Vaccines
Vaccines Endemic
Gardasil Sales by Geography
US grew 9% to $2.641B. International fell to $2.592B from $6.158B. The 2025 drop is China destock.
Shingrix: US vs Ex-US
Ex-US is now 66% of 2025 Shingrix sales (56% in 2024). US immunization reached 44% and US sales fell 17%.
Pneumococcal Franchises, 2025
Prevnar family $6.494B versus Merck Vaxneuvance $825M and Capvaxive $759M in its first full year.
Pediatric Combination Players
Sanofi PPH, Merck MMR-V, GSK established, and Serum Institute dose volume. Tender businesses, not US retail stories.
| Franchise | Company | 2025 sales | Role |
|---|---|---|---|
| Polio / pertussis / Hib (PPH) | Sanofi | €2.554B | Hexavalent and pentavalent tender business. Down 4.4% CER on fewer births, including China. |
| ProQuad / M-M-R II / Varivax | Merck | $2.451B | US schedule backbone for MMR and varicella. Roughly flat (-1%). |
| Established vaccines | GSK | £3.120B | Pediatric combinations plus older brands. Down 5% CER. |
| RotaTeq | Merck | $673M | Rotavirus. Down 5%. |
| Meningitis (Bexsero / Menveo) | GSK | £1.583B | Adolescent and infant meningococcal, +12% CER. |
| Dose volume (Pneumosil, pentavalent, HPV Cervavac) | Serum Institute of India | Not a branded P&L | Gavi/UNICEF backbone. ~4 billion dose capacity, 170+ countries. |
HPV: Merck Value vs LMIC Volume
Gardasil is the branded P&L. Cervavac and Gavi are the dose-volume lane. Country concentration, not a US challenger, is the 2025 risk.
| Lane | Product | Who | 2025 signal | Note |
|---|---|---|---|---|
| US branded | Gardasil 9 | Merck | $2.641B US, +9% | The cash cow. IRA $0 adult copay is a coverage tailwind, not the 2025 print. |
| China / EM branded | Gardasil via tenders / Zhifei history | Merck / Zhifei | International $2.592B, -58% | Destock, not a permanent zero. One-country concentration risk. |
| LMIC volume | Cervavac and Gavi HPV | Serum Institute / Gavi | Dose volume, not Merck P&L | Competes on price and supply, not on US ASP. |
| EU / other | Gardasil 9 | Merck | Inside international | National programs, not the 2025 collapse driver. |
Travel and Biodefense Products
Bavarian, Valneva, Emergent, and Sanofi endemic. A different buyer (travel clinics, BARDA) and a different cycle (outbreaks, stockpile).
| Company | Product | Buyer | 2026 setup |
|---|---|---|---|
| Bavarian Nordic | Jynneos / Imvanex (mpox, smallpox) | BARDA / SNS and outbreak countries | Outbreak-wave revenue, not a routine schedule. |
| Bavarian Nordic | Vimkunya (chikungunya) | Travel clinics; SII tech-transfer Mar 2026 for LMIC | Approved US/EU/UK in 2025. Volume path is Serum Institute. |
| Valneva | IXCHIQ (chikungunya) | Travel (ex-US) | FDA suspended the US license 22 Aug 2025. BLA/IND withdrawn Jan 2026. SII license ended Dec 2025. Still labeled in EU/UK/Canada/Brazil. |
| Valneva | IXIARO (JE), DUKORAL (cholera) | Travel / military | IXIARO €98.4M in 2025, including a US DoD sole-supplier contract. DUKORAL €31.9M, roughly flat. |
| Emergent BioSolutions | BioThrax / CYFENDUS (anthrax) | BARDA / SNS | Stockpile contractor. Distressed operator; biodefense exposure, not a growth compounder. |
| Sanofi | Yellow fever, rabies, endemic bundle | Travel plus national programs | Inside €1.287B meningitis / travel / endemic. |
