Will Monkeypox trigger a similar C19 scenario?

Will Monkeypox trigger a similar C19 scenario?

Will Monkeypox trigger a similar C19 scenario?

Bavarian Nordic’s (CPH: BAVA) vaccine for monkeypox (MPXV), called Jynneos, received US Food and Drug Administration (FDA) emergency usage approval 9th August 2022. The intradermal injection protects high-risk individuals over the age of 18 from the MPXV infection.

  • The Monkeypox virus (MPXV) was first discovered in 1958 in laboratory monkeys, hence the name. According to scientists in the field, the main monkeypox carriers in the wild are rodents such as squirrels, rats and dormice. Rodents are of most concern.
  • Monkeypox is endemic to tropical rainforest areas in Central and West Africa. The first monkeypox zoonotic (micro-organisms that are spread between humans and animals) spill over was detected in 1970 in the Democratic Republic of Congo.
  • Change – Historically, the monkeypox virus has caused small outbreaks. These MPXV outbreaks were limited to a few hundred cases. The current outbreak is in the 10s of thousands. Since 1970, the virus has emerged in other continents via human and animal vectors through international travel and exotic animal imports. There is some concern that monkeypox has the potential to become a pandemic.
  • The first global monkeypox outbreak began in May 2022, with over 30,000 confirmed cases as of 8 August. (Financial Times, 2022)
  • Monkeypox is typically transmitted through prolonged close physical contact with infected people (skin-to-skin, bodily fluids, or sharing infected items) or animals (bites, scratches, bodily fluids, faeces or uncooked meat consumption). These transmission conditions to not make monkeypox an obvious pandemic candidate.
  • However, transmission by animals, especially rats, is driving reappraisal of MPXV’s pandemic potential.
  • Despite the increase in monkeypox infections, epidemiologists seem to be signalling that a similar scenario to C19 is unlikely. According to Centre for Disease Control and Prevention (CDC) and World Health Organization (WHO), smallpox vaccines are considered ~85% effective against the MPX virus. (CDC, Nature, 2022)


Monkeypox virus (MPXV) alternative vaccines – a significant opportunity

The monkeypox virus is here to stay, much like Covid 19. All viruses evolve of course, however unlike Covid the monkeypox virus historically has mutated more slowly.

Current research indicates that the smallpox vaccine can protect against MPXV if it is administered within four days of exposure to the virus. “Vaccination after a monkeypox exposure may help prevent the disease or make it less severe”. (CDC, 2022)

In addition to Bavarian Nordic’s vaccine Jynneos, the FDA has also allowed the use of the ACAM2000 smallpox vaccine under its expanded Investigational New Drug (IND) mechanism, sometimes referred to as “compassionate use” permissions. Unlike Jynneos, the ACAM2000 vaccine is permitted for use with individuals under the age of 18.

In Europe, the Imvanex smallpox vaccine is approved for use in adults as of July 2022 by the European Medicines Agency (EMA).  Bavarian Nordic also manufactures Imvanex.

According to WHO there are only 16.4m doses of smallpox vaccines available globally (total population is ~7.97bn). There is therefore, a significant opportunity for biotech companies to develop the products needed to help fight the MPXV outbreak.


Filling the MPXV vaccine gap

The Coalition for Epidemic Preparedness Innovations (CEPI) is supporting the development of a Monkeypox antibody. CEPI was founded in Davos by Norway, India, the Bill & Melinda Gates Foundation, Wellcome, and the WEF.

CEPI has provided funding of up to US$ 375,000 to the UK Medicines and Healthcare products Regulatory Agency (MHRA) and the UK Health Security Agency (UKHSA) to support the development of a Monkeypox antibody standard and assays. (CEPI, 2022)

In exhibit 1 below we have compiled a list of companies that have produced pre-clinical phase smallpox vaccines for immunisation and diagnostics for MPXV.

Approved smallpox vaccines for usage against MPXV – Emergent BioSolutions’ (NYSE: EBS) ACAM2000, Bavarian Nordic (CPH: BAVA) Jynneos, Meiji Holdings’ (PNK: MEJHY) LC16 KMB (developed in the KM Biologics lab).

