Cytomegalovirus Vaccines in development

CMV is the major cause of congenital deafness; mothers infected during their pregnancy can transmit the virus to their foetus, inducing a wide range of problems in the unborn baby, including deafness. This impacts 1:200 babies, 1:5 of whom develop some congenital complication.

At least one vaccine is in phase 3 trial that i can find (Moderna's mrna vaccine, CMVictory trial).

https://trials.modernatx.com/study/?id=mRNA-1647-P301

Results anticipated 2026. If positive, I'd expect rapid approval and probably government-funded rollout to women of childbearing potential, given the public health problem. If so, would expect significant decreases in congenital deafness by 2030-2031. This might seem a long way away (7/10 years of a DCF model!), but my opinion is that the risk has not been adjusted-for by the market. Based on current multiples, the assumption for COH is that it will continue to grow with a locked-in user base for decades to come.

If congenital CMV is eradicated, the game isnt over for COH. There are other causes of comgital deafness, it can continue to sell devices to people with implants already installed, and can continue expanding to developing economies where the deafness is under-treated. It can also keep pushing for a piece of the age-related deafness market, although implants are not really accepted therapy here yet. In those cases, COH continues to have a market but much lower margins and growth potential.

Im positive on COH but with these risks caution against buying too at current multiples within the next 18 months