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Earnings Call Transcripts

Moderna, Inc.

MRNA
Quarters2 Quarters
ContentQ&A Sections
SourceEarnings Conference Call
Quarter 1

Q4 2025 Earnings Call — February 13, 2026

Terrence Flynn (Morgan Stanley): Hi. Thanks so much for taking the question. I had two part. I guess the first one is just on the flu RTF, implications for the 2028 cash flow break-even guidance, and then timing of the type A meeting, like when you might get some visibility on next steps. And then the INT program in adjuvant melanoma, I know that's a very important program and catalyst for the company. And so can you refine at all the timing of that data, whether it's going to be first half or second half? Thank you so much.

Management: Sure. Maybe I'll take the questions on regulatory first, and then Jamie hand it over to you on any breakeven implications. So we're actually very pleased that the flu file is under review now in Europe, Canada, Australia. We'll be filing in additional countries this year. And all of that is with an eye towards having that start to contribute, as I said a moment ago, in 2027, in the fall of 2027, to our growth. We also are pleased that the flu COVID combination product remains under review and making progress in Europe for this year. As relates to the U.S. timing, it really, we need to engage with the FDA in the type A meeting. That's usually 30 days as a process and understand from them what is going to be required to get that product moving forward in the U.S. We absolutely feel that American seniors should have access to the same innovations. We do think this year, in particular, where there's a potential for a mismatch in one of the strains, it's particularly important that technologies like Moderna's mRNA platform are used to advance new and potentially improved products. But at this point, until we have that type A meeting, we won't really know how quickly we can get moving forward with a 1010 file in the U.S. as we've been doing outside the U.S. Jamie?

Jamie (Title): Yeah. So, Terrence, thanks for the question. I appreciate it, and I recognize that it's on investors' minds. As Stephen just said, though, this is a bit of a fresh and fluid situation. And without understanding the resolution of what is next for our fluid product, it's a little bit difficult to comment

at this time.

But here's what I would say. If you go back to the growth drivers we laid out at Analyst Day, as well as Stephen had in his prepared remarks, we have 10 large shots on goal to increase revenue over the coming years, all with a wide range of potential outcomes. And Stephen mentioned some of the progress. We announced our long-term partnerships with Mexico and Taiwan. We're excited about, as I said, we're excited to deliver for the UK and Australia this year, which will be substantial revenue growth. NextBike had a great first year. We're excited about the second year, both in the U.S. and outside the United States. We're looking forward to Europe opening up. So it's really, there's still so many scenarios that could happen here, Terrence, that it's a little bit too early to tell. On top of that, we have a ton of momentum on productivity and what we're doing from a cost perspective. So we're really excited about our financial profile. We ended the year with over $8 billion in cash. We have a ton of momentum from a cost perspective, and we have a lot of opportunities for growth. So at this point, without knowing resolution to what's going to happen on flu, I think it's a little too early to comment.

Management: And on INT, the second question, we don't have, obviously, more specific guidance than we previously put out there. I'd highlight, as I said a moment ago, that there are five histologies now under review or under different stages of clinical development. So INT for melanoma, the adjuvant melanoma study, is one that we are confident we'll read out this year. It is an event-driven trial, and so it will depend upon the accrual of those events. We have RCC, so renal cell and bladder, now fully enrolled. And again, those are going to be event-driven and milestone-driven readouts, and so it's possible. And then the phase one data that we referenced before for our periadjuvant gastric and adjuvant pancreatic monotherapy cohorts. And so it's going to be a busy year for us over the next number of months, but we don't have more specific guidance because some of the most important readouts are ultimately event-driven. Thank you.

Elizabeth (Goldman Sachs): We wanted to ask about the flu and COVID combination vaccine and just given the RTF-41010, how should we think about this refiling and is there any read-through from a regulatory standpoint in the U.S.? And then maybe just remind us of the study data that went into the submission initially and what the latest thinking is on what might needed to be added for refiling. And then a second question on, in Tismoran, wanted your thoughts on which of those five histologies you just mentioned have the highest probability of success kind of based on the read-through from data generated to date. Thank you so much.

Management: Thanks for both questions. So first, on the 1083 file, again, I'll underscore that we're hoping for approval of the flu-COVID combination product in Europe first, in this year, and so we'll move forward there. As relates to the U.S., we were holding back on refiling the combo vaccine until we'd completed some portion of the review of the flu vaccine. With the refusal to start the review of the flu vaccine, I think that is now gated on, again, the feedback from the Type A meeting, which we haven't had, about what more would be necessary for us to refile for the mRNA 1010 program. And then we would be able to provide more clarity on the flu COVID program and refiling there. Again, all of this in the U.S. because all of those files are moving forward internationally. You asked about the data that was in the file. We had a phase three study for the mRNA 1010 file, which we have previously presented the results on. And actually, it's out for a peer review publication right now. But really excited by that phase three study, which was a randomized 41,000 person study that we had agreed with the FDA and agencies around the world with prior to initiation. In that study,

as a reminder, we saw 27% superior relative vaccine efficacy compared to the standard dose control.