  • Monkeypox specific vaccine – The biopharma companies that entered this race are Tonix Pharmaceuticals (Nasdaq: $TNXP) TNX-801 and Moderna (Nasdaq: MRNA) mRNA MPX Vaccine.
  • Antiviral drug treatments effective against Monkeypox – In the preclinical phase there is NanoViricides (NYSE: $NNVC). In the developed/consumption stage is Siga Technologies’ (Nasdaq: $SIGA) TPOXX and Chimerix’s (Nasdaq: CMRX) Tembexa.
  • Other healthcare companies developing products to counteract the Monkeypox virus include Tomi Environmental Solutions (Nasdaq: $TOMZ). Tomi has developed the SteraMist Binary Ionisation Technology (BIT), which is an ‘environmental’ disinfectant that activates and ionizes 7.8% Hydrogen Peroxide (H2O2) to protect the environment by killing bacteria and fungal spores and inactivating viral cells by destroying their proteins, carbohydrates and lipids.


Exhibit 1 – Monkeypox products under development or available to consumers

ACF Equity Research Monkeypox projects under development

Sources: ACF Equity Research graphics; Nature; Biopharma Reporter; Wired; CEPI; CDC.


Our view

As a result of the C19 pandemic, we understand that containing a virus pandemic is as much about testing, isolating and sterilising as it is about available treatments and vaccines. Intense testing and contact tracing system might be something all governments have to have on standby and test regularly hereon in. The CDC thinks testing and contact tracing is imperative (CDC, Nature, 2022).

The only really effective way to fight a pandemic and consign it to history is via vaccines. We are in the early stages of Monkeypox, but given the perhaps surprising speed at which C19 vaccines were produced, it might be reasonable to assume the same can be achieved for MPXV.

Access to funding and government support will play a key role along with capital markets support. Capital markets may be volatile at the moment, but the other lesson learned from the C19 pandemic and market correction, was that healthcare companies prevailed via a series of almost ‘endless’ opportunities.
In the peer group table below we have included a list of biotech companies that have developed a vaccine or diagnostic or disinfectant for Monkeypox (MPXV):

Siga Technologies (Nasdaq: SIGA) & Tonix Pharamceuticals (Nasdaq: TNXP) developed a therapy: NanoViricides (NYSE: NNVC), developed a test: T2 Biosystems (Nasdaq: TTOO); TOMI Environmental (Nasdaq: TOMZ) developed an environmental disinfectant. Note that Siga is excluded from the median and average values in the peer group to minimise distortions.

The peer group below and the table above suggest that there are candidate investment companies for most investor risk profiles and strategies.


Exhibit 2 – Peer group of companies in the Monkeypox space

ACF Equity Research Monkeypox vaccine peer group

Sources: ACF Equity Research Graphics; Refinitiv.


Christopher Nicholson, Managing Director, ACF Equity Research

Christopher Nicholson

Managing Director/Head of Research

I am a financial analyst, entrepreneur, professionally qualified equestrian and amateur eventer. Amongst others, I trained as a financial analyst at Global US based fund manager Legg Mason Investors and have been head of Technology and Media Equity Research at Bryan Garnier, a pan-European investment bank and brokerage.

I founded ORACA Independent Equity Research a ground breaking highly independent thinking large-cap secondary comm business and ACF Equity Research, a very high-quality independent issuer-pays small and mid-cap research business. I opened our first corporate finance business (Destrier Partners) and am approaching the launch of our first non-financial services business. In my view, I am only able to do these things because of the quality of the team I work with at ACF. For 11 years I broadcasted as an expert guest and wrote regularly in the leading pan-European and international media including Bloomberg Television, BBC Radio 4 and the Financial Times.

I studied Biochemistry at Kings followed by Economics at LSE and can conduct business in English and French, I speak German and have basic knowledge of Spanish and Italian. My free time, which I make sure I carve out, is in part each day spent on my passion – riding, competing with and caring for my horse(s).

 Mike Wort,Non-Executive Chairman, ACF Equity Research

Mike Wort

Non-Executive Chairman

I have managed over 20 IPOs in the US, UK and Europe from small to large cap, I am proud to be ACF Equity Research’s Non-Executive Chairman.

I am also Executive Chairman of Texadon Oil Plc focussed on oil & gas production in the Texas Gulf Basin and is a Non-Executive Director of UK AiM listed Diaceutics, a diagnostics commercialisation business. I am a life sciences communications expert and have a background in large and mega cap pharmaceuticals.

During my more  thann  20 IPOs and secondary raisings I have brought in well in excess of £600m.

In addition, I have co-founded a number of life science start-up companies in Europe and the USA.

