November 02, 2023
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Compared with the median bronchiolitis admission rate before the COVID-19 pandemic, hospitalizations among children increased during the 2022 to 2023 season, according to results published in JAMA Network Open.
Jonathan H. Pelletier
At the bedside, this means that clinicians at childrens hospitals, and particularly those who work in the ICU, can expect to continue to see disproportionate numbers of bronchiolitis admissions, Jonathan H. Pelletier, MD, assistant professor of pediatrics at Northeast Ohio Medical University and pediatric intensivist at Akron Childrens Hospital, told Healio. Without changes to the health care system or clinical workflows, there is a meaningful chance that this will result in recurrent pediatric bed shortages in the fall and winter, similar to what we saw in 2022.
In a retrospective cross-sectional study of 41 U.S. childrens hospitals, Pelletier and colleagues evaluated 400,801 admissions for bronchiolitis (n = 349,609; median age, 6 months; 58.7% boys; 43.7% white) in children aged younger than 2 years between July 2010 and June 2023, to find out how admissions have changed from before the COVID-19 pandemic (2010-2011, 2019-2020) to during the pandemic (2020-2021, 2022-2023).
Prior to COVID-19, the median number of yearly bronchiolitis hospitalizations was 29,309.
Compared with this number, admissions for bronchiolitis dropped by 69.2% (n = 9,030) between 2020 and 2021, whereas the 2022 to 2023 season showed a 75.3% (n = 51,397) rise in admissions.
This wasn't a masking study, but it's really worth noting that masking and social distancing in 2020 were remarkably effective in nearly eliminating bronchiolitis in 2020, Pelletier told Healio. The cost of that was increased admissions this past year, as a larger-than-normal volume of previously unexposed children contracted these viruses.
During 2022 to 2023, researchers observed an increase in hospital days by 47.1%, ICU days by 45.2% and inflation-adjusted hospitalization costs by $375.6 million compared with medians before the pandemic.
Further, researchers found several significant differences between patients hospitalized before vs. during the pandemic, including age (6 months vs. 7 months), the number of patients admitted to the ICU (32.2% vs. 36.7%), the number of patients receiving noninvasive ventilation (6.8% vs. 9.4%), the number of patients receiving invasive mechanical ventilation (6.8% vs. 5.3%) and inflation-adjusted costs per admission (median, $9,439 vs. $9,760).
Using forecasts based on monthly admission counts from before the pandemic, researchers found differences in seasonality of admissions during the pandemic.
Before COVID-19, bronchiolitis admissions peaked in December through February, but peak seasons during the pandemic were August and November. The forecast predicted 943 admissions during August 2021, but the actual number of admissions was 5,036. Similarly, more hospitalizations for bronchiolitis occurred in November 2022 than what was forecasted (10,120 vs. 5,268).
Even after factoring out children with complex chronic conditions and repeat admissions in two sensitivity analyses, researchers continued to observe the same results outlined above.
Notably, among those aged younger than 5 years, admissions for bronchiolitis and viral pneumonia increased from 35,623 before the pandemic to 66,767 in the 2022 to 2023 season. Based on age, the group with the largest increase in admissions was 24- to 59-month-olds, with 5,169 admissions before COVID-19 and 13,973 during the pandemic.
While I had expected the incidence of bronchiolitis to increase transiently due to decreased herd immunity from masking, the magnitude of the change was larger than I expected, Pelletier told Healio. This difference was especially profound in the sensitivity analysis including toddlers aged 2 to 5 years. Admissions in this group increased by more than 50%, which really reinforces the herd immunity hypothesis.
Historically, we havent included these children as having bronchiolitis, though its clinically debatable whether an RSV infection in a 3-year-old is meaningfully different than RSV infection in a 1-year-old, he added.
Pelletier told Healio future studies should evaluate how these trends impact other factors.
This study continues to sound the alarm that ICU admissions for bronchiolitis are rising and are contributing to critical pediatric bed shortages, Pelletier said. My hope would be that future studies will examine whether these trends are related to changes in viral respiratory illness, care practices or both. I also hope to see studies of broader applications of RSV vaccines in infants and pregnant women to reduce the burden of hospitalization.
