RSV season is ramping up, and doctors are hoping a new shot to prevent the virus in young children will ease the caseload this year. However, some pediatricians are facing challenges getting supply.
The CDC and FDA have approved the Beyfortus antibody shot, from drugmakers AstraZeneca and Sanofi, to prevent respiratory syncytial virus in babies from birth to 8 months old, or in children up to 24 months old with severe risk factors.
RSV is the leading cause of hospital admissions in children younger than 1 year old.
Dr. Lauren Fitzpatrick, the medical director of the pediatric unit at Luminis Health Anne Arundel Medical Center, says pediatricians were optimistic the drug could help reduce cases after a record year in 2022.
“We thought that this was groundbreaking, that this could be our game-changer, that we could potentially really reduce the risk of patients being admitted for RSV,” she told CBS News. “I think there was our hopes, and then there was our reality,”
“There was not an infrastructure in place to roll out this vaccine, or monoclonal antibodies, so even though we have families that are requesting it, we can’t meet their demands.”
A big complication right now is the cost, at nearly $500 a dose. While the shot is expected to be covered by most insurance plans, providers have to order supplies before knowing how much they’ll be reimbursed.
“As pediatricians, we’re angry,” Fitzpatrick said. “It feels like we have an opportunity that may be missed.”
And as a mom, Fitzpatrick knows firsthand how important this shot is. Her youngest, now 5, struggled with RSV at 9 months old.
“It was a very hard time,” she said. “I don’t want this to be dollars and cents. This is my kid’s life. But for a lot of the insurance companies, it’s dollars and cents.”
Earlier in the summer, the American Academy of Pediatrics sent a letter to the CDC and the Centers for Medicare and Medicaid Services urging federal leaders to make sure the shot could be distributed widely and equitably.
The CDC recently announced pediatricians will be able to get paid for counseling families about the drug in addition to administering the product.
Fitzpatrick says she would also like to see insurance companies provide more clarity on how they will cover the expensive shot.
“These are small practices that don’t have that type of capital to invest,” she explained. “If there were some type of plan in place that the insurance companies could work with the practices to either expedite their reimbursement or provide some funding ahead of time, that would be helpful.”
Molly Fleenor, who is expecting her second daughter in December, the peak of RSV season, says she hopes the confusion is resolved by then.
“It shouldn’t be a guessing game,” Fleenor said. “It should be pretty black-and-white and should be accessible and available to as many people as possible, if not everybody.”
Fleenor will also be eligible for the new RSV vaccine for pregnant women in their third trimester, to help protect her baby.
Doctors are recommending either that shot for mom or the immunization for the newborn. Fleenor is still deciding between the two, but knows she wants the protection.
“RSV can be very scary,” she said. “It can take a turn really quickly and make children really sick.”
The American Academy of Pediatrics recommends that all infants whose mothers did not receive the maternal vaccine receive the new preventive antibody, especially those at high risk for RSV.
Dr. Debi Johnson is a medical expert and health journalist dedicated to promoting well-being. With a background in medicine, she offers evidence-based insights into health trends and wellness practices. Beyond her reporting, Dr. Debi enjoys hiking, yoga, and empowering others to lead healthier lives.