I am a life science communications expert and former life sciences CEO (large to start-up). He graduated in microbiology and lectured to science undergraduates in both the UK and Nigeria. He joined the pharmaceutical industry, working in a number of senior sales, marketing and clinical roles for Glaxo, SmithKline and Wellcome in the UK and overseas.

Appointed IR Manager for Wellcome, I helped organise its global roadshow for a £2.4bn secondary offering.

I have consulted on and conducted M&A and DD in the life science sector and developed disaster recovery programmes for SME companies.

I worked with Deutsche Bank to privatise the Bulgarian pharmaceutical industry. As the CEO of Balkanpharma, I led the consolidation of the three key assets into one cohesive unit. Balkanpharma has, through a series of M&A activities, become a significant part of NYSE listed Allergan.

Formerly MD at De Facto Communications, Bell Pottinger’s healthcare offering, I recently retired from Walbrook, the UK’s most successful SME PR/IR agency.


Amalia Barnoschi, Head of Operations, ACF Equity Research

Amalia Barnoschi

Head of Operations

Joining ACF at its founding I started in financial services in 2007 on the sell-side with ORACA, a large-cap independent equity research business that changed the industry. Before financial services I was a highly successful and rapidly promoted young manager in manufacturing and have worked closely at board level for over 15 years with SMEs in the City and in other financial markets.

I co-run ACF with our MD, as Head of Operations, responsible for driving profitability and developing and designing processes and managing projects for ACF and for client partners to allow our portfolio of businesses to grow. I am bilingual English/Romanian, read Italian and am working towards my accountancy ACCA qualification with AAT.

I love to relax by making time for my favourite out-of-hours activity – photography – taking my first formal nature course in May 2018. I have a keen understanding and interest in horses, though not a rider, this is combined with a life-long love of polo.

Anne Castagnede, Head of Sales & Strategy, ACF Equity Research

Anne Castagnede

Head of Sales & Strategy

I am a sales professional with a top-tier luxury goods background. In the past 5 years I managed flagship boutiques as well as working for some of the great Haute Couture houses including Chanel and Jimmy Choo, where I established a reputation as a top performer by developing, maintaining and offering information and guidance to new and existing clients.

I have researched, recommended and implemented service opportunities as well as improvements. In the early days of my career I trained with Air France and later with Chanel. On my journey I acquired management skills from back office through to front office and have a high degree of practical IT literacy.

I know from personal experience that passion leads the way to perfection and my will to learn matched with my sales ability will result in clients being in very capable hands. My bilingual languages are French and English and I speak Spanish. Off-duty my passions are languages and art.

Renas Sidahmed, Sales & Strategy / Staff Analyst, ACF Equity Research

Renas Sidahmed

Head of ESG / Staff Analyst

I am a macro-economic and financial analyst, linguist, mathematician, professional dancer and chef. I worked for four years with the IMF, two and half years with the International Finance Corporation (IFC) and eight months with the World Bank in Washington DC.

I also wrote award winning research notes and met with senior politicians with varied global and local interests in both wealthy and less developed economies. My sector expertise includes natural resources (particularly oil & gas) healthcare, manufacturing, infrastructure and investment portfolio management.

At ACF, as part of my staff analyst role, I am also Head of ESG / Sustainability and its products and services.

Before joining ACF Equity Research, I worked with Japan’s second largest brokerage, Mitsubishi Bank, in the London office. I speak six languages including English (native), Italian, French and Arabic and obtained an MBA in Rome and a Mathematics degree from a sister Ivy League – Smith College. I joined ACF because of its entrepreneurial, female friendly City culture, overarching global values and excellent growth prospects.

Anthony Kimber

Anthony Kimber

Senior Analyst ESG / Sustainability

I have considerable experience in the wealth management and private banking industries. I am co-author of the Platforum UK Wealth Management Market Overview report, and previously was Research Director at PAM Insight, a specialist publisher for the wealth management industry. I engage in research and analysis both qualitative and quantitative and am an experienced project and business development manager. I have been commissioned by UHNWI's, companies and organisations for various bespoke projects.

I also contribute to major news and media organisations, compiling and analysing data and research for the Daily Telegraph and Evening Standard on national government and environmental issues. Prior, I contributed to the Guardian, the Spectator, BBC news and investigative programming, the Sunday Times, and the Sunday Times Rich List.

My interest in ESG and sustainability is focused on raising awareness and achieving practical and workable solutions to the climate crisis we are facing. I enjoy spending my free time with family and friends, watching cricket, theatre and film.