And just to give you a sense of where that stands relative to comparators, you know, the two of the licensed preferentially recommended vaccines for those over the age of 65 had run essentially the same study design, one of them even with exactly the same comparator. And those, if you look at the USPI for flu zone, they had seen 24% relative vaccine efficacy for flu block. If you look in there, you see USPI will see 30% relative vaccine efficacy. So at 27%, we felt very good that we were in line in demonstrating superiority in exactly the same way that those standard of cares have in the same population as those over the age of 65. We also ran a phase three study, an immunogenicity and safety study, comparing our vaccine candidate for flu against flu zone high dose. And in that case, we showed statistical superiority to flu zone high dose on immunogenicity. That study has been published in the journal Vaccine and is available, I think, on our website for those who are interested. So, that package was in the initial file. We think it's a very comprehensive data set.

We do think if we can get the review initiated, it will support the use of the product, but we do need to understand first from FDA in that Type A meeting what they would need to initiate the review of the file that they previously had agreed to review. Moving to antismorin, I think it's obvious that you asked where we see the highest probability of success. It's hard to argue with the Phase IIb results that we have for adjuvant melanoma. As we announced last month, the five-year survival data continues to look really strong, approximately a 50 percent reduction in the rates of relapse or death from melanoma. Real stability in those curves through now five years. And if you ask me where do I, you know, think the read-through of that is, I think it's clearly, we hope, into the phase three adjuvant melanoma study that is testing in largely the same population and exactly the same standard of care. You know, I think if it works, if we see that there, one of the reasons we and our partner Merck went in with renal cell and bladder was we thought muscle invasive urothelial cell carcinoma is we thought those would be places where we might also see relatively quick read through.

And so I hope that the, you know, that those also have positive readouts. But I think if you're asking where we think the probability of success is highest, it's clearly in the, it's in the phase three adjuvant melanoma.

Eliana Merle (Barclays): Hey, guys. Thanks for taking the question. Just can you elaborate a little bit on how you're thinking about the European COVID vaccination market and how you see the vaccination rate and pricing evolving there and also how outside of the U.S. you're thinking about the pathway for a potential flu-COVID combination vaccine approval? And then also on that topic around flu, just in your filings for flu in Europe and Canada, has there been any discussion around potential strain selection in the future and potentially selecting the strains closer to the season start? Thanks.

Management: Yeah, thank you for all three. So first I'll take the combination question, or actually the COVID question. So MNEXT Spike is moving forward with approvals internationally, and we're really pleased with the profile of that product. As I'll remind you, we had demonstrated in that phase three study, higher relative vaccine efficacy. In fact, in a post hoc analysis, very high, approximately 25% higher relative vaccine efficacy compared to NexBike in older adults with comorbidities. And so really do think it's got a strong profile as the European COVID market reopens. Now, as to pricing, you know, we haven't issued that yet, but we do believe that the current market is, as we've shared, approximately $700 million today. And that doesn't account for wastage that exists in the market. There are many doses that are being, more doses that are being purchased under that pandemic contract that are not getting used. That estimate of approximately $700 million is just what we see as shots in arms. So we do believe that market will be larger than that, larger than even if we see nothing more than the approximately 20 million shots in arms that currently are happening.

And we do hope to get a sizable share. We think MNEXT Bike will be a very competitive product profile in that market. And we're scaling up for that launch. As you know, Europe is not one market. It is a series of different markets and some places will compete traditionally with sales and market activities. Other markets are more tender driven and we're preparing for all of that activities really starting this year, but as we said, as a meaningful driver of growth in 27 and beyond. On the combination product, we actually think that's the next step in that strategy. We're very pleased by the Combo product's progress in its international reviews. As we've said, based on timing, we do expect a European review to move forward, and we are hoping for approval this year, which gives us a chance to launch, you know, as early as this year, more likely in 27. Again, it just depends on timing of these events because proximity to the season will make a launch very difficult. But it is clearly a great opportunity for us to move beyond just COVID into a combination product and an opportunity to both expand our share in the COVID space, but also grab share in the flu space.

And we are proceeding with the filings elsewhere. I think we referenced in the PR Canada for that combination product as well and hope to similarly bring forward that innovation because we believe there's strong demand from health systems as well as patients for one shot or one vaccine that does multiple things. Now, as relates to the flu, we have been having those conversations. So, mRNA 1010, as we've proceeded outside of the U.S., there has been strong appetite for the question of better strain matching. And in fact, in some public comments, you've seen some European regulators, but also some from other markets, vocally advocate for later strain selection and more diverse strain selections happening in flu vaccines because of the precedent we've shown with COVID vaccines. I'll remind you that we sometimes forget in the U.S., but in this country, we've actually, the FDA has chosen different strains of COVID vaccine than the rest of the world in two out of the four past seasons. And the data has shown that that better matching for the market has led to slightly better efficacy.

