Lilly dives into vaccine research with 3 biotech buyouts

Eli Lilly Acquires Three Vaccine Developers for Nearly $4 Billion

Eli Lilly announced agreements to acquire three privately held vaccine developers—Vaccine Co., Curevo, and LimmaTech Biologics—for a combined value of up to nearly $4 billion. This strategic move aims to establish a robust infectious disease portfolio, reflecting Lilly's deliberate shift towards disease prevention. The acquisitions include Curevo's Phase 2 shingles vaccine, LimmaTech's Phase 1 Staphylococcus aureus bacterial vaccine, and Vaccine Co.'s preclinical Epstein-Barr Virus prospect. This marks Lilly's tenth acquisition this year, leveraging cash from its successful obesity and diabetes drugs to expand into new therapeutic areas.

• Eli Lilly is making a significant strategic pivot into infectious disease research through the acquisition of three specialized vaccine developers. This move is part of a broader initiative to build a comprehensive infectious disease portfolio, aligning with the company's stated goal of preventing diseases at their source rather than merely treating their consequences. This expansion is spearheaded by Peter Marks, the former FDA vaccine chief, now leading Lilly's infectious disease efforts.
• The acquisitions represent a substantial investment, totaling up to nearly $4 billion across Vaccine Co., Curevo, and LimmaTech Biologics. Specifically, Vaccine Co. and Curevo purchases could be worth up to $1.55 billion and $1.5 billion respectively, while LimmaTech's acquisition could total $780 million. These deals bring diverse vaccine technologies into Lilly's pipeline, funded by the success of its obesity and diabetes drugs.
• The acquired assets span various stages of development, from preclinical to Phase 2, addressing multiple infectious diseases. Curevo's lead asset is an experimental shingles vaccine in Phase 2, showing similar immune response but fewer side effects than standard shots. LimmaTech's lead program is a Phase 1 vaccine for Staphylococcus aureus bacterial infections. Vaccine Co. contributes a preclinical prospect for Epstein-Barr Virus, which also secured an ARPA-H grant in 2024.

Why Lilly is Targeting Shingles: Unmet Needs in Prevention

Recent evidence identifies significant gaps in shingles prevention and management that present compelling opportunities for pharmaceutical intervention. Despite available vaccines, substantial unmet needs persist across key patient populations, particularly in vaccination coverage and healthcare access.

• Immunocompromised populations represent a critical underserved segment with vaccination rates as low as 3.0% among oncological patients despite clear clinical recommendations. Patients with hematological malignancies show slightly higher uptake (7.7%) compared to solid cancer patients (1.7%), but coverage remains inadequate across transplant recipients, HIV patients, and those on immunosuppressive therapies.

• Older adults aged ≥50 years face substantial disease burden with lifetime HZ risk estimated at 20-30%, yet vaccination coverage remains extremely low globally — ranging from 1.93% in China's Zhejiang Province to less than 1% for live attenuated vaccine in France. This population accounts for 80% of HZ-related hospitalizations and experiences the highest complication rates.

• Healthcare system implementation gaps create significant barriers including limited physician recommendations, inadequate awareness campaigns, and constrained institutional support. Cost and affordability emerge as primary obstacles, with many patients citing "unnecessary to get vaccinated" as the main reason for non-uptake among higher-income groups.

• Economic burden remains substantial despite prevention opportunities with Spain recording €98.1 million in hospitalization costs (2022-2023) and Brazil projecting 359,797 HZ cases annually without vaccination. Complicated HZ cases account for over 64% of hospitalizations, highlighting the severity of inadequately prevented disease.

• Geographic disparities in access and outcomes are evident across countries, with regional variations in disease burden and healthcare delivery requiring targeted interventions. Urban-rural divides particularly affect healthcare access, with older adults showing unmet outpatient needs and urban residents experiencing higher unmet inpatient care requirements.

• Knowledge and awareness deficits persist among both healthcare professionals and patients, contributing to the perception of HZ as a benign condition despite severe potential complications. Educational disparities significantly impact vaccination intention, with higher education levels associated with improved coverage rates.

Curevo's Shingles Vaccine: A Closer Look at Phase 2 Data

Recent clinical research provides valuable insights into shingles vaccine development and performance across diverse patient populations. Several Phase 2 and Phase 4 studies have evaluated both safety and efficacy outcomes in immunocompromised and healthy populations.

