Question explored with the scientific record
Pfizer (via its partnership with BioNTech on the Comirnaty mRNA vaccine) generated the highest COVID-19 vaccine revenues by a significant margin.
The short version: the evidence retrieved does not contain a single study that compares Comirnaty revenue to any other COVID-19 vaccine, so the hypothesis is entirely unsupported by the information provided.
None of the 32 records in the evidence block address Pfizer/BioNTech's revenue, market share, or sales figures. The studies are about safety—case reports of encephalitis, pancreatitis, vasculitis, myocarditis, DNA impurities, and animal models [1–32]. There is no financial data, no market analysis, and no comparison of Comirnaty revenue against Moderna, AstraZeneca, Johnson & Johnson, Sinovac, or any other vaccine. The evidence on the question asked is zero.
The retrieved safety data does show a real and documented harm signal. A 2025 EudraVigilance study of 35.4 million pediatric doses found a 0.57% serious adverse drug reaction risk, with Comirnaty generating 5,018 reports versus 494 for Spikevax, driven by the sheer volume of Pfizer doses given [8]. The 2024 quantification study found DNA impurities of 3,600–5,340 ng per dose, levels the manufacturer's own qPCR method would systematically undercount [9]. The pig study revealed spike mRNA transfection to liver, spleen, kidney, and heart with up to 100-fold cytokine upregulation [6]. These are the actual data in the record.
| What the evidence covers | What it tells us |
|---|---|
| Pediatric SADR risk (EudraVigilance) [8] | 0.57% overall; Comirnaty 5,792 APMR vs Spikevax 5,671 APMR |
| DNA impurity per dose [9] | 3,600–5,340 ng (7 batches) |
| Spike mRNA in porcine organs [6] | Liver 40–90%, spleen 10–3,000×, kidney 10× |
| Case reports of autoimmune injury [1, 2, 4, 5, 7, 11, 15, 25, 27, 31, 32] | Multiple organ systems, temporal association after 1–16 days |
My call: the evidence retrieved does not answer the revenue question at all. Confidence in the revenue claim from these records: none, because the data simply is not here. If you want to know whether Comirnaty generated the highest revenue, you need financial statements from the manufacturers, which these documents do not provide.
Sources used 32
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Post-Vaccinal Encephalitis with Early Relapse after BNT162b2 (COMIRNATY) COVID-19 Vaccine: A Case Report
This case report describes a 72-year-old man who developed autoimmune encephalitis with early relapse following the BNT162b2 (COMIRNATY) COVID-19 vaccine, highlighting the potential neurological complications associated with vaccination.
DOI: 10.3390/vaccines10071065 -
Pancreatic Injury after COVID-19 Vaccine—A Case Report
This case report describes a rare instance of acute pancreatic injury occurring shortly after the administration of the Pfizer BioNTech COVID-19 mRNA vaccine, highlighting the need for monitoring patients who report severe abdominal pain post-vaccination.
DOI: 10.3390/vaccines9060576 -
Status migrainosus: a potential adverse reaction to Comirnaty (BNT162b2, BioNtech/Pfizer) COVID-19 vaccine—a case report
This case report describes a 37-year-old woman who developed status migrainosus lasting 11 days following the second dose of the Comirnaty (BNT162b2, BioNtech/Pfizer) COVID-19 vaccine, highlighting a potential adverse reaction in individuals with a history of migraine without au…
DOI: 10.1007/s10072-021-05741-x -
A Three-Case Series of Thrombotic Deaths in Patients over 50 with Comorbidities Temporally after modRNA COVID-19 Vaccination
This study presents a three-case series of thrombotic deaths in patients over 50 with comorbidities occurring temporally after receiving the Comirnaty modRNA COVID-19 vaccine, highlighting potential thrombotic risks associated with the vaccine.
DOI: 10.3390/pathogens11040435 -
Cutaneous vasculitis after severe acute respiratory syndrome coronavirus 2 vaccine
This case report describes a 22-year-old woman who developed cutaneous vasculitis following the second dose of the Comirnaty (mRNA BNT162b2) COVID-19 vaccine, highlighting a potential adverse effect of the vaccine.
DOI: 10.1093/rap/rkab050 -
Acute anaphylactic and multiorgan inflammatory effects of Comirnaty in pigs: evidence of spike protein mRNA transfection and paralleling inflammatory cytokine upregulation
This study investigates the acute anaphylactic and multiorgan inflammatory effects of the mRNA COVID-19 vaccine Comirnaty in pigs, revealing significant spike protein mRNA transfection and inflammatory cytokine upregulation across multiple organs.
DOI: 10.1101/2025.06.07.658379 -
A neurologist’s rhombencephalitis after comirnaty vaccination. A change of perspective
This case report describes a rare instance of autoimmune rhombencephalitis occurring in a neurologist after receiving the Comirnaty (Pfizer/BioNTech) COVID-19 vaccine, highlighting the need for further investigation into potential neurological side effects of mRNA vaccines.