In fact, we ran a clinical trial once head to head back in the bivalent days and showed higher point estimates for efficacy. Which makes sense. A better matched vaccine, you would expect to be better at protecting people. And what we're hearing from the international flu community, including, as I said, in Europe, is quite strong support for that. It's a real question today. I mean, just to make the point, there are a couple of different strains of influenza B circulating around the world right now. In the United States, it is a different strain than is circulating in the rest of the Northern Hemisphere. And there doesn't look like there would be great cross protection. And so it just highlights that the right answer for this fall could be very different from a composition perspective for Europe or North America or other regions. And that's where the technology that we have that has allowed us to tailor and meet regional needs with COVID we think can have an impact. There are many other things we need to do to improve flu vaccines, but this is one we know we can do right now.

Greg (TD Cowen): So some investors have been surprised by the higher than expected cash balance at year end. So can you explain why that occurred and what the additional levers to lower cash costs are moving forward? Thanks.

Management: Yeah, sure, Greg. Maybe I'll just go back to our original guidance. So when we laid out our original guidance, we said one point five to two point five billion dollars of revenue. So two billion dollars at the midpoint. And we said five and a half billion dollars of cash costs. So if you take those two together, it's a three and a half billion dollar usage from a starting point of nine and a half billion dollars, which is why we guided six billion dollars. Since then, revenue essentially came in online. We had 1.944. Let's call that pretty close. And cash cost came in at 4.3. So we beat by $1.2 billion. On top of that, we took $600 million of the initial draw from the loan. So that's now $1.8 billion better. Our capital expenditures were $100 million less than we forecasted at the outset of the year. So that's $1.9 billion better. And then if you look at the working capital, I am really pleased. It doesn't get a lot of attention with how the team has performed. Our receivables are at $180 million. Inventory was flat year over year at $270 million. Payable is at $300 million. We have a net working capital balance of $150 million to which we run this company on.

And that is really incredible performance from the team. And that drove the last $200 million. So I don't think it should be too much of a surprise that it's mostly cash costs for $1.2 billion above our original guidance, the loan. A little bit less capital expenditures and then terrific performance on working capital from the team.

Michael Yee (UBS): First, on the adjuvant Phase III melanoma study, can you remind us that that study has interims built in and then of course a final and so like other design studies you've done there's a certain number of cases accrue you take a look at it and then if it doesn't stop you move to the next case uh next interim can you just describe a little bit how that works um uh and remind us the phase two i think did stop at an interim if that if i was correct there and then on norovirus i don't think anyone's asked on that but uh can you just remind us there you um are enrolling or expect to complete enrollment, and then there's actually a readout, I think, planned this year. What is your confidence level there? I know there's been a lot of disappointments previously, but I think you are targeting a different approach and using three different strains, which I think, I assume you believe will capture the majority of coverage. Can you just remind us there and how you think about that result? Thank you.

Management: Yeah, thanks, Mike, for both questions. So first on the INT Phase III for adjuvant melanoma, you're correct. The first analysis that we'll see this year will be an interim analysis looking at the primary endpoints of relapse-free survival. We have a number of additional analyses. If you get there and we don't have the statistical power to declare early success then, then we would move forward to subsequent analyses and ultimately additional endpoints, including things like distant metastasis-free survival. What I'd remind you is the phase two hit, essentially, its statistical hypothesis at the interim. And then what we've been following since are the others. And we believe we've conservatively designed this study so that if those results are repeated, we would be well-powered to see that in this first interim. But if for whatever reason we're told to continue forward, there would be a subsequent analysis. And that, again, would be event-driven, but presumably would come the year after. As to the norovirus study, we are very excited to see those results potentially this year. Again, a case-driven trial.

As you highlighted, there had been some previous efforts in norovirus. Ours are quite different. So first, the composition of our vaccine, as you highlighted, is a trivalent here, and we are looking at strain-matched efficacy, which is important because it does allow us to make sure that we're looking at the performance of the vaccine, which is matched at strains that are in approximately, in most years, two-thirds to 70% of the circulating norovirus disease. And so that trivalent composition and the VLPs that our technology make, we think, is a differentiator. But perhaps the more important one relative to the trial I think you were referencing is we're looking in seropositive populations, not children. And so earlier studies that have struggled in norovirus have looked at in children, in primary vaccination, you know, often a couple of doses, as opposed to really where the burden of disease is as you become an adult is in older adults, those particularly over the age of 65, where, you know, the threat of really profound dehydration can lead to hospitalization and complications of a whole number of medical comorbidities. And so there's actually even bigger need in that population.

And in that case, it's more of a booster trial. It's much more like, you know, it's a bit like primary vaccination for, you know, whatever it is, RSV or flu or COVID, being very, very different than boosting seropositive people so that they can protect, which is a lot more like what you see with our senior flu, COVID, and RSV vaccines, which have obviously been successful. Norovirus is a different one, but we do believe that that difference in population will make a difference in terms of the ability of a vaccine to help protect them against this disease.

