flagship Labs部门发起并孵化了超过100家科技企业，包含20多家上市企业。 Flagship具有特色的投资和运营模式，分为四个阶段： nExplorations（探索阶段）：Flagship团队人员就各种前沿技术提出科学假设，并不断的优化迭代，直至产生突破性的想法和技术； nProtoCos（原型公司）：有前景的设想会在Flagship Labs立项，并赋予一个FL/LS编号，也是他们后期成立初创公司的“雏形”； nNewCo（初创型企业）：当设想被验证成功，Flagship会为其投资，该项目将会作为初创公司成立； nGrowthCo（成长型企业）：随着项目的开展，公司逐渐成长，吸引到外部投资者或合作伙伴。 目前，Flagship孵化的企业包括mRNA技术、核酸递送技术和AI药物开发技术。本期文章，菌菌将关注于mRNA领域，盘点顶级风投Flagship孵化的mRNA企业。 01 Moderna：mRNA疫苗/药物 2010年，麻省理工学院（MIT）化学工程学院教授Bob Langer向Flagship的创始人兼首席执行官（CEO）Noubar Afeyan介绍了“mRNA成药”的设想，由此成立了一家概念验证阶段的合资公司，代号为LS18，意为Afeyan创立的生命科学（Life Science）领域的第18家公司。 随后，LS18被重新命名为Moderna（名称来源于modified RNA），他们的核心技术为使用修饰mRNA在体内表达蛋白，潜在应用领域包括传染病和肿瘤免疫疗法等。 自2014年以来，Moderna成立了多家合资公司，分别聚焦于不同的疾病领域，如专注于mRNA肿瘤疗法的Onkaido Therapeutics、专注于传染病mRNA疫苗的Valera、专注于罕见病mRNA疗法的Elpidera、个性化肿瘤治疗的Caperna。Moderna还通过收购日本OriCiro Genomics获得了无细胞合成DNA的技术。 截止目前，Moderna已将2个mRNA热门管线推至上市，包括新冠疫苗Spikevax（mRNA-1273）和RSV疫苗mRESVIA（mRNA-1345），将有效减轻呼吸道疾病带来的社会负担。此外，Moderna多个管线处于后期临床阶段（2期至3期），包括流感疫苗（mRNA-1010、mRNA-1020、mRNA-1030、mRNA-1011、mRNA-1018）、巨细胞病毒CMV疫苗（mRNA-1647）、单纯疱疹病毒HSV疫苗（mRNA-1608）、带状疱疹VZV疫苗（mRNA-1468）、诺如病毒疫苗（mRNA-1403、mRNA-1405）、莱姆病疫苗（mRNA-1975、mRNA-1982）、寨卡病毒疫苗（mRNA-1893）、癌症疫苗（mRNA-4157、mRNA-4359）、蛋白替代疗法（mRNA-3927、mRNA-3705）等。 表1 Moderna临床2-3期管线汇总 02 Sail：环状mRNA疫苗/药物 Sail Biomedicines成立于2023年，由Falgship孵化的两家公司（环状mRNA公司Laronde与纳米颗粒递送 & AI平台型公司Senda）合并而成。 Sail的环状RNA平台依托于原Laronde公司，这一环状RNA平台被命名为Endless RNA（eRNA），最初由Avak Kahvejian博士团队开发。他们的研究起始于天然环状长链非编码RNA（lncRNA）的发现，随后专注于工程化改造的环状RNA和可编码环状mRNA。2021年，Laronde吸引到4.4亿美元的融资，包括Flagship Pioneering以及其他公共和私人投资者。 原Senda公司的最初研究方向为利用微生物组与人的互作实现疾病治疗，公司同时积累了丰富的AI经验。在一轮关键的融资后，Senda的研究转向了天然纳米颗粒的开发，用于RNA等药物的定向递送。 Sail的成立旨在整合平台资源，借助可编程的endless RNA（eRNA）技术、纳米颗粒和新兴独家AI技术，以释放环状mRNA药物的广泛潜力。 2024年1月份，Sail公开了他们近期的管线开发计划： 其一是疟疾预防和治疗，他们将基于创新型Endless RNA（eRNA）平台开发疟疾疫苗、以及编码单克隆抗体的eRNA药物。该项目获得了比尔和梅琳达·盖茨基金会的资助。 其二是囊性纤维化（CF）治疗，他们设计了一种编码功能性全长囊性纤维化跨膜传导调节因子（CFTR）的eRNA。早期研究数据显示，eRNA介导产生的CFTR蛋白表达水平和持续时间比线性mRNA更高、更长。该项研究由囊性纤维化基金会（CF Foundation）资助。 环状RNA专利方面，Flagship/Sail在circRNA结构设计、递送方案和circRNA应用等多个方面均有布局。 表2 Flagship/Sail在circRNA领域的专利组合布局 03 Omega：mRNA表观遗传疗法 Omega Therapeutics成立于2017年，是由Flagship孵化的一家临床阶段药物研发公司。Omega公司开创性地将mRNA用于靶基因的表观遗传调控，有望用于治疗或治愈多种疾病。 基于mRNA的OEC表观基因组控制子（OMEGA Epigenomic Controllers）是Omega公司的核心技术。OEC是一种模块化、可编程的mRNA疗法，其中mRNA编码一种由DNA结合域和表观遗传效应子蛋白组成的融合蛋白。该效应子能够通过多种表观遗传机制来控制基因表达的各种调节因子，例如 DNA 甲基化/去甲基化和控制染色质状态的机制（例如组蛋白修饰、乙酰化等）。 OTX-2002是Omega公司的代表性管线之一，利用mRNA表达靶向MYC基因的两个表观遗传控制子，目标适应症是肝细胞癌（HCC）。Omega此前公布了OTX-2002的临床前数据，揭示了OTX-2002在多种体外和体内模型中的作用机制和抗肿瘤活性。OTX-2002被FDA授予孤儿药称号，目前在开展1/2期临床研究。 图1 Omega公司OEC表观基因组控制子的结构特征 04 Tessera：mRNA基因编辑疗法 Tessera Therapeutics是由Flagship投资的另一家生物技术公司，此前已完成超5亿美元的融资。Tessera的技术特色在于一种新型基因治疗平台——“Gene Writing”（基因编写），利用该平台能够实现任何基因的删除或插入，具备治愈遗传病的潜力。结合脂质纳米颗粒（LNP）这一新型递送系统，Tessera正在探究该平台用于体内基因编写、体内基因重编写和体外基因编写的应用潜力。 2024年，Tessera在多个学术会议上公开了最新研究成果。借助T细胞靶向性LNP，他们将基于RNA的基因编写器直接递送至体内，并且在体内生成CAR-T细胞。造血干细胞（HSC）靶向的LNP能够将靶向镰状细胞突变的RNA基因编写器递送至体内，完成了RNA基因编写器治疗镰状细胞病（SCD）的体内概念验证。Tessera的另一研究项目是一种肝脏单基因遗传病——α-1抗胰蛋白酶缺乏症（AATD），Tessera平台优化后的RNA基因编写器成功校正了肝细胞中的基因组DNA。目前该项目已完成非人灵长类动物（NHP）的体内概念验证。 05 Repertoire：mRNA自免耐受疫苗 与Sail的成立类似，Repertoire也是由两家初创生物技术公司合并而成——Cogen Immune Medicine和Torque Therapeutics。其中Cogen专注于开发T细胞和免疫分析技术，随后衍生得到DECODE平台；而Torque聚焦于新型细胞免疫疗法。 Repertoire的成立，建立了一个T细胞受体（TCR）表位发现平台“DECODE”以及基于mRNA-LNP平台，专注于开发自身免疫性疾病的替代疗法。 2024年4月份，Repertoire宣布与百时美施贵宝（BMS）达成战略合作协议，开发针对自身免疫性疾病的耐受疫苗（Tolerizing vaccine）。耐受疫苗由编码抗原表位的mRNA和编码免疫调节因子的mRNA组成。耐受疫苗的作用机制是：通过触发机体内抗原特异性调节性T细胞的扩增，从而抑制免疫反应，恢复体内平衡，直接解决自身免疫疾病的真正驱动因素。耐受疫苗的成功有望在低给药频率下实现持久的效应，将改变自身免疫性疾病的管理模式。 06 结语 总体而言，Flagship Pioneering投资模式无疑鼓励了前沿性生物科技的成果转化，其孵化的mRNA创新企业均具备特色的技术风格。Moderna基于修饰mRNA，深耕于mRNA疫苗和蛋白替代疗法；Sail搭建了mRNA的2.0版本——环状RNA平台，将基于这一更稳定的结构释放RNA疗法的广阔潜力；Omega、Tessera和Repertoire则将mRNA-LNP技术应用于更前沿的基因疗法或细胞免疫疗法，期待改善遗传性疾病和自身免疫疾病的治疗模式。 识别微信二维码，添加生物制品圈小编，符合条件者即可加入 生物制品微信群！ 请注明：姓名+研究方向！ 版 权 声 明 本公众号所有转载文章系出于传递更多信息之目的，且明确注明来源和作者，不希望被转载的媒体或个人可与我们联系(cbplib@163.com)，我们将立即进行删除处理。所有文章仅代表作者观点，不代表本站立场。