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Disclosures: Pelletier reports receiving grants from the National Institute of Child Health and Human Development outside the study. Please see the study for all other authors relevant financial disclosures.
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What GAO Found
The COVID-19 pandemic demonstrated the importance of a strong public health infrastructure to prepare for and respond to threats, including a skilled workforce, and physical infrastructure, such as laboratories. The Department of Health and Human Services' (HHS) Centers for Disease Control and Prevention (CDC) annually supports public health infrastructure in jurisdictionsstates, localities, and territoriesthrough two key preparedness programs: (1) Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases and (2) Public Health Emergency Preparedness. The programs' award amounts to jurisdictions from annual appropriations totaled about $845 million on average per year from fiscal year 2019 through 2022. Separately, in fiscal years 2021 through 2023, using supplemental appropriations from the most recent COVID-19 relief law, CDC also provided jurisdictions with about $7.1 billion in awards to enhance infrastructure. Of this, $3.5 billion can be used over 5 years for a new longer-term infrastructure investment to help with future threats. Jurisdiction officials GAO spoke with cited important benefits of awards from both annual and supplemental appropriations, such as supporting epidemiology staff and purchasing supplies for laboratories.
Selected jurisdictions and stakeholder groups identified several challenges building and maintaining infrastructure to be sufficiently prepared for public health threats. These include challenges in the following areas:
Jurisdictions are key partners in preparing for and responding to public health threats. The infrastructure challenges they face can impact how quickly and effectively CDC and other response partners are able to contain these threats, as was demonstrated during the COVID-19 pandemic. According to CDC officials, increased and ongoing investments in public health infrastructure are vital to the response to contain threats on a national level.
CDC is the primary federal agency responsible for helping strengthen jurisdictions' public health infrastructure to aid emergency preparedness and response capabilities.
The CARES Act includes a provision for GAO to report on the federal response to the COVID-19 pandemic. This report (1) describes CDC awards to support jurisdictions' public health infrastructure for preparedness, and (2) examines challenges selected jurisdictions and stakeholder groups identified to building and maintaining such infrastructure.
GAO analyzed CDC's data on awards provided to jurisdictions using annual appropriations and certain supplemental appropriations made in response to the pandemic. Specifically, GAO analyzed annual award data from fiscal year 2018 (the year GAO last reported on award data) through 2022 (most recent data available at the time of GAO's review). GAO also analyzed data on awards using appropriations from the most recently enacted COVID-19 relief lawthe American Rescue Plan Act of 2021.
GAO interviewed officials from a nongeneralizable sample of 12 jurisdictionsselected based on governance structure, funding received, and rurality. GAO also interviewed representatives from 10 stakeholder groups representing public health professionals and policy organizations, among others.
GAO provided a draft of this report to HHS for review and comment. HHS provided technical comments, which GAO incorporated as appropriate.
For more information, contact Mary Denigan-Macauley at (202) 512-7114 or deniganmacauleym@gao.gov.
Damian Williams, the United States Attorney for the Southern District of New York, and James Smith, the Assistant Director in Charge of the New York Field Office of the Federal Bureau of Investigation (FBI), announced the unsealing of an Indictment today charging DOUGLAS RAYMOND ARNTSEN with masterminding a fraudulent scheme to obtain more than $1.3 million in government-funded loans designed to provide relief to small businesses during the COVID-19 pandemic. ARNTSEN was arrested this morning and presented this afternoon before U.S. Magistrate Judge Sarah Netburn. The case is assigned to U.S. District Judge P. Kevin Castel.
U.S. Attorney Damian Williams said: As alleged, Douglas Raymond Arntsen, a disbarred attorney, recruited multiple co-conspirators in a scheme to defraud the government out of more than $1 million by submitting fraudulent loan applications. These loans were funded by the American taxpayers and meant to help small businesses struggling from the effects of the COVID-19 pandemic. They were not meant to line peoples pockets for personal gain. Todays arrest demonstrates this Offices ongoing commitment to holding accountable those who illegally profited from a national emergency.