Management: And as a follow-up, do you think that the guidance with FDA or the discussion or regulatory path for this would be very different or, to put it another way, much more obvious than perhaps what's going on in the flu?

Management: So look, Michael, I'd remind that we got three products approved last year in the U.S. or some label expansions, RSV, a new COVID product, and a pediatric COVID. And in those cases, the guidance was different. What we're experiencing with flu is, I think, we hope flu-specific. Our norovirus study, to your point, is a very large placebo-controlled study. And so the refusal to file letter that we have received from the FDA on flu really speaks to a change in their perspective on the comparator used. But in the case of norovirus, there is no comparator to use. And so the comparator in that clinical trial is placebo. If we're able to demonstrate efficacy over placebo, it's hard to argue that there's a problem with the comparator.

Shelby (RBC Capital Markets): Maybe on INT, congrats on the recent five-year data for melanoma, and it's great to see the hazard ratio for RSS is remaining consistent with prior cuts. However, what about OS? I remember at ASCO in 2024, you showed some pretty compelling data with the initial separation of the curves, but the press release this time was silent on OS. How should we read that? Does that mean the OS curves are no longer separated, or are you just keeping the details for maybe an upcoming medical meeting? Any color there. Much appreciated.

Management: Yeah. Let me say it this way. We look forward to sharing the OS curves at an upcoming medical meeting. Where you see relapse-free survival holding, obviously included in relapse-free survival is survival. And so we obviously didn't put that out because we want to make sure that we're able to bring that forward to the community in a place where they can see all of that data. But all data from this five-year interim analysis will be presented at an upcoming medical meeting. Until then, I really shouldn't say more.

Courtney Breen (Bernstein): Just a couple and building off the conversation around the RTF that you got for the flu 1010. We've managed to find kind of an immunogenicity sub-study, I think, of that phase three efficacy study, which suggested, and it was a very small population of that study, suggested there was a 50-50 ratio between those under and over 65% can you just remind us or share with us what percentage of patients in that efficacy study were 65 or older? And then additionally, as we think about kind of INT and the path to approval and kind of have you had any feedback in the design of that clinical trial that perhaps provided some recommendations that weren't followed? Additionally, kind of will it be you or Merck taking that file forward? And kind of can we assume that CBA will be the FDA group that will assess that particular file? Thank you so much.

Management: Yeah, thank you for the questions. So first on the phase three trial design for our flu vaccine, you're correct, and your memory's right. More than 50% of the population in the study, but it was stratified that at least 50%, would be over the age of 65. We also had a very large population, you know, north of 10%, that was above the age of 75. And as we have presented at medical meetings, and will be available in the upcoming publication, we've seen really strong superior efficacy across all of those populations. In fact, it's remarkably consistent. And as you add frailty or other risk factors to age, or as you look to severe outcomes such as hospitalization, you'll see those point estimates for superiority go even higher and in many cases become even more statistically significant. So we feel very good about that 41,000 person study which, as you just described, or as I just said, has more than 20,000 people over the age of 65 in it. I did describe a separate Phase III study, just to avoid confusion, the P303 study, Part C. That has 3,000 people in it, and that was the study that was head-to-head against gluzone high dose that showed superior immunogenicity.

But the efficacy study, I think, was the one that you were asking about. Now, as it relates to INT, INT is, we're moving forward in a very novel field. And so we've had robust and I would say highly productive engagement with the FDA and truly global regulators around what will be a first of its kind individualized neoantigen treatment. Those dialogues are detailed and I think broadly we are very aligned both ourselves and Merck with those regulators. It is with CBER at FDA, but obviously other offices are involved because it is an oncology therapy of high import. It gets a lot of attention. And I would just say generally we're working closely with regulators to make sure that we're doing everything they want so that they can conduct rapid reviews of the file. Merck is our partner in this. Merck is the sponsor for the Phase III study, so we and they participate in the in those discussions and back and forth, and we each have different responsibilities in our 50-50 joint venture partnership. But the BLA submission, if it goes forward, will be from Merck.

Matthew (Bank of America): Hey, guys. This is Matthew on for Alec. Appreciate you taking our questions. Maybe for RCC, can you walk us through what makes you confident that Phase 2 could be registrational and what hazard ratio or benefit you think would be compelling? And then if you do need to run a Phase 3, curious whether you think Keytruda would be the appropriate comparator arm or whether Keytruda-Belzutaban combo would be preferred pending the LightSpark 22 data. Thanks.

Management: Yeah, that's a great question. You know, one of the exciting things in oncology is it's a fast-moving space, and in individual histology, sometimes the standard of care will evolve, and you're highlighting BALZU for RCC. Look, first, I'd say the Phase II study is blinded, it's powered, and if we see a really significant or profound benefit, you know, we haven't gotten what that hazard ratio would be, but let's assume it's something that would look really dramatic and highly statistically significant. Then it is structured so that it could be a registrational study. But, you know, it wasn't initially intended and powered as that. It's not a phase three study because our primary goal here was we wanted to confirm the hypothesis that INT works well across a range of tumors. And in particular places that we thought there was an opportunity to improve a prawn PEMBRO as a standard of care. Since we started and enrolled that study, there's obviously been the good news of the Balazoo results. Again, that's with our partner Merck. And so, if we see equally great response here for INT, we'll have a conversation with Merck about what we do with INT.