Focuses on ten product approvals through 2027 Expects to submit next-generation COVID vaccine for approval in 2024 Expects to submit flu/COVID combination vaccine for approval in 2024 Announces positive Phase 3 results for its RSV vaccine for high-risk adults aged 18 to 59; expects to submit sBLA for U.S. approval in 2024 Announces positive Phase 3 results for its standalone flu vaccine for adults aged 65 and older relative to high-dose licensed comparator Announces norovirus vaccine advances into Phase 3 study, bringing the total of non-respiratory pivotal stage programs to five, across oncology, rare diseases and first-in-class vaccines Implements portfolio prioritization and cost efficiencies to reduce R&D expense by $1.1 billion, from $4.8 billion in 2024E to $3.6-3.8 billion in 2027 Updates and extends financial framework through 2028 CAMBRIDGE, MA, USA I September 12, 2024 I Moderna, Inc. (NASDAQ:MRNA) today announced program and financial updates demonstrating progress and strategic prioritization of its mRNA pipeline at its annual R&D Day event. The updates include data readouts in the Company’s respiratory vaccine portfolio and a revised financial framework. “Moderna now has five respiratory vaccines with positive Phase 3 results and expects to submit three for approval this year. In addition, we have five non-respiratory products in pivotal studies across cancer, rare diseases and latent vaccines with potential for approval by 2027. Our demonstrated probability of success in R&D has been higher than industry standards at every stage of development,” said Stéphane Bancel, CEO of Moderna. “The size of our late-stage pipeline combined with the challenge of launching products means we must now focus on delivering these 10 products to patients, slow down the pace of new R&D investment, and build our commercial business.” Research and Development Strategy Over the past three years, Moderna’s robust pipeline has achieved milestones across multiple late-stage clinical trials, and its early-stage portfolio has produced proof-of-concept data with multiple candidates ready for pivotal studies. Moderna’s rate of success in research and development has been higher than the traditional biopharmaceutical industry. The Company’s combined probability of success across its mid- and late-stage pipeline is approximately 66% compared to the industry average of approximately 19%.[1] Moderna’s broad clinical success and recent commercial challenges necessitate a more selective and paced approach to its research and development investment. Through portfolio prioritization and cost efficiencies, the Company expects to reduce annual research and development expense by approximately $1.1 billion starting in 2027. During this time, Moderna will expand its commercial portfolio into oncology, rare diseases, and first-in-class non-respiratory vaccines. The Company expects this strategy to yield 10 product approvals over the next three years. Specifically, in 2021-2023, Moderna invested proceeds from its pandemic-era vaccine sales into building a diverse pipeline and established the market for its COVID-19 vaccine, Spikevax®. In 