Navigating the Evolving Shingles Vaccine Landscape

The shingles vaccine landscape has undergone significant transformation over the past five years, primarily driven by the emergence and widespread adoption of the recombinant zoster vaccine (RZV/Shingrix). RZV, which consists of recombinant viral glycoprotein E and the Adjuvant System 01 (AS01B), demonstrates superior efficacy compared to its predecessor, offering greater than 90% protection against herpes zoster and associated complications in immunocompetent individuals, with efficacy persisting above 80% for 11 years. Pooled vaccine effectiveness data from post-2020 studies show RZV achieving 79.2% effectiveness against herpes zoster in adults, substantially outperforming the live-attenuated zoster vaccine (ZVL/Zostavax), which demonstrated 45.9% pooled effectiveness in the same indication.

The implementation timeline reflects this evolving landscape, with several countries transitioning their vaccination programs during this period. Australia initially added ZVL to its National Immunisation Program in November 2016, targeting adults aged 70-79 years, but subsequently introduced RZV to the market in June 2021 following its registration in 2018. Similarly, Spain implemented systematic vaccination with RZV in 2021. Real-world effectiveness data from Australia's program demonstrates tangible clinical impact, with an estimated 7,000 zoster cases prevented within two years of implementation and a steady decline in incidence among the target population, showing an estimated decrease of 2.25 cases per 1,000 person-years annually.

A critical advancement in the treatment landscape has been the expanded utility of RZV in immunocompromised populations, addressing a significant unmet medical need. As a non-live vaccine, RZV can be safely administered to immunocompromised patients who are contraindicated for ZVL, demonstrating 68-87% efficacy in severely immunocompromised individuals with excellent immunogenicity in patients receiving JAK inhibitors and corticosteroid therapy. Additionally, clinical research has established that RZV can be co-administered with routine vaccines including influenza, pneumococcal, Tdap, PCV13, and COVID-19 mRNA vaccines without compromising immunogenicity or safety profiles, with vaccine response rates remaining consistently high (95.1-99.1%) regardless of administration strategy. Despite these advances, implementation challenges persist, including suboptimal vaccine coverage, cost-effectiveness concerns for national programs, and significant vaccination disparities across demographic groups and geographic regions.

Beyond Blockbusters: Lilly's Bold Leap into Vaccines

Eli Lilly, a pharmaceutical powerhouse currently riding a wave of unprecedented success driven by its innovative diabetes and obesity therapies like tirzepatide, is making a significant strategic maneuver that signals a broader vision for its future. While the company has long been a leader in metabolic health, leveraging its deep expertise in insulin development and pioneering new GLP-1/GIP agonists, its latest move underscores a deliberate and substantial pivot towards disease prevention. This shift is evidenced by the acquisition of three privately held vaccine developers for a combined value of up to nearly $4 billion, funded directly by the robust cash flow generated from its blockbuster drugs.

This strategic expansion is not entirely new territory for Lilly, which has a historical legacy in infectious disease treatment, having developed antibiotics such as vancomycin, daptomycin, and dirithromycin to combat challenging pathogens like Staphylococcus aureus. However, these new acquisitions represent a distinct foray into prophylactic medicine. The pipeline additions include a Phase 2 shingles vaccine, a Phase 1 Staphylococcus aureus bacterial vaccine, and a preclinical Epstein-Barr Virus prospect. The Staphylococcus aureus vaccine, in particular, addresses a critical and persistent global health threat: antibiotic resistance. With existing evidence highlighting the increasing demand for new agents against resistant Gram-positive pathogens, a successful preventative vaccine could be a transformative solution, moving beyond the limitations of treatment.

While this diversification promises to build a more resilient and robust portfolio, it also comes with inherent considerations. Early-stage vaccine candidates, such as the S. aureus and EBV prospects, face significant development hurdles and high attrition rates, meaning the substantial investment carries a degree of risk. Furthermore, successfully integrating these new vaccine platforms and navigating the distinct R&D, manufacturing, and regulatory landscapes of vaccine development will require careful execution. The competitive environment for vaccines, especially for established indications like shingles, also means that any new entrant must demonstrate clear differentiation to capture market share. Nevertheless, this bold move positions Lilly to not only expand its therapeutic footprint but also to play an increasingly vital role in global public health by shifting the paradigm from managing illness to preventing it.