It may mean going forward. It may mean adding it to those because there's always a desire to improve outcomes in cancer. It will entirely depend upon what the data actually says. And so, at this point, we're just excited to look forward to it. But once we have it, the thing that, you know, I think we will be most focused on is, does this confirm the opportunity for INT to work across a range of different cancers and other histologies?

Addy (Evercore): Hi, this is Addy on for Corey. We had a question on the adjuvant melanoma as well. Could you share how do you anticipate use across the broader PD-1, PD-L1 class or primarily only with Pembrolizumab separately as sub-Q PEMBRO and other options become more prevalent? Do you see any impact on regimen selection, logistics, or ultimately uptake for Intuzumab? Thank you for both questions.

Management: So first, I think we will be pursuing a label. Obviously, it's on top of a standard of care in the trial, which is PEMBRO. But we believe that that label could broadly apply to other PD-1, PD-L1s that are approved in the same indication for adjuvant melanoma. Obviously, that will depend upon discussions with regulators, but I think that would follow the precedent of other approaches. And it's in our mutual interest with Merck. We want to see INT be used for as many patients as possible, regardless of the choice of the PD-1 or PD-L1 backbone. Um, the, um, as relates to sub Q, um, you know, I think it, that's really, uh, within the PD one class question. Um, and so how do those antibodies, um, you know, get subbed out for each other going forward? It really wouldn't relate in our mind, uh, to INT, which would be a category of one, uh, and the benefit that INT provides, we believe would apply equally well, although we'll have to see what regulators want to see to see this, but we think the community would agree that would likely apply equally well, whether you're doing a subcutaneous or IV use of a PD-1 antibody. But that's really a question about what they're doing in terms of class share there, because INT will be in a category unto itself.

Management: Ladies and gentlemen, this concludes the Q&A portion of today's presentation. I'd like to turn the call back to Stefan for any further remarks.

Stefan (Title): Well, thank you very much, everybody, for joining. We look forward to speaking to many of you in the coming hours, days, and weeks. Have a great day. Thank you. Ladies and gentlemen, this concludes today's presentation. You may now disconnect.

Quarter 2

Q3 2025 Earnings Call — November 6, 2025

Salveen Richter (Goldman Sachs): As we look to the expense management on the forward here, can you help us understand what's being deprioritized or changed to allow for these changes? And then secondly, in accordance with kind of Royvent and the IP dynamics that are playing out here, can you just frame your strategy here on the forward as we look to 2026? Thank you.

Executive: So it depends on your reference point in terms of what you talk about from a cost-out perspective. Over the last few years, as I mentioned, we're down 50% from a cash cost basis. But if I'm more recent in our recent $500 million to $700 million reduction, that's split evenly across R&D and cost of sales. So cost of sales is purely driving efficiencies. Everything that the teams are hard at work and have been hard at work doing, they're just accelerating and getting it done faster. So that's unutilized manufacturing capacity. That is all the waste that we saw in materials. They're doing a great job reducing that, driving productivity within the labor force. So that's not really a deprioritized investment. On R&D, it's a bit of both. It is the execution of our clinical trials has been much more efficient. We've talked in the past about the fact that we were operating for speed, and this time we were operating for cost as well and efficiency. So a lot of this is just the execution of our trials. But we are making decisions here and there to not continue to advance to Phase II or Phase IIIs or even out of Phase I here and there.

Broadly, we're taking down our, you know, just big picture story from the last couple years. Our large phase three vaccine trials are really running down and winding down, including CMV recently and flu combination vaccine. And after that, we are moving into oncology, which is a different amount of patients that are under those trials. So there is some prioritization in there, as we've always said, but a lot of it is also execution, but we still have prioritized our pipeline. So we are excited about the nine or 10 late stage programs that we have that Stephen highlighted in his prepared remarks, and we look forward to continuing to take out additional costs, and we do see that coming down over the coming years, and we'll update you more at Analyst Day.

And good morning, Salveen. On Arbutus, the trial in the U.S. is scheduled for March 9th, 2026. We remain confident in the groundbreaking technology we pioneered, including our lipid and particle delivery system. We are vigorously defending the case and responding to new filings outside the U.S. We believe that our technology does not infringe any valid patents asserted by arbiters. Thank you.

Gina Wang (Barclays): Thank you for taking my questions. Maybe two very quick questions. First one is regarding the U.S. COVID revenue, $781 million that I assume majority of this basically is the inventory buildup or delivery to the pharmacist. So maybe how often do you track pharmacies to maintain their inventory and what are, you know, additional color you can share regarding your estimate of the revenue for the remaining of this year? And then second question is regarding the CMS, sorry, CMV vaccine. So what is the learning there? You know, why immunogenicity data did not translate to clinical benefit?