DOI: 10.1186/s42466-021-00156-7 -
Serious Adverse Drug Reactions to COVID-19 Vaccines in the Pediatric Population: A Retrospective, Cross-Sectional Study Utilizing the Eudravigilance Database for the European Economic Area
A retrospective, cross-sectional analysis of pediatric adverse drug reactions to COVID-19 vaccines in the EU using the EudraVigilance database, estimating a real-world SADR risk around 0.57% and comparing Comirnaty (Pfizer) vs. Spikevax (Moderna) with detailed ADR categories and…
DOI: 10.3390/jcm14186542 -
Methodological Considerations Regarding the Quantification of DNA Impurities in the COVID-19 mRNA Vaccine Comirnaty®
This study critically evaluates the methodologies used to quantify DNA impurities in the COVID-19 mRNA vaccine Comirnaty, revealing significant under-detection of DNA contamination due to reliance on qPCR and advocating for alternative fluorescence spectrometric methods for accu…
DOI: 10.3390/mps7030041 -
Differential efficacy of first licensed western vaccines protecting without immunopathogenesis Wuhan-1-challenged hamsters from severe COVID-19
A side-by-side evaluation in Syrian hamsters shows four first-approved Western COVID-19 vaccines (Comirnaty, Spikevax, Jcovden, Vaxzevria) provided protection against Wuhan-1 SARS-CoV-2–induced severe disease without VAERD, with AdV vaccines eliciting neutralizing antibodies aft…
DOI: 10.1038/s41541-025-01100-5 -
Epstein-Barr virus reactivation after COVID-19 vaccination in a young immunocompetent man: a case report
This case report describes the first documented instance of Epstein-Barr virus reactivation with cutaneous manifestations in an immunocompetent patient following the COVID-19 vaccination with Comirnaty.
DOI: 10.7774/cevr.2022.11.2.222 -
Comparison of Post-Vaccination Response between mRNA and Vector Vaccines against SARS-CoV-2 in Terms of Humoral Response after Six Months of Observation
This study compares the humoral immune response between mRNA (Comirnaty) and vector (Vaxzevria) vaccines against SARS-CoV-2 over six months, finding that mRNA vaccines elicit a stronger and more persistent antibody response.
DOI: 10.3390/vaccines11101625 -
Erythema Migrans-like COVID Vaccine Arm: A Literature Review
This literature review investigates the adverse skin reaction known as COVID Vaccine Arm (CVA), characterized by erythema and edema at the vaccination site, and its implications following mRNA COVID-19 vaccinations.
DOI: 10.3390/jcm11030797 -
Asian-Origin Approved COVID-19 Vaccines and Current Status of COVID-19 Vaccination Program in Asia: A Critical Analysis
A critical analysis mapping Asian-origin COVID-19 vaccines and the status of vaccination programs across Asia as of March–May 2021, detailing vaccine platforms, clinical trials, regulatory approvals, demographic coverage, and cost considerations.
DOI: 10.3390/vaccines9060600 -
COVID-19 vaccination-related small vessel vasculitis with multiorgan involvement
This study reports a case of a 77-year-old woman who developed small-vessel vasculitis with multiorgan involvement following the administration of the Pfizer-BioNTech COVID-19 vaccine, highlighting potential autoimmune side effects of COVID-19 vaccinations.
DOI: 10.1007/s00393-022-01159-8 -
The Impact of COVID Vaccination on Symptoms of Long COVID: An International Survey of People with Lived Experience of Long COVID
An international, cross-sectional online survey of 812 adults with long COVID found that a first COVID vaccination was associated with overall symptom improvement in 57.9% of participants and deterioration in 17.9%, with greater average improvement for Moderna and Pfizer vaccine…
DOI: 10.3390/vaccines10050652 -
Who Is Really at Risk for Anaphylaxis Due to COVID-19 Vaccine?
An expert commentary reviews early anaphylaxis reports after Pfizer-BioNTech COVID-19 vaccination and proposes a pragmatic risk-stratification protocol, arguing the MHRA's broad contraindication is overly restrictive.
DOI: 10.3390/vaccines9010038 -
COVID- 19 vaccination reduces new-onset fibromyalgia risk in survivors
This study investigates the protective effect of COVID-19 vaccination on the risk of new-onset fibromyalgia in COVID-19 survivors, finding a significant reduction in risk among vaccinated individuals compared to unvaccinated ones.