According to the allegations in the Indictment, which was unsealed today:[1]
Between in or about June 2020 through at least in or about August 2020, DOUGLAS RAYMOND ARNTSEN orchestrated a scheme to defraud the Small Business Administration (SBA) by submitting fraudulent loan applications through the Economic Injury Disaster Loan (EIDL) Program. In doing so, ARNTSEN recruited multiple co-conspirators. ARNTSEN promised potential co-conspirators a way out of their difficult financial circumstances. Certain of those co-conspirators trusted ARNTSEN because they thought he was an attorney. In reality, ARNTSEN had been disbarred.
ARNTSEN asked his co-conspirators to give him their personal information, including social security and drivers license numbers, and then used this information to submit fraudulent loan applications to the EIDL program. The applications submitted by ARNTSEN falsely claimed that the co-conspirators owned businesses that had substantial revenue. Often, the co-conspirators named as owners of the businesses, in fact, had no legitimate connection to the businesses at all. After the loan applications were submitted, ARNTSEN directed his co-conspirators to lie to the SBA during the loan diligence process.
ARNTSEN also directed his co-conspirators to recruit additional participants to his fraudulent scheme. After one co-conspirator had obtained a fraudulent loan, ARNTSEN directed him, in sum and substance, to [g]et me one more warm body. The co-conspirator proceeded to give ARNTSEN the personal information of a relative, which was then used to obtain another fraudulent loan.
ARNTSEN and his co-conspirators enriched themselves through the fraud. In total, ARNTSEN and his co-conspirators obtained at least approximately $1.3 million in fraudulent loans and attempted to obtain hundreds of thousands of dollars of additional loans that the SBA declined to fund. After one fraudulent loan was approved by the SBA, ARNTSEN texted a co-conspirator, in sum and substance, Need how you want your bank checks. Your chariot has arrived this morning.
* * *
ARNTSEN, 45, of Staten Island, New York, is charged with one count of conspiracy to commit wire fraud, which carries a maximum sentence of 20 years in prison; one count of wire fraud, which carries a maximum sentence of 20 years in prison; and one count of aggravated identity theft, which carries a mandatory consecutive sentence of two years in prison.
The maximum potential sentences in this case are prescribed by Congress and are provided here for informational purposes only, as any sentencing of the defendant will be determined by a judge.
Mr. Williams praised the outstanding investigative work of the FBI and additionally thanked the Suffolk County District Attorneys Office for its assistance.
This case is being handled by the Offices General Crimes Unit. Assistant U.S. Attorney Adam Sowlati is in charge of the prosecution.
The charges contained in the Indictment are merely accusations, and the defendant is presumed innocent unless and until proven guilty.
[1] As the introductory phrase signifies, the Indictment and the description of the Indictment set forth herein constitute only allegations, and every fact described should be treated as an allegation.
The flu season typically worsens in the fall and winter months. Photo: Getty Images.
This years flu vaccine should be very protective against the current influenza strains, so as Thanksgiving approaches, now is the perfect time to get your flu shot.
The countdown to Thanksgiving and the other holidays has started. Tis the season for germs, said infectious disease expert Dr. Michelle Barron.
She keeps a close eye on data and studies from South America and Australia to get early insights into how the flu season is likely to develop in the United States.
A recent study of flu cases in South America found that this years vaccine did an excellent job of protecting against severe illness and hospitalization, said Barron, who is UCHealths senior medical director of infection prevention and control and a professor at the University of Colorado School of Medicine.
Its a great match, Barron said. The vaccine is well matched to the strains that are actually causing infections this year. We dont always have that.
She compares a well-matched flu vaccine (efficacy) to a hot-shot guard who is roaming around our bodies, ready to go after bad guys. If the shot is good, the immunities in our bodies are well-primed to spot attackers and nab them before they make us severely ill.
Its like the FBIs Most Wanted List, Barron said. Your body knows what the top bad guys look like, and if an attacker shows up on your doorstep (or in your body), theres no ambiguity about what it is.
If you get your vaccine this year, your body will be ready to rustle up the bad guys and knock them out before they sicken you.
Thats a really good thing because theres no ambiguity, and your immune system will be primed to go after the virus, Barron said.