Executive: So ultimately the end measure is vaccinations in the U.S. We've got shots in arms. And so in the third quarter, yes, we ship a lot of our product into wholesalers, and then they take it down to our end pharmacists, whether that's a retail pharmacy or an IDN network, a doctor or physician's office. And so we track that almost daily. And really what we put, what Stephen shared with you on the screen, is that's why we show shots in arms. We believe that's the ultimate measure. And if you look at season to date through October 24th, shots and arms are down in the U.S. 30%. There's a lot of reasons for that, some of which we anticipated. And if I take this back to our guidance, when we originally guided at the beginning of the year, we said $1.5 billion in the U.S. sales, one to $1.5 billion. The $1.5 billion was essentially flat year over year for all aspects, whether it's market share, competitive dynamics, vaccination rates, et cetera, excluding a one-time item from the prior year. And the billion dollars, as I said, is down 33%. So we obviously anticipated that the vaccination rate, which is the largest variable here, could go down.

And so now we've seen that go down, and we've reduced our range. So we said we believe vaccination rates will now be down 20% to 40%. And we are – in the heart of the vaccination season, we're probably half to two-thirds of the way through. So we have good visibility to this. We are measuring shots in arms. We talked about our share as well. And we also look at every single day and every single week, is there more pull-down? Is there more pull-down to the physicians? Is there more pull-down to retail? Are there more shipments even in the fourth quarter? And we feel very comfortable with our range now of $1 billion to $1.3 billion. But we do not see vaccination rates in the U.S. getting back to flat, which is the change from the high end, from going from $1.5 to $1.3 billion.

And, Gina, I'll take the CMV question. So, first, we really only have, at this point, the top-line data from that trial. And over the coming weeks and months, we will get a tremendous amount of more information, including detailed information on a bunch of other things on immunogenicity and potentially even correlates protection and have the ability to generate hypotheses on what maybe didn't work. What I can say at this point is, you know, as you know, going into the trial, we and the field had high hopes that a pentamer neutralizing antibody response, which had not been a part, a strong pentamer neutralizing antibody response, which had not been a part of previous intensive vaccines, was going to be the missing piece for being able to prevent infection with a CMV vaccine. Prevention of infection with the herpes virus or in CMV was an incredibly high bar. It was a difficult bar to go after, but ultimately the only one we thought that we could test that had a chance at meeting our target product profile for prevention of congenital CMV.

So I guess what we can say at this point, until we get that additional data, is it looks like pentamer neutralizing antibodies weren't the missing piece and that it wasn't sufficient by itself to drive a dramatic improvement in the prevention of infection with CMV. Now, we'll dig into the data as we get it over the coming months. Obviously, look forward to publishing it, sharing it at medical conferences, and hopefully the entire field can learn where vaccine development in CMV might need to go next. But ultimately, pentamer wasn't enough.

Corey Kasimov (Evercore): I want to ask about your norovirus program. Are you surprised at all by the slow case accruals here, or is this kind of anticipated? And do you believe this offers any sort of reflection on the commercial opportunity or potential demand for the product should it be approved? Thank you.

Executive: So, yeah, predicting epidemiology in norovirus is still an early space. And so, we had always designed the study as a potential two-season study. In fact, we always expected that it was possibly going to be necessary. That happens in flu vaccines. That has happened in other respiratory vaccines, other, you know, vaccines based on case accrual. It happened to us here. I think we believe we're getting better at predicting where that epidemiology will be, where we cite the trials, and ultimately being able to accrue cases that are matched to the vaccine composition. And I think we are hopeful that with this additional second season, which was always a possibility, that we'll be able to show or accrue enough cases to conduct that IA and ultimately demonstrate the efficacy of the vaccine.

The impact on commercial target product profile moving forward, I would say we don't believe that there's been a change to that. At the end of the day, what matters here is hopefully a highly effective vaccine against preventing norovirus. It is a well-established burden of disease globally, and we do believe that the health economic benefit of prevention of severe to moderate infections with norovirus will be clear, particularly those that are at highest risk, including those that live in long-term care facilities or for other occupational reasons might be at risk. So we still feel strongly about that target product profile and think that the epidemiology challenges of the last season will be addressable with the second season of enrollment.

Luca Issi (RBC): Congrats on the progress. Maybe, Jamie, can you just talk about what gives you confidence as you can reiterate your cash break-even guide for 2028? I'm appreciative you're making some fantastic progress in terms of managing the alt-packs and the cap-packs, but still your cash cost at the midpoint this year is $4.6 billion. So I think in order to break even in 2028, you really need your top line to re-inflect quite materially from here. So can you just talk about that? I mean, it looks like COVID is still declining. You know, RSV, maybe it's one and done for now. CMV did not make it. INP initially is going to be just for adjuvant melanoma. So what are the near-term products that you think can really inflect the top line in the foreseeable future? And then maybe second, Stefan, quickly, I think a few media outlets have reported that Moderna is working on potential large deals with pharma. So wondering if you can comment on that. And then maybe bigger picture, what's your latest thinking on DD these days? Thanks so much.