2023-2026, the Company is establishing a portfolio of five commercial respiratory vaccines that address viruses with the greatest burden of disease. Its RSV vaccine mRESVIA® was approved this year, and its investigational next-generation COVID-19 vaccine, combination flu/COVID vaccine, and RSV vaccine for high-risk younger adults, are moving toward regulatory submissions in 2024. Looking ahead to 2026-2028, Moderna will expand its commercial portfolio with first-in-class vaccines and therapeutics to address non-respiratory diseases, including cytomegalovirus, norovirus, propionic acidemia, methylmalonic acidemia, and melanoma. Updates from Moderna’s late-stage portfolio and approved vaccines include: Respiratory Virus Vaccines COVID-19 According to the U.S. Centers for Disease Control and Prevention, COVID-19 causes three times more hospitalizations than flu in people aged 65 years and older.[2] Additionally, more than 95% of adults hospitalized in 2023-2024 due to COVID-19 had no record of receiving the latest vaccine.[3] People who are hospitalized may experience a significant impact on their quality of life, including loss of muscle mass, decline in daily activity, risk of hospital readmission and death. Additionally, Long COVID data also suggest even traditionally low-risk groups should be vaccinated.[4] More than 200 symptoms of Long COVID have been reported, such as anxiety, brain fog and extreme fatigue, and Long COVID can impact many different parts of the body, including the brain, heart and lungs. Moderna continues to address the needs of the endemic COVID-19 market by supporting public health efforts to drive vaccination coverage rates to reduce the substantial burden of COVID-19 as well as by advancing next-generation vaccines. The Company’s mRNA platform produced variant-matched vaccines on an accelerated time horizon to help ensure the availability of Spikevax targeting the two selected strains this season. The updated Spikevax formulas have been approved or authorized in multiple regions including the U.S., Taiwan, Japan, the UK, Switzerland, the United Arab Emirates, South Korea and Israel. Positive results from the NEXTCove Phase 3 trial in participants aged 12 years and older showed that Moderna’s next-generation COVID-19 vaccine, mRNA-1283 , demonstrated non-inferior relative vaccine efficacy (rVE) compared to Spikevax, with a positive point estimate of 9.3% (99.4% CI: -6.6, 22.8). rVE was highest at 13.5% (95% CI: -7.7, 30.6) in participants aged 65 years and older. mRNA-1283, which is designed to have enhanced stability in refrigerated conditions and will be packaged in pre-filled syringes, paves the way for a combination vaccine against flu and COVID-19, enhancing the Company’s overall respiratory portfolio. The Company expects to file for approval in 2024 and intends to use a Priority Review Voucher. Respiratory Syncytial Virus (RSV) In addition to acute mortality and morbidity, RSV infection is associated with long-term sequelae such as exacerbation of chronic obstructive pulmonary disease in older adults. In the U.S., each year there are up to 160,000 hospitalizations and 10,000 deaths in adults 65 years and older due to RSV.[5] Across high-income countries in 2019, RSV caused an estimated 5.2 million cases, 470,000 hospitalizations and 33,000 in-hospital deaths in adults 60 years and older.