WICHITA, Kansas — A national shortage of a new immunization that protects babies from severe cases of respiratory syncytial virus is worrying Kansas doctors as they try to avoid a repeat of last year’s “tripledemic” that filled hospitals with COVID-19, flu and RSV patients simultaneously.
The drug is one of several new RSV immunizations that doctors heralded as lifesaving when they were approved earlier this year. While RSV usually causes mild cold-like symptoms in healthy adults, it can cause more serious illness in young children, older adults and the immunocompromised.
The shot for infants, called nirsevimab, is not a vaccine but a monoclonal antibody shot recommended to prevent severe illness in babies under 8 months old and those who are 8-19 months old and immunocompromised. Separate vaccines were approved for adults 60 and older and pregnant women.
Pediatricians were pleasantly surprised by strong interest from parents in getting their children immunized — but they can’t find enough doses of the new drug.
“People are really excited about it,” said Dr. Gretchen Homan, a Wichita pediatrician and president of the Kansas chapter of the American Academy of Pediatrics. “But, right now, we’re not able to connect them with it.”
She said most infants who catch the respiratory virus do not need hospitalization. Still, the virus can cause lingering illness that’s often stressful for parents to manage.
“It’s really hard,” she said. “They can be sick for weeks at a time with terrible congestion, needing suctioning from their noses and having difficulty coordinating their ability to drink.”
The Sedgwick County Health Department received just more than 100 doses — from the state and from the drug’s manufacturer — but associate director of preventive health Bev Bruce said that that’s all they’re getting.
“We were told by the manufacturer that we won’t be able to receive any more this year,” she said.
The supply issues appear to stem from greater-than-anticipated demand for nirsevimab as well as its high sticker price. The private sector cost per dose is nearly $500, making it one of the most expensive immunizations on the market. Clinics ordering the drug have to pay that cost up-front and trust that insurers will pay them after shots are administered.
Last week, the Centers for Disease Control and Prevention told doctors to prioritize giving 100 milligram doses of the drug — for babies weighing more than 11 pounds — to the youngest infants and those with health conditions that put them at greater risk of severe illness.
Experts are also urging pregnant women who are eligible for the RSV vaccine to get it to help protect themselves and reduce the number of babies who need the antibody shot. Maternal vaccination between 32 and 36 weeks of pregnancy has been shown to give sufficient protection to infants in most cases.
“They will develop an antibody and immune response, and then those antibodies will be transferred to baby through the placenta prior to the baby being born,” said Dr. Dana Hawkinson, director of infection control at the University of Kansas Health System.
He said the recommendation comes amid an overall drop in maternal vaccination rates.
“It’s important to continue to be able to find, first of all, maternal health care,” he said. “And then talk with your providers and get those vaccines to help [protect] both yourself and your baby.”
Public health experts are also reminding parents to take routine precautions to help protect their kids from RSV and other seasonal viruses.
“Keeping them away from sick people. Washing hands frequently,” Bruce said. “All the things we do to prevent respiratory illnesses.”
Homan encourages parents to stay in contact with their doctor’s office and ask to be notified when more doses of nirsevimab become available.
“We’re thrilled that the interest is so high about finding protection against [RSV],” she said. “Hopefully we can figure out the supply and solve that piece of it as soon as possible.”
Rose Conlon reports on health for KMUW and the Kansas News Service.
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