Executive: There's a lot in there. And we recognize it's on everybody's mind, and we're going to lay this out at Analyst Day, just so you know. But I'll mention a couple things here. You know, when we say, and we all commit to breaking even, it is both a mix, to your point, of revenue growth and cost reduction. And so on the cost reduction side, as I mentioned earlier to Selveen's question, we see ample opportunity, and I mentioned that we will update our 2026 and 2027 framework at Analyst Day, but there's still plenty to do on that front. On the revenue side, we see a lot through geographic expansion, through our strategic partnerships that I mentioned in my prepared remarks, through new product introductions. We'll get through and lay that out in a more fulsome way at Analyst Day, but we remain committed, but, yes, it is a mix of both the revenue side growing as well as the cost side reducing, and we still feel confident in our plan.

And on the deal side, as we spoke about in several of our last calls, we really want to get products like the latent vaccine, like EBV, for example, to patients. As we've said, part of our prioritization of our portfolio, we do not want to fund a phase three by ourselves. And so, we are talking to pharma companies. We are talking to financial sponsors. As you know, we have a partnership with Blackstone that we lead on flow and. So, those discussions are ongoing, and when we have something to communicate, we will.

Tyler Van Buuren (TD Cowen): It looks like Mnex spike is already taking the slight majority of your COVID vaccinations over spike back. So how do you expect the split between these two vaccines to continue to evolve? And I'd also be interested to hear what feedback you're hearing from pharmacists and other clinicians about Mnex spike so far.

Executive: So, you know, we're obviously really pleased with that launch. It has become, you know, our leading product in the overall COVID franchise. And that's been, you know, frankly, exceeded our expectations in a positive way. It really speaks to the profile, we think, clinical data, as well as, you know, the overall sort of momentum in the market towards higher risk populations. Some of that as a result of changes in recommendation in this country has in the United States towards high-risk individuals and those over the age of 65. We're continuing to build up that medical story, and the data has been shared, obviously, at ECIP, but in medical meetings. And we hope to continue to build momentum behind the MNIC Spike brand as our leading product in the franchise. Now, SpikeFacts will always have a place. And as you know, SpikeFacts is the only approved product in pediatrics down to six months to four-year-olds. And that is an important population, particularly for those with high-risk factors, you know, those with lung disease or those with underlying comorbidities, even in the young population.

So we will always expect some portion to be at spike facts, but over time, we would hope that the older adults and higher-risk populations might migrate to MNIC spike. That's consistent with the feedback we've been getting. And, in fact, if you look at many of our large customers, both health systems and pharmacies, that is how they are thinking about the products and using them. We'll be working with governments around the world as we move to launch MNEX Spike outside of the U.S. for the next season, and we hope to continue to see growth in that brand as a part of our overall franchise. But as I said, we will always have both. I don't have specific guidance on the split because at the end of the day, this is a decision made by healthcare providers and customers about what's the most appropriate choice for their patients.

Jessica Fry (JPMorgan): How is the U.S. COVID vaccine demand tracking this season relative to your projections, and what about the ex-U.S. season? And also, can you orient us around the potential annual revenue contribution tied to the manufacturing sites in the U.K., Canada, and Australia?

Executive: So our revised guidance is $1 to $1.3 billion in the U.S. We anticipate that vaccination rates are going to be in the range of down 20 to down 40%. That's not too different than what we thought at the outset of the year that it could be flat to down. We definitely incorporated a scenario where vaccination rates could be down, but we feel good about it. We are mostly halfway through the season and feel good about and have confidence in our U.S. range. Outside the United States, we actually raised the bottom end of our revenue guidance. So we used to be half a billion to $700 million. Now it's $600 million to $700 million. That's due to everything is now contracted. A lot of it has been delivered. And as we look to the last couple months of this year, what's really coming down to the only variables left are delivery timing, whether some of this falls into the first quarter of 2026 or remains in 4Q25. And then there are a couple markets that are predicated upon vaccination rates, so the demand is still tied to vaccination rates. So we feel very comfortable with our range outside the United States as well.

Then in terms of the strategic partnerships, if you remember, in I think the second quarter, we said that the deliveries for our UK strategic partnership has already shifted outside the year, which was the reason we dropped the high end from $2.5 billion at that time to $2.2 billion. So we do not expect any revenue inside this year. That will be pure growth in the year 2026. I mentioned in my prepared remarks that half of our OU international revenue was in Canada in the third quarter. So Canada is up and running. We believe Australia will be up and running from a revenue perspective, that is, in the fourth quarter, and then the U.K. in the first quarter of next year. So we feel good heading into next year that we should be able to see some revenue growth from our strategic partnerships.