[6] In the younger adult population, potential risk factors such as chronic obstructive pulmonary disease (COPD), asthma, diabetes and obesity may cause an increased risk for RSV disease. Moderna’s RSV vaccine, mRESVIA (mRNA-1345) , has been approved for adults aged 60 years and older in the U.S. and EU. mRNA-1345 is in an ongoing Phase 3 study (P303) designed to test immunogenicity and safety in high-risk adults 18 to 59 years of age. In the trial, mRNA-1345 met all primary immunogenicity endpoints and the 50 µg dose, which is the same for the currently approved mRESVIA vaccine for adults 60 years and above, was well tolerated with no safety concerns identified. The Company intends to file a supplemental Biologics License Application (sBLA) for U.S. approval in 2024 to extend the indicated age range of mRNA-1345 to high-risk adults 18 to 59 years old, and intends to use a Priority Review Voucher. Influenza (Flu) Worldwide, there are 3-5 million severe cases of flu and 290,000-650,000 flu-related respiratory deaths annually.[7] Two main types of influenza viruses (A and B) cause seasonal flu epidemics, and the influenza A viruses lead to most flu-related hospitalization in older adults. Moderna has several seasonal influenza vaccine candidates in clinical development. The Company’s investigational seasonal flu vaccine, mRNA-1010 , demonstrated consistently acceptable safety and tolerability across three Phase 3 trials. In the most recent Phase 3 trial (P303), which was designed to test the immunogenicity and safety of an optimized vaccine composition, mRNA-1010 met all immunogenicity primary endpoints, demonstrating higher antibody titers compared to a licensed standard-dose flu vaccine (Fluarix®). In an older adult extension study of P303, mRNA-1010 met all primary immunogenicity endpoints-including superiority for all strains-compared to a licensed enhanced flu vaccine (Fluzone HD®) and showed an acceptable reactogenicity profile. Moderna is no longer pursuing an accelerated approval pathway for the regulatory submission of its standalone flu vaccine, mRNA-1010, to focus its resources on the submission of a potentially more impactful flu/COVID combination vaccine, mRNA-1083, this year. The Company plans to start a confirmatory vaccine efficacy study for mRNA-1010 in 2024, funded by previously announced project financing through Blackstone Life Sciences. Combination Respiratory Vaccines Currently, flu and COVID-19 are responsible for thousands of hospitalizations and hundreds of deaths each week in the U.S. To address the burden of these respiratory diseases, the Company’s combination vaccine candidates are designed for increased uptake, higher compliance, consumer convenience and benefits to healthcare systems. As announced in June, the Phase 3 study of the Company’s investigational combination vaccine against flu and COVID-19, mRNA-1083 , met its primary endpoints and elicited higher immune responses against influenza virus and SARS-CoV-2 than licensed flu and COVID vaccines in adults 50 years and older, including an enhanced flu vaccine in adults 65 years and older.mRNA-1083 also showed an acceptable safety and reactogenicity profile compared to co-administered flu and COVID-19 vaccines. The Company expects to file for approval in 2024 and intends to use a Priority Review Voucher. Latent and Other Virus Vaccines Cytomegalovirus (CMV) CMV, a latent virus, is the most common infectious cause of birth defects in the U.S. and is responsible for several billion dollars in annual healthcare costs. One in 200 babies in the U.S. are born with a congenital CMV infection, and of those affected, one in five will have