US cuts child vaccine guidance; Merck's sales may drop by $2 billion, says Bernstein

The U.S. ended its longstanding guidance that all children receive vaccines against rotavirus, influenza, meningococcal disease and hepatitis A, a sweeping change that advances one of Health Secretary Robert F. Kennedy Jr.'s long-term goals

The new schedule also recommends U.S. children receive a single dose of the human papillomavirus (HPV) vaccine, rather than a two-dose course

Most at risk is Merck MRK.N, with notable impact on HPV vaccine Gardasil and rotavirus vaccine Rotateq, said brokerage Bernstein

"At the high end, over time, this could negatively impact MRK’s future vaccine revenues by up to $2B annually" — Bernstein

"The largest single impact for our coverage here is Rotateq — this currently contributes $450M in revenue in the US, with these changed terms ... US revenues could recede close to zero over time" — brokerage

For Gardasil, Bernstein expects an impact of closer to $1 billion annually

In 2025, MRK rose 5.8%