A New Era in Immunisation: Forecasting the Future of Combination Respiratory Vaccines

As seasonal respiratory illnesses continue to place immense pressure on global healthcare systems, a new frontier in immunisation is rapidly emerging: combination vaccines. 

At World Vaccine Congress 2025 in Washington DC, Airfinity presented insights into the opportunities and complexities of combination vaccines. With several key players poised for commercial breakthroughs and a multibillion-dollar market on the horizon, these vaccines could reshape how we approach respiratory disease prevention in the future.

What are combination vaccines and who’s leading the charge?

Combination vaccines are single formulations that protect against multiple pathogens. While well-established in paediatric care, like the MMR or DTP vaccines, the focus is now shifting to adults, particularly in the context of seasonal respiratory infections.

Leading players include Moderna, Pfizer/BioNTech, Novavax, Sanofi, GSK, and AstraZeneca. Notably, Moderna’s mRNA-1083 is on track to be the first COVID-19/influenza combination vaccine, while AstraZeneca’s IVX-A12 leads the RSV/hMPV category.

What impact could combination vaccines have for patients and health care systems?

Combination vaccines could make a real difference for patients by reducing the number of appointments needed, simplifying protection against multiple diseases in a single injection. This greater convenience is expected to boost vaccine uptake, particularly among older adults and working-age populations, while also reducing vaccine fatigue. 

For healthcare systems, the benefits are equally important. There will be efficiency savings from streamlining immunisation logistics, reducing administrative burden, and cutting operational costs. Higher vaccination rates would also reduce hospitalisations for respiratory diseases, easing pressure on hospitals and helping to build a more resilient healthcare system overall.

What are the challenges to developing a successful combination vaccine?

Despite the clear potential, combination vaccines face several hurdles. Different respiratory diseases peak at varying times, making it harder to optimise vaccination schedules to ensure protection against both diseases. At the same time, vaccine fatigue and declining COVID-19 vaccination rates could limit public enthusiasm for new combination products, while early data suggests that higher reactogenicity, particularly with mRNA-based combinations, may affect acceptance, especially among older adults.

Pricing and reimbursement also pose risks to widespread adoption. Combination vaccines could be priced higher than standalone options, potentially creating barriers for healthcare payers and patients alike. Without careful positioning and strong communication around benefits, these challenges could slow uptake and blunt the public health impact that combination vaccines are poised to deliver.

How big is the market? Airfinity estimates $8 billion in the G7 alone

Airfinity estimates that the COVID-19/influenza combination vaccine market could be worth $8 billion annually across the G7, driven by high demand in elderly and high-risk groups. However, successful market entry will depend on:

• Regulatory approval and age group indications

• Payer willingness and reimbursement structures

• Consumer preference and awareness

• Procurement efficiency and accessibility

Airfinity’s Forecasting Models: Predicting demand with precision

To navigate the complexity of launching and scaling combination vaccines, accurate forecasting is paramount. Airfinity’s forecasting and simulation modelling provides real-time updates on combination vaccine demand.

• Always-on Forecasting

• Parameter Adjustment

• Scenario Analysis

• Decision-maker Insights

Combination vaccines for respiratory illnesses represent a seismic shift in public health strategy - one with the potential to dramatically reduce hospitalisations, streamline immunisation efforts, and unlock significant commercial value. However, achieving that will require careful navigation of epidemiological, clinical, behavioural, and economic variables.

At Airfinity, our real-time, always-on forecasting tools are built to meet this challenge, helping stakeholders anticipate demand, mitigate risk, and drive outcomes that matter. If you would like to explore the full analysis behind these insights - including detailed forecasts, modelling scenarios, and strategic recommendations - please get in touch to request the full presentation.