severe, life-altering health problems. Possible short- and long-term sequelae of CMV infection include microcephaly, chorioretinitis, seizures, sensorineural hearing loss, cognitive impairment and cerebral palsy. CMVictory is a pivotal Phase 3 trial evaluating mRNA-1647 against primary CMV infection in women 16 to 40 years of age. The trial is accruing cases, and a Data Safety Monitoring Board (DSMB) will evaluate vaccine efficacy from the interim analysis when the trial has accrued 81 confirmed cases. The Company expects a vaccine efficacy readout as early as the end of 2024. Norovirus Enteric viruses, including norovirus, are a leading cause of diarrheal diseases, resulting in significant morbidity and mortality worldwide, particularly among young children and older adults. Norovirus is highly contagious and a leading cause of diarrheal disease globally, associated with 18% of all acute gastroenteritis (AGE),[8] resulting in approximately 200,000 deaths per year and substantial healthcare costs.[9] Given the wide diversity of norovirus genotypes, a broadly effective norovirus vaccine will require a multivalent vaccine design.[10] A Phase 1 trial designed to evaluate the safety, reactogenicity and immunogenicity of a trivalent norovirus vaccinecandidate, mRNA-1403 , in participants 18 to 49 years of age and 60 to 80 years of age in the U.S. is ongoing. An interim analysis showed that a single dose of mRNA-1403 elicited a robust immune response across all dose levels evaluated with a clinically acceptable reactogenicity and safety profile. Additionally, robust histo-blood group antigen (HBGA) blocking antibody titers were observed against vaccine-matched norovirus genogroup I and II selected strains across all dose levels evaluated. Similar mRNA-1403-induced HBGA-blocking antibody titers were observed in younger adult and older adult age groups. The Company plans to initiate a pivotal Phase 3 trial imminently. Oncology Therapeutics The Company’s oncology portfolio includes the individualized neoantigen therapy (INT) being developed in partnership with Merck. Earlier this year, Moderna and Merck initiated three new randomized clinical studies in additional tumor types, including a Phase 2 adjuvant treatment in patients with renal cell carcinoma, or kidney cancer; a Phase 2 adjuvant treatment in patients with high-risk muscle-invasive bladder cancer; and a Phase 2/3 neoadjuvant and adjuvant treatment in patients with cutaneous squamous cell carcinoma, the second most common form of skin cancer. Moderna’s global clinical trial footprint for INT has grown to more than 45 countries. The Phase 3 clinical trial for adjuvant melanoma, mRNA-4157 , is substantially enrolled and has closed screening to new patients in many countries. Moderna and its partner Merck have had preliminary discussions with regulators on approval based on the Phase 2 results. While discussions are ongoing, initial feedback from FDA has not been supportive of accelerated approval based on the current data. The Company and its partner Merck will continue engaging with regulators on the program, and remain focused on executing the Phase 3 trial. Rare Disease Therapeutics In the prioritized portfolio, the Company’s rare disease candidates include therapies targeting two organic acidemias caused by deficient metabolic enzymes, methylmalonic acidemia (MMA) and propionic acidemia (PA), both of which are characterized by metabolic decompensation events (MDEs) that can lead to severe and life-threatening symptoms such