Vaccine makers have to make educated guesses as they create flu shots well in advance of the respiratory virus season. Sometimes, the guesses are only so-so. But the ingredients in this years vaccine appear to be right on target.
This means that if you get your flu vaccine this year which I strongly encourage you will have great protection against whatever is circulating, Barron said.
It takes about two weeks after vaccination for the flu shot and other vaccines to become fully effective. So Barron is encouraging people to get their flu vaccines now (if they havent already). That way, theyll be fully protected when holiday gatherings begin this month.
Now is great because Thanksgiving and all of the major holidays that involve gatherings and travel are about to occur, she said.
If you get the flu, youre going to feel pretty lousy, and you could miss out on holiday gatherings. Thats really sad, she said. So, if you havent gotten your flu shot yet, now is the optimal time to get your vaccine.
The number of patients who have needed to be hospitalized with the flu is beginning to tick up at UCHealth hospitals, as are flu cases in Colorado and across the U.S., Barron said.
Barron said its very common for the flu season to hit suddenly. Typically, there will be a handful of cases, and then hospitalizations will suddenly shoot up.
I suspect that in the next couple of weeks, well really see a very high escalation in flu cases, she said.
So before that happens, Barron urges people to visit their doctors office, a flu clinic at work or a drug store and get a jab.
On top of getting your flu vaccine as soon as possible, how else should you prepare for the flu season? We went over some of the basics with Barron.
No, the flu shot does not give you the flu. It is possible to already have been exposed to the flu before you get your vaccine. Also, in some years, the vaccine isnt a great match, so you can still get the flu if youre vaccinated. Even so, a flu vaccine will help reduce the severity of illness and will help prevent hospitalizations and deaths.
Even if the vaccine is not 100% effective at preventing a case of the flu, it does make it milder, and it almost universally keeps you out of the hospital, which is a big deal, Barron said.
Yes, the flu is still quite deadly. And thanks to vaccines, deaths from the flu are preventable. Thats why its so vital to get your flu shot every year.
Experts at the U.S. Centers for Disease Control and Prevention (CDC) estimate that between 17,000 and 98,000 people died from the flu during the 2022-23 flu season. (The data are still preliminary. Thats why the range is so broad.) In addition, up to 50 million people in the U.S. probably got the flu last year, and well over half a million people had to be hospitalized due to the flu.
It takes about two weeks to be fully effective, so get your jab now, Barron said.
No, its not too late. Dont worry about timing your shot perfectly. Just get your flu vaccine as soon as possible.
The typical flu symptoms are high fever, body aches, runny nose, sore throat and cough, Barron said.
A case of the flu can come on very suddenly. People can feel exhausted. Your appetite may be poor. But even if you dont feel like eating or drinking, its really important to stay hydrated.
There is a medication which can help people recover faster if they get the flu. Its called Tamiflu. But in order to shorten the severity and length of illness, a sick person needs to receive Tamiflu within 48 hours of the onset of symptoms.
Barron advises people who are especially vulnerable to call for help if they think they might have the flu.
We have tests available. If you have the flu, we can help you. Tamilflu is a treatment option, and it can shorten the duration of the disease.
First, get your vaccine. Second, if you are immunocompromised, wear a mask in crowded indoor settings and, if possible, avoid crowds.
If you are sick, stay home from work or social gatherings.
I dont like being the flu police, but anybody with cold symptoms should consider wearing a mask to protect other people. Nobody wants to get the flu, Barron said.
If you get diagnosed early in the course of your illness, you can take Tamiflu. (Thats a prescription medication, so youll need to call your doctor.)
If you are recovering at home, Barron recommends basic over the counter medications.
And good old-fashioned chicken soup can help you feel better, Barron said.
Any time you develop breathing problems or your fever isnt going away, you definitely need to seek medical attention, Barron said.
Very young babies and older adults are especially vulnerable. Immunocompromised people can also get very sick if they get the flu. This includes people who are being treated for cancer and people who have had organ transplants.
Barron said people with breathing difficulties like underlying asthma and lung disease also can get very sick with the flu.
They should be sure to get their flu shots and should be careful to avoid getting sick during the peak respiratory illness season during the fall and winter.
Just do yourself a favor, and get your shot, Barron said. Stay heathy so you can enjoy the holidays.
