Global Vaccine Industry in Sharp Decline: Macro Headwinds and Eroding Public Trust Trigger Unprecedented Downturn

Text｜Amino Observation

The latest Q3 2025 financial reports from the four major vaccine giants—Sanofi, Merck, Pfizer, and GSK—show a collective slowdown in their vaccine businesses.

Despite the specific circumstances faced by each vaccine giant being different — for example, Pfizer's COVID-19 vaccine has seen a narrowing of its recommended usage and a subtle shift in public attitude towards vaccines, Merck's HPV vaccine has been affected by challenges in the Chinese market, and GSK’s RSV vaccine has struggled against competition — a common factor contributing to the decline in vaccine businesses of Merck, Pfizer, Sanofi, and GSK points to the challenging "macro factors."

As U.S. Surgeon General Robert F. Kennedy Jr. continues to push policies that undermine vaccine credibility, the CDC's Advisory Committee on Immunization Practices has been completely replaced, and over 30% of Americans express skepticism toward vaccines—market concerns about the vaccine industry are gradually turning into cold financial data.

More importantly, unlike the competitive and consumer economy factors in China, the vaccine trust crisis exacerbated by such macro factors in the U.S. points to a greater underlying issue: people are failing to get vaccinated against potentially devastating diseases.

The occurrence of the first measles death case in a decade has plunged the U.S. public health system into unprecedented embarrassment. In this country, where measles had been eradicated 25 years ago, there have been 44 measles outbreaks this year, with over 1,600 confirmed cases, compared to only 285 cases throughout last year. This has resulted in the death of three unvaccinated individuals, equaling the total number of measles-related deaths in the past 25 years.

Under the chaotic situation, the vaccination rate in the U.S. market may continue to decline, directly leading to a reduction in revenue for vaccine manufacturers. Public distrust and the government's "missteps" seem to be pushing the United States to repeat Japan’s past mistakes. When expectations and confidence disappear, the impact is bound to be profound.

/ 01 / The Big Four Continue to Adjust

Excluding the special variety of COVID-19 vaccines, influenza vaccines and 13-valent pneumococcal vaccines can be considered stable "cash cows" for these vaccine giants. However, the situation began to shift last year. In 2024, the combined sales of the top ten global vaccines amounted to $38.4 billion, marking a 19% decrease from 2023.

In 2025, the downward trend continues. The latest third-quarter reports show that vaccine giants Merck, Pfizer, Sanofi, and GSK are all facing varying degrees of challenges, with their star vaccine products collectively suffering a major setback.

Sanofi Becomes the First Giant to Sound the Alarm. The financial report released on October 24 shows that Sanofi's sales revenue from COVID-19 and flu vaccines in Q3 dropped by 17% year-on-year, with traditional vaccine business income falling by 8% to 3.36 billion euros, mainly due to a slowdown in the flu vaccine business. In addition, sales of the polio series vaccines (-12%) and meningitis vaccines (-2%) also declined. In a statement, CEO Paul Hudson directly pointed out that intensified price competition and a decrease in vaccination rates were key factors behind the decline in performance.

GSK's plight seems more symbolic. In the third quarter, its vaccine business revenue was 2.678 billion pounds, a year-on-year increase of 2%. Among this, the sales of the shingles vaccine Shingrix were 830 million pounds, a year-on-year increase of 13%, but there was a 15% decline in the U.S. market. The company attributed this decline to "macro factors surrounding vaccines."

Merck Faces a Dual Blow. First, its star product, the 9-valent HPV vaccine, encountered setbacks in the Chinese market, with Gardasil/GARDASIL 9 sales reaching $1.75 billion in Q3, down 24% year-over-year; for the first three quarters of this year, revenue totaled $4.2 billion, plummeting 40% year-over-year. Excluding the Chinese market, Gardasil/GARDASIL 9 sales fell by 3% year-over-year.

Not only in the Chinese market, but also in the U.S. domestic market, conditions have worsened: sales of the MMRV vaccine ProQuad, the MMR vaccine M-M-R II, and the varicella vaccine Varivax all dropped by 3%. The company's CFO, Caroline Litchfield, also attributed the issue to "macro factors."

In contrast, Pfizer's pain is within market expectations. Global sales of its COVID-19 vaccine Comirnaty dropped by 20%, and the U.S. market plummeted by 25%. Comirnaty has long been at the center of political friction and anti-vaccine rhetoric. As the FDA restricted the use of Comirnaty to the elderly and high-risk populations, and the CDC narrowed its vaccination recommendation scope, policy tightening and public doubts have led to a continued rapid decline in the sales of the COVID-19 vaccine.

Beyond the COVID-19 vaccine, Pfizer's 13-valent pneumococcal vaccine and RSV vaccine also performed disappointingly. The former generated $1.742 billion in revenue in Q3, a year-on-year decrease of 3%. This was partly due to the impact from Merck, and partly because Prevnar’s pediatric products faced delays in government bulk procurement. Meanwhile, the RSV vaccine saw a year-on-year decline of 22% in Q3.

Behind the Synchronized Decline of the Big Four: A Deep Adjustment in the Industry

/ 02 / Uncontrollable macro factors

As mentioned earlier, although the specific situations faced by each vaccine giant are not identical, a common factor contributing to the decline of their vaccine businesses points to the thorny "macro factors."