as vomiting, lethargy, seizures and coma. Methylmalonic acidemia (MMA) therapeutic In an ongoing Phase 1/2 study designed to evaluate safety and pharmacology in trial participants with MMA , mRNA-3705 was generally well-tolerated to date with no discontinuations due to safety and no events meeting protocol-defined dose-limiting toxicity criteria. Initial data is encouraging, withreductions in methylmalonic acid and other pathway biomarkers in participants, particularly at doses of at least 0.4 mg/kg Q2W. Early results suggest potential decreases in annualized rates of MMA-related hospitalizations and MDEs compared to pre-treatment rates. Moderna is working to identify an optimal dose and continues to engage with the U.S. FDA, via the START Program , and other global regulators. The Company is on track to begin generating pivotal study data by the end of 2024. Propionic acidemia (PA) therapeutic In an ongoing Phase 1/2 study designed to evaluate safety and pharmacology in trial participants with PA, mRNA-3927 was generally well-tolerated to date with no events meeting protocol-defined dose-limiting toxicity criteria. Early results suggest potential decreases in annualized MDE frequency compared to pre-treatment, and the majority of patients have elected to continue on the open label extension study. The Company is on track to begin generating pivotal study data by the end of 2024. Programs Discontinued Based on the Company’s strategic prioritization, five programs in its pipeline are discontinued: Financial Updates Moderna expects its commercial respiratory franchise to be profitable in 2024 and beyond. In addition, the Company is updating its projected 2024 research and development expenses to approximately $4.8 billion, primarily driven by the purchase of a Priority Review Voucher, and selling, general and administrative expenses to approximately $1.2 billion. Moderna is also reducing its expected research and development investment for 2025-2028 by approximately 20%, from $20 billion for the period to $16 billion through prioritization. The Company aims to complete the majority of its respiratory investments by 2026. It is increasing research and development investments in oncology, and pacing its investments in latent and other vaccines and in rare disease therapeutics. The Company is introducing an updated financial framework for 2025 and 2026-2028. Revenue: The Company expects 2025 revenue of $2.5 billion to $3.5 billion. For 2026-2028 the Company expects a compounded annual growth rate of more than 25% or more, driven by new product launches. Cost of Sales: Cost of sales is expected to be in the range of 35% to 45% in 2025. For 2026-2028, the Company expects cost of sales to decrease as a percentage of sales with increasing revenue. Research and Development Expenses: Full-year 2025 research and development expenses are anticipated to be $4.2 billion to $4.5 billion. In the 2026-2028 period, research and development expenses are expected to be approximately $11.5 billion on a cumulative basis. Selling, General and Administrative Expenses: Selling, general and administrative expenses for 2025 are projected to be $1.0 billion to $1.2 billion. For 2026-2028, selling expenses are expected to increase incrementally as new products are brought to market, while general and administrative expenses are expected to remain flat. Income Taxes: The Company continues to expect its full-year 2025 tax expense to be negligible. Tax will also be negligible for the 2026-2028 