The U.S. government has reduced its recommended childhood vaccine schedule from 17 diseases to 11, following a directive from President Donald Trump. The new policy removes the recommendation for vaccines against influenza, COVID-19, and rotavirus, making them optional.
BMO Capital Markets analyst Evan David Seigerman told BioSpace in an email that the changes are “all in not great, but this can be managed.” He added that investors have been cautious about vaccine prospects under the current administration and recent CDC advisory committee meetings, which have included anti-vaccine sentiment.
The previous guidelines called for at least one dose of COVID-19 vaccine, two doses of rotavirus vaccine, and one dose of influenza vaccine for children. These will now be left to individual choice rather than official recommendation.
Merck is among the companies affected by these changes. The company produces RotaTeq, a rotavirus vaccine, and Gardasil for HPV. The number of recommended Gardasil doses has also been reduced from two to one. Merck’s revenue from Gardasil has already been declining outside the U.S., particularly in China and Japan. However, sales in the U.S. have recently increased due to higher prices and favorable public-sector purchasing patterns. In 2024, RotaTeq generated $711 million globally while Gardasil brought in about $2.2 billion.
The pneumococcal vaccine remains on the recommended list for children—a positive development for companies operating in that market segment. Salim Syed of Mizuho noted via email that this market is significant—over $8 billion—and children account for about two-thirds of its revenue.
Syed also said: “Investors have been quite bearish for some time now that this administration would treat all vaccines equally (vs Covid-19 vaccines), but this is clearly not the case, so should help sentiment for stocks in this vaccine sleeve.” This outlook could benefit large manufacturers like Pfizer and Merck as well as smaller firms such as Vaxcyte.
Vaxcyte is preparing a new 31-valent pneumococcal shot intended to compete with Pfizer’s Prevnar—which had $1.6 billion in sales in 2024—and Merck’s Capvaxive, which reported $244 million in third-quarter sales last year.
Public health organizations criticized the revised schedule. Ronald Nahass of the Infectious Disease Society of America stated: “Making these changes amid ongoing outbreaks of vaccine-preventable diseases shows a disregard for the real confusion families already face.” Robert Hopkins from the National Foundation for Infectious Disease commented: “As we are already seeing signs of a severe respiratory season, this is not the right time to make changes that are not supported by clear evidence.”
Seigerman said investors are likely to seek other opportunities within biopharma given current policy headwinds: “Vaccines are not going to be the driver of an investment in Merck—at least under the current admin,” he wrote. “Too much uncertainty and policy headwinds for folks to get excited.”