Anda Maria Onu, Sales & Strategy, ACF Equity Research

Anda Maria Onu

Sales & Strategy

I have strong analytical, planning and execution skills, I love working as part of a team both inside ACF and externally with our clients and prospective clients.

I am used to working with and within senior leadership teams and understand the needs of small and medium sized companies through my current and previous professional experience, I graduated in life sciences with a specialisation in Ecology and Environmental Protection in Romania in 2007 and for my first job I worked in a laboratory carrying out chemical analysis of industrial waste-water.

I am passionate about the environment and work as a volunteer for the Sussex Wildlife Trust doing conservation work at the Old Lodge nature reserve. In my spare time I am a school governor and have been a juror at the Royal Court of Justice. My hobbies are dance, horses, swimming, opera and theatre.

Zak Mir, Technical Analyst, ACF Equity Research

Zak Mir

Technical Analyst

Zak Mir has 30 years financial markets experience and understands credible influencing across digital channels in order to drive stock liquidity. He is an accomplished author.

I am part of ACF’s advisory and execution team helping growth companies (nano, micro, small and mid-cap) maximise their profiles to achieve the optimal investment message.

Amongst others I have worked for Man Group companies, Berkeley Futures and Sucden. I have been a technical analyst, derivatives broker and Chief Market Strategist for a number of brokers in the retail space developing and optimising client trading strategies. I ran the well-attended annual Master Investor conferences and am a keynote speaker at the UK investor show. I also host the CityAM Podcast.

Analytical communications is part of my forte – I have variously been a markets columnist, editor and commentator for influential retail financial information outlets, amongst others – Investors Chronical, Yahoo! Finance, Shares Magazine, international leading long-form periodical The Spectator, CNBC and Bloomberg TV.

Away from the markets, I am a song writer and musician and have a long and patient interest in politics – areas that continue to be potential additional professional careers.
I was attracted to ACF because of the effectiveness of its high quality research and its forwarding thinking culture.

Richard Calvert, Director, Distribution & Service, ACF Equity Research

Richard Calvert

Director, Distribution & Service

I’m a Modern Marketing Strategist with a strong CXM, digital transformation and innovation background working with global blue chip clients, modern creative and media agencies and start-ups.

I put people, data, technology and brand at the heart of everything I do – always delivering highly creative and effective integrated solutions with engaged, excited teams. I believe in taking everyone from the Account Exec to the C-suite client with me on the journey.

I work with Global clients as easily as entrepreneurial start-ups across a broad range of categories from Automotive to FMCG, Financial Services and Technology. My recent focus has been on Digital integration; Relationship Marketing; Content Planning and Brand evolution.

Specialties: Strategic Planning, CXM, Digital and Business Transformation, Programmatic Marketing, Proposition Development, Content Planning, User Experience Development and Design, Mobile, Consumer Insight Development, Brand Planning and Development, Information Architecture and Design, Business Development, Digital Channel Strategy Development, Brand Development, CRM Strategy and Delivery, Business Development

Vicky Ryce, Director, Research Distribution, ACF Equity Research

Vicky Ryce

Director, Research Distribution

I am a digital communications and distribution specialist and strategist used to board level decision making. I started my career as part of the ground-breaking young cadre that for a short exciting time formed the original Text 100, and whose members have gone on to lead and influence thought in digital communications.

During my career I have worked with world leading agency Publicis and counselled the C-suite of some of the world’s biggest public companies, including Philips, Xerox and Microsoft, on how to improve their communications reach and then helping them execute. I also work with smaller and mid-sized private and public companies on the FTSE 250 and below. I am as comfortable dealing with retail reach, as with corporate and institutional capital markets distribution strategies.

I am an equestrian, proven entrepreneur and charitable volunteer and when I can cut out the time, I help young adults via the Princes Trust. I am an English and History graduate with an MA in Media and Culture. ACF Equity Research has a determined problem solving, enlightened forward-thinking capital markets culture and a global values set.

Adrian Chiappe, Editor, ACF Equity Research

Adrian Chiappe


Adrian has over 20 years investment research writing, editing and supervisory analysis experience for leading investment banks including Barclays Capital, UBS, BNP Paribas, Jefferies, S&P, Danske Bank, ABN Amro, Lombard Odier and Bear Stearns.

He has a deep understanding of his subject. Adrian has executed editing and supervisory analysis for investment banks, brokerages and fund managers. He has up-to-date knowledge of the operational and regulatory framework for international institutional equities markets. Adrian is a materials scientist and has languages