DOI: 10.1186/s12916-025-04069-z -
Minimal Change Disease After First Dose of Pfizer-BioNTech COVID-19 Vaccine: A Case Report and Review of Minimal Change Disease Related to COVID-19 Vaccine
This case report documents a 60-year-old man who developed de novo minimal change disease with nephrotic syndrome and acute kidney injury approximately 10 days after a first dose of the Pfizer-BioNTech COVID-19 vaccine, was treated with steroids leading to remission, and is disc…
DOI: 10.1177/20543581211058271 -
The development of China’s vaccine industry in the past decade: the perspective from drug regulatory science
This paper analyzes China’s vaccine industry from a regulatory science perspective over 2011–2020, showing stable overall vaccine production with growth in new and multi‑disease vaccines, ongoing improvements in regulatory standards, and rapid development/approval of vaccines du…
DOI: 10.1080/21645515.2021.2002640 -
Vaccination Coverage in Adult Patients with Inflammatory Bowel Disease: Impact of a Tailored Vaccination Pathway Including COVID-19 and Herpes Zoster in a University Hospital Vaccination Center
A single-center, observational study at the University Hospital Vaccination Center in Messina, Italy, showing that a tailored, multidisciplinary vaccination pathway for adults with inflammatory bowel disease substantially improved vaccination coverage for influenza, pneumococcal…
DOI: 10.3390/vaccines13090961 -
Overview of Knowledge Levels of People Who Are Willing to Vaccinate Against COVID-19 in the COVID-19 Vaccination Program at RSUMM
This study investigates the knowledge levels of individuals willing to vaccinate against COVID-19 at RSUMM, revealing that 87% of respondents demonstrated good knowledge, primarily sourced from social media.
DOI: 10.18502/kme.v3i2.13062 -
Risk of flare or relapse in patients with immune-mediated diseases following SARS-CoV-2 vaccination: a systematic review and meta-analysis
This systematic review and meta-analysis assess the risk of flare or relapse in patients with autoimmune and immune-mediated diseases following SARS-CoV-2 vaccination, finding a minimal overall prevalence of 6.28%, particularly lower with vector-based vaccines.
DOI: 10.1186/s40001-024-01639-4 -
Post-Vaccination Syndrome: A Descriptive Analysis of Reported Symptoms and Patient Experiences After Covid-19 Immunization
This study provides a comprehensive analysis of post-vaccination syndrome (PVS) symptoms and patient experiences following COVID-19 vaccination, highlighting significant health burdens and psychosocial stress among affected individuals.
DOI: 10.1101/2023.11.09.23298266 -
Case of Covid Mrna Vaccine Linked Antiphospholipid Syndrome
This case report presents a 22-year-old male who developed antiphospholipid syndrome and a large pulmonary embolus following COVID mRNA vaccination, suggesting a potential autoimmune reaction linked to the vaccine.
DOI: 10.33140/ijdmd.07.01.07 -
Comparison of the rates of emergent otologic adverse events following mRNA COVID-19 versus influenza vaccination: a matched cohort analysis
In an hdPS-matched retrospective cohort of 20,325 adults per arm, new-onset otologic adverse events were rare after mRNA COVID-19 or pre-pandemic influenza vaccination; vertigo was lower (OR 0.81) and aural fullness higher (OR 2.16) in the COVID-vaccinated group.
DOI: 10.3389/fneur.2025.1637870 -
Rapidly progressive IgA nephropathy with membranoproliferative glomerulonephritis-like lesions in an elderly man following the third dose of an mRNA COVID-19 vaccine: a case report
This case report describes a 77-year-old man who developed rapidly progressive IgA nephropathy with membranoproliferative glomerulonephritis-like lesions following the third dose of an mRNA COVID-19 vaccine, highlighting potential renal complications associated with COVID-19 vac…
DOI: 10.1186/s12882-023-03169-3 -
Incidence, Clinical Presentation, and Management of Myocarditis following mRNA-Based Covid-19 Vaccines: A Brief Report
Myocarditis after mRNA Covid-19 vaccines is rare, most common in younger men after the second dose, usually mild and self-limiting, with the benefit of vaccination outweighing the risk.
DOI: 10.1159/000522216 -
Impact of sex and age on vaccine-related side effects and their progression after booster mRNA COVID-19 vaccine
This study investigates the impact of sex and age on the frequency and duration of vaccine-related side effects following the third mRNA COVID-19 vaccine dose in a cohort of 272 healthcare workers in Japan, revealing that females and younger adults experience more severe and pro…
DOI: 10.1038/s41598-023-46823-4 -
A Case of COVID mRNA Vaccine Linked Antiphospholipid Syndrome
A 22-year-old healthy male developed antiphospholipid syndrome with a large pulmonary embolus, markedly elevated triple-positive antiphospholipid antibodies, and multisystem symptoms after his second dose of an mRNA COVID vaccine, with negative COVID testing, and improved on api…
DOI: 10.33140/bscr.02.01.13 -
Biphasic anaphylaxis after exposure to the first dose of Pfizer‐BioNTech COVID‐19 mRNA vaccine
A 30-year-old male with prior allergies developed an initial allergic reaction after the first Pfizer-BioNTech COVID-19 vaccine dose and a recurrent biphasic anaphylactic reaction on Day 3, treated with epinephrine and corticosteroids.
DOI: 10.1002/jmv.27109 -
Case of Myocarditis, Pericarditis, and Fatal Aortic Dissection Following COVID-19 mRNA Vaccination
A 34-year-old previously healthy male developed myocarditis, pericarditis, and a fatal thoracic aortic dissection 16 days after his first COVID-19 mRNA vaccine dose, with autopsy showing vaccine-derived spike protein and eosinophilic/lymphocytic infiltrates.
DOI: 10.33140/bscr.03.03.03