Merck Shifts Rotavirus Vaccine Delivery to China

Pharmaceutical company Merck & Co., Inc. is ending a 6-year vaccine supply agreement for West Africa, reported Michaeleen Doucleff with NPR's Science Desk.   

But, Merck is sending its RotaTeq vaccine to China to help prevent a deadly form of diarrhea, called rotavirus. 

Rotavirus kills about 200,000 young children and babies each year, says the World Health Organization (WHO). 

Almost every child worldwide is exposed to rotavirus by age 5. 

Children who become infected with rotavirus can have 6 to 20 diarrhea bouts in a single day and dehydrate extremely fast. 

In wealthy countries, rotavirus infections are rarely lethal but can be severe.

Before the introduction of the rotavirus vaccine in 2006, infections caused more than 50,000 hospitalizations each year in the USA, reports the Centers for Disease Control and Prevention (CDC).

Merck said in an email to NPR that "supply constraints" were preventing them from fulfilling their supply agreement to the West African countries. 

As a result of Merck's decision, more than a half-million children in West Africa may not receive the rotavirus vaccine in 2018 and 2019, Gavi, the Vaccine Alliance told NPR. 

"This is deeply disappointing news and in the short term will mean that children are likely to miss out on this lifesaving vaccine, leaving them vulnerable to this horrific disease," Gavi's CEO, Dr. Seth Berkley said in a statement to NPR. 

In poor countries a rotavirus infection can quickly become life-threatening, says Dr. Mathuram Santosham at Johns Hopkins University. 

Back in 2011, Merck agreed to sell its rotavirus vaccine to low-income countries, via Gavi, for about $3.50 per dose. 

At the same time, GlaxoSmithKline (GSK) developed a second rotavirus vaccine, Rotarix. GSK sells that vaccine to Gavi at a reduced price of $2.25 per dose. 

For the past 6 years, the pharmaceutical companies have stuck to those agreements. 

GSK has delivered nearly 220,000 million doses to 42 countries around the world. And Merck has delivered more than 30 million doses to four countries in West Africa; Burkina Faso, Ivory Coast, Mali, and Sao Tome and Principe. 

But earlier this year, Merck informed UNICEF and Gavi that it would supply the West African countries with only two-thirds of the doses they need for 2018 and 2019. 

And in 2020, the company would deliver no vaccines to these countries for the foreseeable future, Gavi told NPR. 

Merck told NPR in an email that the shortfall is due to a supply shortage caused by factors, such as "country-specific requirements, unanticipated manufacturing issues and packaging challenges that put greater stress on our already strained packaging capacity." 

At the same time, Merck has started to supply China with the vaccine. 

Breaking into the Chinese vaccine market is difficult for foreign pharmaceutical companies, says Kasey Fu, who directs epidemiology for the analysis firm GlobalData. 

But, once a company gains approval in China, it has the potential to boost sales dramatically, Fu says. "China is a very big market. Just the sheer size of the population of China makes it a very lucrative market," she says. 

"The rotavirus vaccine is needed in every country, whether you're affluent or not," says Dr. Santosham. 

"So I have no problem with Merck selling the vaccine in China. But kids should not be denied vaccines just because they belong to a poor country." 

"We all as a community should come together and make sure these kids get this vaccine," Dr. Santosham told NPR. 

Related rotavirus news:

• Vaccine Wants to Knock Out Traveller's Diarrhea
• Infant Diarrhea Deaths Reduced 1/3 By Rotavirus Vaccination
• Rotavirus Vaccine Found Safe And Effective For ‘At-Risk’ Children Too

Before rotavirus vaccines were introduced in the USA, rotavirus was responsible for about 3 million episodes of gastroenteritis, 410,000 physician visits, 205,000 emergency department visits, 55,000 hospitalizations, and between 20 and 60 deaths among children younger than age 5 years each year. 

In the USA, there are 2 rotavirus vaccines available. Both vaccines are given orally, not by a shot:

• Rotarix
• RotaTeq

These vaccines should be delivered 6 weeks after birth, says the CDC. 

The rotavirus vaccine cost varies depending on your insurance and which state you live.

The CDC Vaccine Price List provides the private sector vaccine prices for general information. 

Vaccine discounts can be found here. 

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.