Separate measles, mumps, rubella vaccine formulations discontinued

A representative from Merck announced that the company plans to discontinue production of monovalent measles, mumps, rubella vaccine formulations during the Advisory Committee on Immunization Practice’s meeting yesterday.

“We greatly value the role the CDC and the ACIP have taken in putting forth recommendations and policies about the optimal use of vaccines for infectious diseases. Similarly, we take our role very seriously in terms of developing and supplying vaccines that are optimally suited to meet these needs,” said Mark Feinberg, MD, PhD, vice president of medical affairs in Merck’s division of vaccines and infectious diseases. “Based on discussions that took place at the last ACIP meeting among scientific leaders we have decided that Merck will not resume production of our monovalent measles, mumps and rubella vaccines.”

Feinberg added that the company will focus attention to meet current prevention needs on production of the combination M-M-R II vaccine. “When we receive questions from parents or other interested parties we will refer them to the useful information provided by the CDC, the ACIP, the AAP and other professional organizations.”

The announcement occurred during discussions to streamline recommendations made during the past year in the committee’s 2010 immunization schedules for children and adults. Merck’s decision is based on the ACIP’s stated general preference for combination vaccines and follows controversial debates concerning the increased risk for febrile seizures among measles, mumps, rubella and varicella virus live vaccine (ProQuad, Merck) recipients at the past several meetings.

Health care providers continue to experience push back from vaccine-hesitant parents, despite no evidence to support long term adverse events among patients who experienced the seizures and amid additional unfounded concerns that vaccines cause autism. These parents either decline vaccination or request to space out recommended vaccines, contrary to evidence that indicates delaying vaccines poses a greater risk to children than the theoretical threat from vaccines.

Merck’s announcement was welcomed by applause from committee members and meeting attendees, who recognized the moves potential positive effect on public health. Combination vaccine formulations typically cost more for manufacturers to produce, undergo more rigorous testing to receive approval and yield lower reimbursement rates for physicians, but result in less pain for children and have the potential to improve vaccine coverage rates.

In addition to the announcement, the committee passed motions to incorporate clarified language concerning decisions made earlier this year, including:

Changes to footnotes for hepatitis A and B, Haemophilus influenzae type B, inactivated polio, meningcococcal and rotavirus vaccines in the childhood and adolescent immunization schedule.
Clarifications in intervals between pneumococcal vaccine administration in the childhood schedules.
Language to distinguish between seasonal and H1N1 influenza in both the child, adolescent and adult schedules.
Language to distinguish between seasonal and H1N1 influenza in both the child, adolescent and adult schedules.
General recommendations for handling and storing herpes zoster vaccine.

Final language and wording changes will be reflected in the 2010 immunization schedules available to health care providers in the Jan. 8 issue of the Morbidity and Mortality Weekly Report. – by Nicole Blazek