As COVID Demand Shrinks, Vaccine Makers Rethink Their Strategy

With tighter rules and a smaller market, mRNA leaders refocus on high-risk groups and aim to sharpen delivery and messaging.

6 Jun 2025

The COVID-19 vaccine market in the United States is entering a sharp reset. This year, the Food and Drug Administration tightened its rules, recommending routine boosters only for adults over 65 and those with serious health risks. The change leaves vaccine makers navigating a leaner landscape with fewer eligible patients and higher stakes.

For millions of younger, healthy adults, annual shots are no longer advised. That shift is rippling through pharmacies and insurers, which now must sort out eligibility, manage prescriptions, and explain costs clearly. For some patients, the difference could be stark: a free dose with insurance versus a $140 bill out of pocket.

"If coverage isn't clear, you risk confusion and frustration right when public confidence in vaccines is still fragile," said one health policy analyst. To cut through the noise, many pharmacies have adopted blunt signage: "$0 with insurance if eligible."

The narrower pool has also intensified competition. With fewer arms to reach, companies are fighting for market share. Novavax, which offers a protein-based alternative, is aiming to win ground, though it stops short of marketing itself as the anti-mRNA option.

Moderna and Pfizer-BioNTech, meanwhile, are betting on long-term staying power. Moderna is touting its newly approved mNEXSPIKE shot as the foundation of a strategy focused on Medicare and high-risk patients. Pfizer and BioNTech are leaning on their record of speed and scale, promising to keep updating formulas as new variants emerge.

This fall's rollout will show whether the industry can shift from mass campaigns to targeted outreach. The age of universal demand may be over, but a more precise, patient-focused chapter is beginning. For vaccine makers, this slimmer market could prove just as defining as the frenzy that came before.