Government panel takes middle road on blockbuster vaccines

Fast. What's Pfizer's top-selling product?

If you're wrapped up in the world of immune-modulating arthritis drugs and cancer immunotherapies, you may not realize the answer is an older immune system booster: the pneumonia vaccine Prevnar 13, which is given to both infants and older adults and generated $5.8 billion in annual sales last year.

And the use of the vaccine in older adults was making some investors nervous, because herd immunity from kids getting the vaccine is making disease caused by the strains of pneumococcus it prevents increasingly rare. Yesterday, the Advisory Committee on Immunization Practices removed a hard recommendation that older adults should get the vaccine, STAT's Helen Branswell reports. At the same time, ACIP said Prevnar vaccination should be left as "shared decision-making" between doctors and patients, meaning it will probably still have insurance coverage. A similar ruling was made for Merck's human papilloma virus vaccine, Gardasil, which prevents growths that may turn into cancer.

That's what Umer Raffat, an analyst at Evercore ISI, had predicted would happen. Shared decision-making, he wrote in a note to investors, "avoids the bad scenario of a somewhat permanent reduction in utilization rates." That leaves the door open to new pneumococcus vaccines that are being developed by both Pfizer and Merck. For now, he wrote, usage already reflects this middle road, anyway, because patients and doctors apparently aren't feeling the need to use the vaccine.