The Centers for Disease Control and Prevention has added Merck & Co.'s quadrivalent measles-mumps-rubella-varicella vaccine, Proquad, to its Vaccines for Children contract.
The approval will help set a standard of care for the vaccine (MMRV), Dr. Michael Brady, a member of the American Academy of Pediatrics' Committee on Infectious Diseases, said in an interview.
“Getting the federal government to acknowledge the value of a new vaccine means a greater possibility of getting it to all children who would benefit,” he said, adding that approval by the Vaccines for Children program “makes it easier to get coverage through commercial payers.”
VFC provides free vaccines to Medicaid beneficiaries, the uninsured, and other children with limited health insurance coverage. The CDC's Advisory Committee for Immunization Practices recommended last October that MMRV be added to the Vaccines for Children program.
“With Proquad now available through the [Vaccines for Children] program, more children are able to gain access to a vaccine that helps protect against four serious diseases,” said Dr. Mark Feinberg, vice president for policy, public health, and medical affairs for Merck Vaccines Division, in a statement.
Dr. Sarah S. Long, who also serves on the AAP Committee on Infectious Diseases, anticipates that the academy may recommend a second dose of the varicella vaccine, now that the MMRV has been accepted into the Vaccines for Children program.
The AAP supports combination vaccines and is confident of the safety and immunogenicity of the MMRV, she said in an interview. The academy currently recommends that children get immunized twice for measles-mumps-rubella (MMR), but no such recommendation exists for varicella.
“We're still looking at data to see if it's warranted to give a second dose of varicella vaccine as well. But that's not going to be practical unless you have a vaccine with all four viruses. Proquad will be able to satisfy that recommendation in a single injection,” she said.
One injection means physicians will have more of an incentive to give a second dose of varicella, Dr. Brady said. “It would make a big difference in trying to increase immunity to varicella.”
The MMRV was approved last September by the Food and Drug Administration for simultaneous vaccination against measles, mumps, rubella and varicella in children aged 12 months to 12 years. The vaccine combined two existing Merck vaccines: MMR and varicella (Varivax).
The vaccine is costly however, and the concern is whether the federal government will be able to afford it under this free program, Dr. Long said. Cost for the MMRV under the Vaccines for Children program is a bit more than purchasing the old vaccines separately—but not by much, a CDC spokeswoman said in an interview.
The federal government will be paying $74.85/dose for the new combination vaccine, she said. By comparison, it currently pays $16.67 for MMR and $52.25 for varicella on its federal contract, which adds up to $68.92, about $6 less than the combination vaccine. For now, the CDC seems to think it's worth the extra cost. The MMRV “is beneficial in that the child receives one injection instead of two,” the spokeswoman said.