Is 2023 turning out to be an early or late flu season?
It's a little bit delayed. We've had some unusual seasonality lately because of COVID. The flu really diminished during COVID because people were taking precautions such as wearing masks, social distancing, and not going out in public. Because of that, flu dropped a lot. And the seasonality of it hasnt returned to normal yet. For example, last year and the year prior to that, the flu season started incredibly early. Whereas right now, if we look at the number of cases that are being reported to the Centers for Disease Control, its still quite low. We may be shifting back to what it was like pre-COVID, when infections started to rise significantly in December, persist through January and February, then start to taper off in March and April.
The current flu vaccines are quadrivalent, which means they protect against four different strains. These include two influenza A viruses, the H1N1 and H3N2 subtypes, which are cocirculating. The other major influenza type that causes severe morbidity and mortality is influenza B, so we incorporate two influenza B strains into the vaccine each year as well.
Yes. We know, for instance, that immunity against H1N1 does not provide protection against H3N2, because they're so different from one another. It's important to have multiple types in the vaccine to provide the best protection.
The vaccine can be reformulated every year. Generally, around the world, there are H1N1, H3N2, and influenza B viruses that are constantly circulating and constantly evolving. Because of that, we do studies to understand: Does immunity from last year's vaccine provide protection against what is currently circulating in the southern hemisphere? If it does protect, then we don't reformulate the vaccine against that particular type of the virus. But if the virus that is currently circulating evades immunity against last year's flu vaccine, then we update the vaccine.
Absolutely not. There are two types of vaccines you can get. The first is an inactivated flu vaccine its a live virus that's grown, but then it's treated to be inactive so it can no longer live. The vast majority of people receive an inactivated influenza vaccine. The other type of vaccine that people, largely children, receive is the live attenuated vaccine. This is a live virus, but its adapted to inefficiently infect humans. It can persist upward of a day to two days within the nasal tract, but it is typically cleared in healthy children with no to minor symptoms. Often the symptoms people experience following vaccination that feel like the flu is just your immune response trying to mount an effective immune response.
Yes, you absolutely can.
There's no point in getting the vaccine if you actively have an infection, because it's too late for it to do anything. What a vaccine is intended to do is to inform your immune system that, Hey, this is something you could be exposed to in the next year, so it can jack up the antibodies and mount a response. But if you're already infected, it's not going to do much, because antibodies take weeks to develop
Generally, the immunity you generate from an infection is fairly good; it's just not as pleasant as getting a vaccine. If you want to make sure you don't get the next flu virus, it doesn't hurt to get the vaccine within three months after getting infected. One reason for doing that is that when you get infected, youre only seeing one strain, such as H1N1, H3N2, or one of the B viruses. When you get vaccinated, you see all of them. You're boosting your immune response against all influenza, as opposed to just one type.
We dont have at-home tests for the flu like we do for COVID-19. One benefit of getting tested is so you can know if you have something you can spread to other people. The second benefit is that if you catch the infection early enough, there are antivirals that can be prescribed. Those give you the potential to beat it before it gets too bad, or at least minimize infection and spread.
Vaccination is the obvious one, then just being cautious of where you're going and what you're doing. If you're going somewhere you know there could be sick people, such as a clinic, be cautious and wear a mask.
As the flu season approaches, flu shots are available at Falls Community Health. The flu shot remains one of the most effective safeguards against the influenza virus.
The Centers for Disease Control and Prevention (CDC) recommends everyone six months and older receive a flu vaccine annually, but certain groups are at higher risk for complications from influenza. Those groups include adults aged 65 and older, pregnant women, and those with chronic medical conditions such as diabetes, asthma, heart disease, and chronic kidney disease.
Adults and children can get the flu shot by appointment at Falls Community Health, located at 521 North Main Avenue. Most insurance will cover the cost of the flu shot, but a sliding fee discount will apply for patients who qualify for the sliding fee program. To schedule an appointment, call 605-367-8793. The clinic operates from 7:30 a.m. to 5 p.m. on Monday, Tuesday, Thursday, and Friday, and from 9 a.m. to 5 p.m. on Wednesday. Learn more at www.SiouxFalls.org/FCH. Falls Community Health is a community health clinic operated by the City of Sioux Falls Health Department.
