Alarm as CDC calls for separate MMR vaccines despite measles outbreak | US healthcare

Measles, mumps and rubella (MMR) vaccine under scrutiny Trump administration in the ongoing re-evaluation of vaccines despite the worst measles outbreak in decades.

Jim O'Neill, Undersecretary of the United States Health and Human Services (HHS), as well as the acting director of the US Centers for Disease Control and Prevention (CDC) called on Monday for the development of new vaccines to replace the current MMR shots.

“I call on vaccine manufacturers to develop safe monovalent vaccines to replace the MMR combination vaccine and to “break the MMR vaccine into three completely separate shots,” O'Neill wrote in his report. mail on X/Twitter.

He cited Donald Trump's Sept. 26 message advocating against the use of Tylenol and “mixed” vaccines and delaying hepatitis B vaccination from birth to age 12.

Many of the vaccines included in the routine childhood immunization program are combined to reduce the number of vaccinations children receive, and their safety and effectiveness have been demonstrated through decades of research.

Refusing vaccines “would be extremely difficult, time-consuming, costly, but most importantly, unnecessary,” said Jason Schwartz, an assistant professor at the Yale School of Public Health.

Adding more vaccinations to the schedule will make it more expensive for children to be vaccinated, and they will need more pediatrician visits to get their shots. If all childhood vaccinations were given separately, it would take 20 visits to fully vaccinate a six-month-old child.

“The more visits, the more follow-up doses that will be required, parents – given that life is complex and the vaccine schedule – are less likely to complete all the follow-up appointments or follow-up visits that are needed,” Schwartz said. “The breakup will mean fewer children undergoing the MMR series.”

Breaking them apart is “no use,” said Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia and co-inventor of the rotavirus vaccine. “We're already talking about the difficulties of providing all this.”

Some vaccines, such as the diphtheria, tetanus, and pertussis (DTP) vaccine, are only given together and cannot be separated. Although individual measles, mumps, and rubella vaccines were licensed in the 1960s, only MMR combination vaccines are now available for use in the United States.

Current MMR vaccinations in the United States are produced by Merck and GSK. Both companies have said There is no published scientific evidence to support vaccine separation, and combination vaccines play an important role in making vaccination easy and inexpensive. Releasing individual vaccines now would require entirely new placebo-controlled clinical trials with saline under the Trump administration's new policy – an “unimaginable” process when safe and effective vaccines already exist, Schwartz said.

Even if manufacturers were able to conduct new trials for individual vaccines, it would be “incredibly unethical” to conduct them, said Angela Rasmussen, a virologist at the University of Saskatchewan's Vaccine and Infectious Diseases Organization.

“You're essentially exposing babies to potentially fatal diseases,” she said. No ethics or regulatory board would approve such a trial, and health care providers and families are unlikely to participate, she added. “There will be no such tests.”

There was another one meeting CDC's Advisory Committee on Immunization Practices (ACIP) is scheduled for October 22-23. It has been postponed indefinitely.

“This is just speculation,” Schwartz said. ACIP could say it would like to see monovalent vaccines, but there are no approved monovalent vaccines that they can recommend, he said.

At a meeting in September, independent advisers began discussing delaying the hepatitis B vaccine, the first of which is currently recommended at birth, but delayed the discussion.

Young children typically receive later doses of hepatitis B in combination vaccines, so if this recommendation were changed, combination vaccines would be affected.

Offit has “no idea” what vaccine advisers might be discussing, he said. “These people aren't making decisions based on science, they're making decisions based on their own anti-vax beliefs – so who knows. Anything can happen.”

But he said discussions about splitting up MMR were asked and answered by ACIP more than two decades ago.

Offit worked at ACIP from 1998 to 2003, during which time the now-retracted study by Andrew Wakefield was published and attracted attention.

Wakefield stated, without any evidence in the study, that there was a potential link to autism between “the combined measles, mumps and rubella vaccine (rather than the monovalent measles vaccine).”

A year before the study was published, Wakefield applied for a patent on a monovalent measles vaccine, although he did not disclose conflicts of interest in the study.

Wakefield argued that the combination jab weakened the immune system and caused cascading effects that led to autism. “We didn’t have any evidence of that,” Offit said.

ACIP held a vote to change its recommendations for the MMR vaccine shortly after the study was published.

“Obviously, we all voted against it because there was no evidence that the MMR vaccine causes autism,” Offit said. At that time, there were already epidemiological studies that showed no connection between autism and vaccination.

In September, ACIP voted to rescind the recommendation for the combination MMR and varicella vaccine. The move was officially adopted by the CDC last week. The changes are already creating confusion among patients and pediatric departments.

“Let's not underestimate how devastating complexity and confusion is to vaccination efforts for both patients, their families and health care workers,” Schwartz said.

Making the process more confusing, expensive and time-consuming is another way to deter children from getting vaccinated, Rasmussen said.

“By making many of these vaccines monovalent, we will essentially just cut off access to them, and there will be no vaccines at all,” she continued. “Those vaccines will probably still be produced, but if a vaccine sits on a shelf and doesn't get into someone's arm, then it's essentially useless. I think anti-vaxxers like vaccines that sit on shelves.”