period. Capital Expenditures: Capital expenditures for 2025 are expected to be approximately $0.3 billion. For 2026-2028, capital expenditures are expected to be flat to down from 2025 levels. Cash and Investments: Year-end cash and investments for 2025 are projected to be approximately $6 billion. Moderna plans to break even on an operating cash cost basis (which excludes stock-based compensation, depreciation and amortization expense) with $6 billion in revenue. The Company expects to achieve this in 2028. The Company has sufficient capital to fund its plans until achieving break even on a cash cost basis without raising additional equity. About Moderna Moderna is a leader in the creation of the field of mRNA medicine. Through the advancement of mRNA technology, Moderna is reimagining how medicines are made and transforming how we treat and prevent disease for everyone. By working at the intersection of science, technology and health for more than a decade, the Company has developed medicines at unprecedented speed and efficiency, including one of the earliest and most effective COVID-19 vaccines. Moderna’s mRNA platform has enabled the development of therapeutics and vaccines for infectious diseases, immuno-oncology, rare diseases and autoimmune diseases. With a unique culture and a global team driven by the Moderna values and mindsets to responsibly change the future of human health, Moderna strives to deliver the greatest possible impact to people through mRNA medicines. For more information about Moderna, please visit modernatx.com and connect with us on X (formerly Twitter), Facebook, Instagram, YouTube and LinkedIn. INDICATION (U.S.) SPIKEVAX (COVID-19 Vaccine, mRNA) is a vaccine indicated for active immunization to prevent coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in individuals 12 years of age and older. IMPORTANT SAFETY INFORMATION FOR SPIKEVAX INDICATION (U.S.) mRESVIA (Respiratory Syncytial Virus Vaccine) is a vaccine indicated for active immunization for the prevention of lower respiratory tract disease (LRTD) caused by respiratory syncytial virus (RSV) in adults 60 years of age and older. IMPORTANT SAFETY INFORMATION FOR MRESVIA Spikevax® and mRESVIA® are registered trademarks of Moderna. Fluarix® is a registered trademark of GSK. Fluzone® is a registered trademark of Sanofi Pasteur. [1] Statistics for Moderna based upon internal data from 10 Phase 2 trials, and six Phase 3 trials. Data reported as of September 12, 2024. Industry statistics derived from Phase 2 and 3 study data from Wong et al., Biostatistics (2019) 20, 2, pp 273-286. [2] https://www-cdc-gov.libproxy1.nus.edu.sg/resp-net/dashboard/index.html. Data last updated as of September 6, 2024 for 2023-2024 season. [3] https://www-cdc-gov.libproxy1.nus.edu.sg/respiratory-viruses/risk-factors/older-adults.html [4] https://www.yalemedicine.org/news/covid-vaccines-reduce-long-covid-risk-new-study-shows [5] https://www-cdc-gov.libproxy1.nus.edu.sg/rsv/php/surveillance/index.html [6] https://pubmed-ncbi-nlm-nih-gov.libproxy1.nus.edu.sg/36369772/ [7] https://www-who-int.libproxy1.nus.edu.sg/news-room/fact-sheets/detail/influenza-(seasonal) [8] Ahmed, S.M., et al., Global prevalence of norovirus in cases of gastroenteritis: a systematic review and meta-analysis. Lancet Infect Dis, 2014 [9] https://www-who-int.libproxy1.nus.edu.sg/teams/immunization-vaccines-and-biologicals/diseases/norovirus [10] https://www-cdc-gov.libproxy1.nus.edu.sg/norovirus/downloads/global-burden-report.pdf SOURCE: Moderna