Alarm as CDC calls for separate MMR vaccines despite measles outbreak | Health care in the United States

The measles, mumps and rubella (MMR) vaccine is under increased scrutiny by the Trump administration in its ongoing reassessment of vaccines despite the worst measles outbreak in decades.

Jim O’Neill, deputy secretary of the US Health and Human Services (HHS) and acting director of the US Centers for Disease Control and Prevention (CDC), on Monday called for new vaccines to replace current MMR doses.

“I call on vaccine manufacturers to develop safe monovalent vaccines to replace the combined MMR vaccine and ‘split the MMR dose into three completely separate doses,’” O’Neill wrote in an article. mail On x/twitter.

He quoted Donald Trump’s September 26 post urging against the use of Tylenol and “combination” vaccines, as well as delaying hepatitis B vaccination from birth until age 12.

Many vaccines are combined in the routine immunization schedule for children in order to reduce the number of doses children receive, and their safety and effectiveness have been proven through decades of research.

Jason Schwartz, an assistant professor at the Yale School of Public Health, said dismantling vaccines “would be a very complex, time-consuming, and expensive procedure, but most importantly, it is unnecessary.”

Adding more doses to the schedule would make it more expensive to vaccinate children, and they would need more visits to pediatricians to get vaccinations. If all children’s vaccinations are given separately, it will take 20 visits for a six-month-old to be fully vaccinated.

“The more visits, the more appointments, and the more follow-up doses required, parents — because life is complicated and vaccine schedules are complicated — will be less likely to complete all of the additional appointments or follow-up visits required,” Schwartz said. “The separation will mean that fewer children will complete the MMR series.”

Dismantling it “serves no purpose,” 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 enduring all of this.”

Some vaccines, such as the diphtheria, tetanus, and pertussis (DTaP) vaccine, are only made together and cannot be taken apart. While separate vaccines for measles, mumps, and rubella were licensed in the 1960s, only combination MMR shots are now available for use in the United States.

Current MMR rounds are manufactured in the United States by Merck and GSK. Both companies have He said There is no published scientific evidence to support separation of vaccines, and combination vaccines play an important role in making vaccination easy and inexpensive. Schwartz said launching separate vaccines now would require entirely new placebo-controlled clinical trials under new Trump administration policies — an “unimaginable” process when safe and effective vaccines already exist.

Even if manufacturers could conduct new trials for separate vaccines, it would be “incredibly unethical” to conduct them, said Angela Rasmussen, a virologist at the University of Saskatchewan’s Vaccine and Infectious Disease Organization.

“It will expose children, essentially, to potentially fatal diseases,” she said. No ethics or regulatory board would approve such a trial, and providers and families were unlikely to participate, she added. “Those trials are not going to happen.”

There was another interview The CDC’s Advisory Committee on Immunization Practices (ACIP) is scheduled to meet October 22-23. It has been postponed indefinitely.

“It’s anyone’s guess,” Schwartz said. He said ACIP could say it would like to see monovalent vaccines, but there are no monovalent vaccines approved to recommend.

At the meeting in September, independent advisers began discussing delaying the hepatitis B vaccine, which is currently recommended at birth, but put the discussion on the agenda.

Young children usually receive later doses of hepatitis B as part of combination doses – so if this recommendation is changed, combination vaccines will be affected.

He said Offit had “no idea” what vaccine advisers might discuss. “These people aren’t making decisions based on scientific data, they’re making decisions based on their own kind of anti-vaccine notions — who knows. Anything can happen.”

But he said discussions about dismantling MMR specifically have been raised and answered by ACIP for more than two decades.

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

Wakefield claimed, without evidence in the study, that there was also a possible link to autism between “the combined measles-mumps-rubella vaccine (rather than the monovalent measles vaccine).”

A year before the study was published, Wakefield filed a patent application for a monovalent measles vaccine, although he did not disclose this conflict of interest in the study.

Wakefield argued that the combination dose weakened the immune system and created cascading effects that led to autism. “We had no evidence of any of this,” Offit said.

ACIP held a vote on changing the MMR vaccine recommendation shortly after the study was published.

“Obviously we all voted no because there is no evidence that MMR causes autism,” Offit said. There were already epidemiological studies at the time showing no relationship between autism and vaccination.

In September, ACIP voted to rescind the recommendation to combine the MMR vaccine with the varicella (smallpox) vaccine, a move that was formally approved by the Centers for Disease Control and Prevention last week. The changes are already creating confusion among patients and pediatric offices.

“Let’s not underestimate how damaging the complexity and confusion of vaccination efforts is, for both patients, their families, and health care providers,” Schwartz said.

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

She continued: “By making many of these vaccines monovalent, it will actually prevent access to them, and there will be no vaccines at all.” “These vaccines could potentially be manufactured, but if the vaccine is sitting on a shelf and doesn’t get into someone’s arm, it’s basically worthless. I think anti-vaxxers like vaccines that sit on the shelf.”