Jeff Meacham (Citigroup): I have two for you. So the first one on the cost reduction and just looking at the 2028 breakeven target, I was curious if your pipeline evaluation process has evolved just to look at maximizing, you know, ROI on your R&D investments. And then on the rare disease platform, you know, what's the capacity in this TA to add more programs? It does seem like it could be quicker to get the proof of concept data, but I just maybe wanted to compare that to oncology and how you guys were thinking about it.

Executive: So, first on R&D, I think it was a couple years ago, reiterated last year, that we said as far as large phase three programs in our infectious disease pipeline, that we would defer further Phase 3 investments until we crossed break-even, cash break-even in 2028. And then as a result of that, there would be this substantial downshifting in our R&D expenditures over last year and this year and the next year ahead as the large Phase 3s for flu, for COVID, for CMV, and even norovirus runoff. And so we've maintained that position all the way through how we've been constructing our pipelines, which I would say is not necessarily ROI maximizing. It is, you know, cash and investment optimizing. We do believe we have several compelling phase two programs. EBV is one example of a vaccine against infection mononucleosis and perhaps multiple sclerosis, but one that we are not moving forward with in terms of investment. I believe that ROI is attractive and positive. We do, but we will wait to make investments until we've shown we can break even based on the current products. And so that's the way our portfolio has been evolving from a construction perspective.

Now, there are instances, for instance, in our oncology space where we do see an opportunity to make cash investments within our prior guidance, whether that's with the Antismeran program or with 4359 that we think have a very attractive ROI and, again, can fit within our break-even guidance for 28. And so those are instances of where we will continue to move forward. And maybe that's a natural segue to that last part of your question, which is that is also true to some extent in the rare disease space. We have the two programs, PA and MMA, that are moving towards or, you know, in the case of PA, fully enrolled in their potential registrational studies. And it is a platform where we do believe we can do much more. There's a very large number of diseases for which we think a technology can work. But, again, we want to demonstrate discipline. And so we are not prioritizing making further investments in the rare disease space until we have PA and MMA through those registrational studies, and ideally until we also achieve our break-even targets for 28. It is a lower cash investment to move those programs forward.

And so, as you alluded to, it might be a place that naturally, as we get more comfortable over the next year or two, that we start moving perhaps a third or a fourth program through. But that will have to be balanced against further investments in oncology, like the 4359 programs, or potentially the reinitiation of pivotal investments in our infectious disease portfolios. And at this point, we'll make those decisions in the future and haven't got a strategic view one way or the other right now.

Courtney Breen (Bernstein): Just wanted to probe a little bit more on the R&D cuts, perhaps kind of in contrast to Salveen's question, perhaps a little bit more forward-looking. As you think about kind of the efficiencies that you've garnered and the new approach, are there more cuts that you can make going forward to that R&D plan, or would that require actually stopping off programs or changing kind of your prioritized list of assets that you have in the pipe? Thank you so much.

Executive: So we do expect further reductions in costs. We'd previously communicated how we were moving towards breakeven. And so today's cash costs for 2025, while they are better than our guidance, they are not done. And we expect further reductions in our gap costs for R&D over the coming year and two, purely based on the sunsetting of our existing prioritized investments. And so we believe that those reductions will happen without further program stops. And we will continue to do investment in the early stage space as well, which, as you know, is a less cash-intensive, capital-intensive area. So at this point, we believe we can continue to drive efficiencies and further cost reductions in our R&D investment in the coming years simply by completing the work that we had started several years ago in our infectious disease vaccines portfolios.

John (William Blair): So, maybe a follow-up to an earlier question on the CMV program. I know that you're still going through the data, but was wondering if you could speak to any read-through from the CMV trial missing to any of your other latent vaccine studies, or if you view the CMV miss as an isolated event?

Executive: So, CMV was unique in our pipeline in that it is the only pivotal study, phase three study that we're running against a latent virus and the only one that was going after prevention of infection. So, we do believe that prevention of infection was unfortunately the only way to try and demonstrate a potential for the vaccine against congenital CMV, but it was by far the highest bar. Vaccines generally don't prevent infections, they prevent diseases from the viruses. And even in the case of CMV, we still believe that there's an opportunity for mRNA-1647 to have an impact in patients undergoing bone marrow transplant where they are already infected, but they see a reactivation of their CMV that can have serious potential morbidity and mortality. And for that reason, we think there's an opportunity for a vaccine to help control that reactivation even a vaccine against CMV. So I guess I would say we don't have other programs in our late stage or prioritized pipeline that have a similar read-through or a read-through from the CMV results because we are not trying to prevent infection with any of them. We're trying to prevent diseases. And even in the case of CMV, we see a potential opportunity in an indication like bone marrow transplant CMV reactivation, where, again, the target product profile is going against prevention of a disease, not prevention of infection.

Management: Well, thank you, everybody, for joining today. We look forward to talking to many of you in the coming days and weeks, and we look forward to seeing many of you here on campus on November 24th in Vestal Day. Have a great day.

Management: Ladies and gentlemen, that concludes today's presentation. We thank you for your participation. You may now disconnect and have a wonderful day.