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FDA refuses to review Moderna’s mRNA flu vaccine

Dive Brief: The Food and Drug Administration has declined to review an application to approve Moderna’s messenger RNA-based influenza vaccine in a surprise decision that represents another regulatory setback for the company directed by current leadership at th

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Dive Brief:

  • The Food and Drug Administration has declined to review an application to approve Moderna’s messenger RNA-based influenza vaccine in a surprise decision that represents another regulatory setback for the company directed by current leadership at the Department of Health and Human Services.
  • Moderna said Tuesday that it received a “refuse-to-file” letter stating that the agency won’t consider approval of the shot, mRNA-1010, because of the comparator the company chose to test it against in a Phase 3 trial. The letter, dated Feb. 3 and written by top vaccine official Vinay Prasad, said that trial wasn’t “adequate and well-controlled” because that comparator didn’t reflect the “best-available standard of care” in the U.S. at the time. Prasad didn’t cite any safety or efficacy concerns.
  • Moderna, which took the unusual step of publicly posting Prasad’s letter , claimed that the agency’s rationale was “inconsistent” with prior guidance. The agency had recommended Moderna test its shot against a higher-dose flu vaccine, but didn’t voice concerns about the study when the company submitted the trial protocol or thereafter, the company said. Moderna also submitted data from a separate Phase 3 trial last year that involved a high-dose flu shot as a control. The company has requested a meeting to “understand the path forward.”

Dive Insight:

The letter amounts to another new regulatory hurdle in the U.S. for Moderna, whose mRNA technology helped end the COVID-19 pandemic but has since become a target of federal health officials under the Trump administration. Prior to becoming HHS Secretary, Secretary Robert F. Kennedy Jr. long questioned the safety and efficacy of mRNA technology and COVID vaccines, specifically. The technology allows for the speedy creation of vaccines that can be used to quickly respond to viral threats such as COVID, respiratory syncytial virus and influenza. During the pandemic, that potential was showcased with the development and large-scale testing, in record time, of mRNA shots credited with saving millions of lives . Kennedy, though, has falsely claimed that mRNA shots fail to effectively protect people against respiratory infections like COVID and the flu. And under his leadership, the HHS has terminated millions of dollars in government contracts for mRNA vaccine research. The FDA, meanwhile, has set stricter approval standards for COVID vaccine shots and narrowed their use when issuing new approvals. Moderna has felt the brunt of this shift in sentiment. Despite a recent stock run, the company has lost most of its market value since the pandemic amid dwindling COVID shot sales and the presence of a more unpredictable regulator. The oppositional climate led CEO Stéphane Bancel to claim last month that the company will pull back investments in late-stage trials for vaccines. Its back-and-forth with the FDA over a flu vaccine — a product Moderna has spent years developing and testing — is the latest example. Moderna has been working on that shot, as well as a related, combination COVID and flu vaccine it’s seen as important to its future. But the company pulled an application for the combination vaccine last year following a request from the FDA for more data from the shot’s flu-preventing component , a move some Wall Street analysts viewed as suggestive of a newly higher bar for vaccine approvals. It has since accumulated that data in a large, late-stage trial showing mRNA-1010 reduced the risk of flu-like illness by 27% compared to a standard-dose vaccine. Moderna had been expecting an approval this year and even used a “priority review voucher” in anticipation of a speedier review. The company argued that the FDA has gone against its own guidance for flu vaccines in declining to evaluate the application, as that protocol doesn’t “contain any reference” to the use of the “best-available standard of care” as a comparator. The FDA letter “does not further our shared goal of enhancing America’s leadership in developing innovative medicines,” CEO Bancel said in a statement. “It should not be controversial to conduct a comprehensive review of a flu vaccine submission that uses an FDA-approved vaccine as a comparator in a study that was discussed and agreed on ... prior to starting." The agency’s decision “reflects the ‘maximum pressure’ footing vis-a-vis mRNA vaccines by current HHS/FDA leadership,” wrote Leerink Partners analyst Mani Foroohar, in a Wednesday note to clients. Foroohar added that the situation leaves the future of Moderna’s combination shot in doubt, “imperils” its chances of breaking even financially in 2028, and prolongs its reliance on COVID vaccine revenue.

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Source: www.medscape.com ↗
02China: Threat or opportunity?