This vague term, which repeatedly appeared in the earnings calls of the Big Four, hides a common name behind it: Robert F. Kennedy Jr.

The U.S. Secretary of Health and Human Services (HHS), who took office in early 2025, is a well-known "anti-vaccine activist" who has been spreading anti-vaccine rhetoric and conspiracy theories for decades, including the debunked claim that vaccines cause autism. Under his leadership, the anti-vaccine organization Children's Health Defense gained prominence and was involved in spreading vaccine misinformation during the COVID-19 pandemic, resulting in the organization being suspended from Facebook and Instagram.

Since his assumption of the position, the market's concerns about the vaccine industry have finally become a reality. Under Kennedy's leadership and advocacy, the landscape of U.S. vaccine policy is being reshaped at an astonishing pace:

At the end of May, he unexpectedly announced the cancellation of the recommendation for COVID-19 vaccination for healthy children and pregnant women, followed quickly by the FDA's restrictive approval.

In early June, all 17 members of the CDC's Advisory Committee on Immunization Practices (ACIP) were dismissed and replaced with several advisors holding anti-vaccine views.

In the same month, HHS terminated a $760 million mRNA avian influenza vaccine contract with Moderna, stating that the technology was "not sufficiently tested"; days later, the FDA approved Moderna's next-generation COVID-19 mRNA vaccine.

In July, the National Institutes of Health (NIH) announced the layoff of approximately 1,200 employees, many of whom were from the vaccine development department...

The chaos is obvious. Paul Offit, a member of the FDA's Vaccines and Related Biological Products Advisory Committee, said that Kennedy "is basically telling you not to trust the government or the scientific basis on which the government's recommendations are made."

Uncertainty Surrounding Public Vaccine Perception and ACIP Recommendations Fuels More Pessimistic Market SentimentAt present, vaccine skepticism in the United States is at an all-time high. According to a new survey conducted by ValuePenguin through LendingTree, 30% of Americans are skeptical about vaccines. This concern is particularly evident regarding childhood vaccinations. A recent Gallup poll found that the percentage of Americans who believe childhood vaccines are extremely important has dropped from 58% in 2019 to 40% in 2024.

Even overseas analysts believe that the vaccination rate in the U.S. market may continue to decline. This means that vaccine companies are now at the center of the storm, with revenues potentially continuing to shrink.

/ 03 / The Cost of Collapsed Trust

If we look beyond these figures to the essence, we will discover an even more alarming cost behind the turmoil in the vaccine industry: people have failed to receive vaccines that could prevent devastating diseases.

According to data released by the CDC on November 4, there have been over 1,600 confirmed measles cases in the U.S. in 2025, spanning more than 40 states, compared to just 285 cases throughout last year. More shockingly, this outbreak has resulted in the deaths of three unvaccinated individuals — equivalent to the total number of measles-related fatalities in the U.S. over the past 25 years — including two children.

In 2000, the United States was considered to have eliminated measles, but now it has made a comeback, mainly due to the decline in vaccination rates in some parts of the country. This means that a trust crisis has led to a corresponding decline in childhood vaccination rates, which in turn has set the stage for the current outbreak of measles in the U.S.

Despite the dispersion of U.S. federal medical regulatory authority across multiple agencies such as the FDA and CDC, the Health Secretary cannot unilaterally overturn existing vaccine policies. Previously, in the case of "Biden v. Missouri," the Supreme Court ruled to block the Biden administration from enforcing a broad vaccine-or-testing mandate for large private companies. In an opinion, the Court stated: "While Congress has undeniably empowered the Occupational Safety and Health Administration to regulate occupational hazards, it has not granted the agency broader authority to regulate public health."

At the same time, the bargaining power within the pharmaceuticals industry is also not to be underestimated. The U.S. vaccine market is enormous, and major pharmaceutical companies, including Pfizer and Merck, possess significant lobbying capabilities.

However, the tragedy of the measles outbreak still sends a warning: when vaccine trust collapses, the first to pay the price are always the vulnerable groups. All of this could have been avoided. As overseas media bluntly stated, the root cause is simply that a regulator in charge of a critical and prestigious U.S. institution—originally meant to help Americans become healthier—was left unchecked to further undermine public confidence in vaccines.

History always repeats itself in surprising ways. This scene inevitably reminds people of the decline of Japan's vaccine industry. In the 1970s, adverse reactions to the DTP vaccine triggered a public trust crisis; subsequently, the government’s "questionable actions," such as amending the Immunization Law to cancel mandatory vaccinations, completely altered the fate of the vaccine industry.

Vaccine development is inherently a time-consuming, labor-intensive, and costly endeavor. However, the Japanese government has been both reluctant to invest sufficient funds and lacking in proactive policy guidance for the vaccine industry. Against this backdrop, the decline of Japan's vaccine industry seems almost inevitable. This has resulted in less than 30% self-sufficiency in vaccines, with heavy reliance on imports, leaving Japan no choice but to spend more money and time to restore lost trust.

What determines the direction of an industry is never the unpredictable administrative orders, but the expectations and confidence of the people in the industry towards the future, which in turn also affects the future of the industry.

In the future, where will the vaccine industry in the United States and even globally head amid this turmoil?