Falls Community Health would also like to remind the public to practice good hand hygiene, cover their coughs and sneezes, and stay home if they feel ill.
Vaccine mandates do play a significant role in boosting vaccination rates. This was particularly true during the 2020-2021 influenza season according to the study Vaccine Mandates and Influenza Vaccination During the Pandemic.
Authors of the study, published in the November 2023 issue of Pediatrics, assessed influenza vaccination data using insurance claims for children ages 6 months to 18 years living in Massachusetts, New Hampshire and Maine. They found during the pandemic, a flu vaccination mandate for children in school was associated with higher vaccination rates, particularly for those who were not previously vaccinated.
The story is different for families who vaccinated their children in years prior and who lived in areas with elevated COVID-19 numbers during the 2020-2021 influenza season. These children had a lower predicted probability of receiving a flu vaccine. Possible reasons include avoiding in-person clinic visits based on fear of COVID-19 exposure, the inability to schedule appointments due to limited availability of in-person office visits or a lack of options for a vaccination because school services shut down with the switch to remote learning.
Researchers say understanding how the COVID-19 response and mandate policies affected changes in decision making about influenza vaccination, particularly for previously unvaccinated children, may aid in the development of future strategies to increase youth vaccination rates for flu and other infectious diseases like COVID-19.
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Simon Fraser University researchers studying the evolutionary history of flu viruses have found that a new quantitative analysis of how they evolved may help predict future strains. The research draws on a field known as phylogenetics, which focuses on how groups of organisms are evolutionarily related, and is published in the journalScience Advances.
Researchers used large phylogenetic trees to predict which strains are most likely to grow during the upcoming flu season, and determined that this approach was moderately effective in detecting future strains of the influenza virus, and could be another tool in the toolbox to guide seasonal flu vaccine development.
The COVID-19 pandemic has caused a significant change in influenza transmission dynamics, says mathematics professor and Canada Research Chair, Caroline Colijn. We explored how machine learning can identify influenza virus sequences that are potentially good candidates for inclusion in seasonal influenza vaccines.
In order for vaccination to be successful, the specific viruses included in seasonal flu vaccines need to be similar to those influenza viruses that will circulate in the upcoming season, Colijn explains. The effectiveness of seasonal influenza vaccines varies (for example, ranging from 25-75 per cent in children), and depends on whether the strains that circulate match those that were projected and included in the vaccine.
Researchers studied phylogenetic trees, essentially the family tree of the influenza virus, with information from the Global Initiative on Sharing Avian Influenza Data (GISAID). After creating phylogenies using over 65,000 RNA sequences from influenzas surface proteins, collected between 1970 and 2020, they used features in these trees to identify strains that were likely to rise in number in the coming season.
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We were able to identify similar candidate strains to those proposed by the World Health Organization, suggesting that this machine learning approach can help inform vaccine strain selection, says Colijn.
Reference:Hayati M, Sobkowiak B, Stockdale JE, Colijn C. Phylogenetic identification of influenza virus candidates for seasonal vaccines. Sci Adv. 2023;9(44):eabp9185. doi: 10.1126/sciadv.abp9185
This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.
Parents and carers of pre-school and primary aged children are being encouraged to make sure their child gets the free flu vaccine this winter.
Given as a painless nasal spray, the vaccine not only helps protect children but can also help prevent them spreading the virus to more vulnerable family members and friends over the winter months.
Invitation appointment letters for 2 to 5-year-old pre-school children were posted from August and primary school aged children have received consent forms for in-school vaccination sessions taking place this autumn around Ayrshire. If your child has missed their appointment or school clinic, or has been given an appointment thats not suitable, they can attend a Childhood Vaccination Team drop-in session. The locations and times are listed below:
Please note these clinics can only accommodate pre-school children age 2 to 5 years and primary school aged children (only after a vaccination session has been held in the relevant school).
NHS Ayrshire & Arran Director of Public Health Lynne McNiven said:
Flu can be serious, even for otherwise healthy children. Thats why all 2 to 5-year-olds and school aged children are being offered the flu vaccine this winter. The flu virus is always changing, so your child needs to get the vaccine every year to make sure they have the best protection.