One of the biggest biotech news stories of recent years is China’s continued rise as a biotech and life sciences powerhouse. China conducts a quarter of all clinical trials and drug development and has almost 1,500 new drugs in development.¹ Many China-based biotechs have benefitted from government funds, out-licencing deals with large pharmas and venture capital funding. However, policymakers in the US and EU have concerns about the possible threat to their region’s biosecurity and competitiveness as centres for health and life science research. Given China’s increased importance, ICON Biotech conducted the same biotech sector survey with 100 China-based biotech leaders. The results show that Chinese biotechs face many of the same challenges as biotechs located elsewhere. They share the same funding challenges and burdens associated with increasingly complex clinical trials and regulations.

Source: www.biopharmadive.com ↗
03Lifestyle Matters: How do environmental and lifestyle factors influence Alzheimer’s disease?

Dr. Harrison and Finnish neuroscientist Dr. Miia Kivipelto explore the complex interplay between genetics and lifestyle in Alzheimer's development. Learn how the groundbreaking FINGER study demonstrates potential prevention strategies, and discover the latest evidence on how environmental factors, diet, and chronic conditions influence Alzheimer's risk.

Source: www.biopharmadive.com ↗
04Why Muscle Cells Might Do Some Heavy Lifting

Brown was studying gene therapy in the 1990s when he designed a technology to turn mRNA expression on or off in different cells. For the new mouse study, published in Nature Biotechnology , he adapted the technology to turn off mRNA expression in dendritic cells, muscle cells, or liver cells. The researchers then vaccinated the mice with each version, delivering the vaccines both intravenously and intramuscularly. “The results were pretty stunning,” Brown said. When mRNA expression was turned off in muscle cells, T-cell response went down, suggesting muscle cells play a role in immunity. When expression was turned off in liver cells, T-cell expression tripled — indicating liver cells dampen immunity. Turning off expression in dendritic cells had no effect on T-cell activation, though it did reduce the number of killer T cells by as much as half. (Interestingly, no such reduction occurred when the antigen was SARS-CoV-2 spike. Brown is now investigating why different antigens had varying effects.) Knowing all this is crucial for designing effective mRNA vaccines and therapies. That’s because different mRNA therapies require different strategies. Cancer vaccines must boost tumor-fighting killer (CD8+) T cells. For genetic disease treatments, scientists want to avoid triggering the immune system to prevent killing the very cells the mRNA is meant to modify. “Understanding the immunology is extremely important for this class of drug,” Brown said. The finding doesn’t mean dendritic cells aren’t important for mRNA vaccines to work. “It just means that the mRNA doesn’t have to get into those cells to induce an immune response,” Brown said. Instead, the antigen can be transferred to those dendritic cells.

Source: www.medscape.com ↗
05What Comes Next

With data expected in the fourth quarter of 2026, we are prioritizing histology alongside patient-reported outcomes using the Celiac Disease Symptom Diary, one of only two instruments developed in line with U.S. Food and Drug Administration (FDA) guidance, to capture changes in symptoms such as abdominal pain and nausea. Ultimately, the broader aim is to give gastroenterologists and patients a therapeutic option for a disease that has long been managed without one. The future of drug development will not be defined by statistical significance alone, but by whether new therapies also improve the daily burden of living with celiac disease. “The first therapy to cross the line could change the field,” Geller concluded. “It would help establish celiac as a serious medical condition with options beyond a restrictive diet and open the door for what comes next.” Dr. Paul Lizzul is chief medical officer at First Tracks Biotherapeutics, a clinical ‑ stage biotechnology company advancing antibody therapeutics that modulate immune pathways implicated in autoimmune and inflammatory diseases. Marilyn Geller serves as an advisor to First Tracks Bio. Footnotes Abadie V, Jabri B. IL-15: a central regulator of celiac disease immunopathology. Immunol Rev . 2014;260(1):221-234. https://doi.org/10.1111/imr.12191. Yokoyama S, Watanabe N, Sato N, et al. Antibody-mediated blockade of IL-15 reverses the autoimmune intestinal damage in transgenic mice that overexpress IL-15 in enterocytes. Proc Natl Acad Sci U S A . 2009;106(37):15849-15854. https://doi/full/10.1073/pnas.0908834106. Anthony S, Schluns KS. Emerging roles for IL-15 in the activation and function of T-cells during immune stimulation. Research and Reports in Biology . 2015;6:25-37. https://doi.org/10.2147/RRB.S57685.

Source: www.biopharmadive.com ↗
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Peptide Therapy Guide Editorial Team

Editorial team for Peptide Therapy Guide.

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