The vaccine is a quick, painless, nasal spray, and will just feel like a tickle in their nose. If your child has missed their appointment or you need to reschedule, you can head along to one of the drop-in sessions being run by our Childhood Vaccination Teams.
For more information about the childhood flu vaccine, visit www.nhsinform.scot/childflu or call:
ENDS
Background
For updates on drop-in seasonal flu vaccination clinics offered by the Childhood Vaccination Team please visit: https://www.nhsaaa.net/services/services-a-z/flu-vaccine/
An illustration if the medication Beyfortus. (Credit: AstraZeneca)
After children were cooped up during the COVID-19 pandemic, hospitals last winter were overwhelmed by young patients with another respiratory disease: respiratory syncytial virus, or RSV.
In July, the Food and Drug Administration for the first time approved a shot, nirsevimab, that could prevent infants from contracting a severe case of RSV.
The problem is, the treatment is proving difficult for Chicago-area families to access. Some pediatric clinics simply dont have it to give.
Centers for Disease Control Director Dr. Mandy Cohen said manufacturers, who are making the immunization for the first time, underestimated demand.
What were seeing is, greater demand for that vaccine than any vaccine in child history, Cohen told WTTW News on Monday, when she was visiting a COVID-19 and flu vaccine clinic for seniors at the Martha Washington Apartments in North Center.
I personally have been talking with the companies that produce this, just to make sure we can accelerate as much of the production as possible because we want folks to get vaccinated, we want them to get protected, Cohen said. So, I understand the demand that is out there, and I know its frustrating for families.
Illinois Department of Public Health Director Sameer Vohra said its difficult to pinpoint the depth of the shortage, but he recognized demand outstrips supply.
Its difficult to measure right now, Vohra said.
The CDC recommends adults older than 60 get vaccinated for RSV, as well as those who are 32 to 36 weeks pregnant.
But Vohra said the scarcity is most impacting the immunizations for those eight months and under. Vohra said he spoke about it Monday during a meeting with Cohen, and that IDPH is having conversations with doctors offices and other health care providers that dont have enough of the treatment for families requesting it.
Were aiming for, you know, to work with parents and get a resolution as soon as possible, Vohra said. Some of that stuff is trying to get the manufacturers and the wholesalers to move and be able to ship, but you know, try to do it always as quickly, as efficiently as possible to get that treatment to our residents.
He hopes for a resolution within weeks, as the state is seeing a small increase in RSV cases.
We know that even one year ago by September, October, November we were seeing pediatric hospitals and ICU beds full, Vohra said. Right now, were fortunate to have pretty good capacity across the state still, and we just had a conversation last week with members of the chief medical officers across the state, and theyre pretty happy and right now theyre feeling like hospital capacity is holding.
The CDC director said she is hopeful availability will improve within week.
Theres more and more vaccine every day, every week getting out there, Cohen said.
Cohen recommends families call their pediatrician, and keep trying.
The supply problem is mostly impacting those with private insurance. Cohen said the CDCs Vaccines for Children program, serving those who are on Medicaid or are uninsured, has good availability as the government contracted for the infant RSV treatment ahead of time.
Were working really hard with the American Academy of Pediatrics and with these companies make sure that they can accelerate the vaccine, Cohen said.
She said last year was a particularly bad season for RSV because when they were in semi-isolation for COVID, children werent exposed to it; as regular living resumed, double the number of kids got exposed in the same season.
While bigger kids are probably going to be okay because by now theyve had exposure, Cohen said, babies under 8 months old have yet to experience an RSV season.
Thats why the shots are targeted at babies 6 to 8 months old and under. Theres also a priority order within that criterion. Medical professionals are prioritizing the infants most at-risk, including premature babies, infants with low weight and those with underlying conditions.
RSV can present as a cold, but can be life threatening for vulnerable babies and elderly individuals.
For the first time in history we have a vaccine for older adults and for our babies, Cohen said. We have the tools, we have to use them.
Follow Amanda Vinicky on Twitter:@AmandaVinicky
