Many of you have reached out regarding the recent approval of nirsevimab (Beyfortus), a new monoclonal antibody injection, to prevent severe RSV disease in infants. As exciting as the idea of an RSV vaccine is for all of us, this has been a very difficult process for us to manage as a primary care office. We would love to be able to provide this to all eligible infants, but unfortunately this is not going to be possible for the 2023-2024 season. We have only been allocated vaccine stock to cover a portion of our eligible patient population.
Rest assured, we have been managing RSV in babies for our entire careers and are very experienced in caring for patients with RSV. For most babies and children, RSV is a bad cold and can be managed at home. However, some infants and children will develop more severe symptoms and require additional support to get through the illness. We will always have nursing phone support and same day appointments to evaluate and manage the virus with you and to determine if higher level care is needed.
Additionally, there is a new maternal vaccine approved for patients between 32 and 36 weeks of pregnancy to help prevent severe RSV disease in infants. We strongly encourage you to get this vaccine if you are currently pregnant due to the shortage of nirsevimab for infants.
Here is some background information. There are 2 doses of the vaccine – one for babies less than 11 lbs, and one for babies 11 lbs and over. We hope to be able to reorder the smaller dose for the less than 11 lb babies throughout the season. However, it is unlikely we will be able to get any more doses for babies equal to or over 11 lbs, so we are really limited in how we can fairly provide the vaccine.
Compounding this, not every insurance has committed to cover the charge of this vaccine. Because it is so costly, we can only give it to patients whose insurance has officially listed a price under our contracts. We are checking this weekly with the payors to make sure we are as up to date as possible. Unfortunately, due to insurance contracting policies, we cannot offer to give this vaccine for an out of pocket payment.
Finally, due to the shortage of available nirsevimab for the 2023-2024 season, the CDC has narrowed the criteria for the RSV vaccine to include only babies less than 6 months or older babies with certain risk factors. CMC will be following these guidelines.
THEREFORE, we will be offering the lower dose vaccine at newborn visits and the 2 month visit if your child is less than 11 lbs AND your insurance has committed to reimburse the cost.
For patients less than 6 months who are greater than 11 lbs, we have extremely limited supply.
• Today and tomorrow we will be sending an Appointment Scheduling Request to the MyChart accounts of babies 1-6 months of age with insurance committed to at-cost reimbursement, and we will have VERY LIMITED APPOINTMENTS available the week of November 13th.
• You will not be able to schedule this appointment until 8am on Wednesday, November 8th . If you don’t see an available appointment, then they have all been scheduled, and we have no additional doses to give.
• We will ONLY be offering MyChart scheduling for these appointments via an Appointment Request sent to your MyChart account; our phone triage nurses cannot schedule these very specific appointments.
• We know this will be frustrating for many of you who cannot get an appointment. Our triage team has no other information to share, so please try not to call or MyChart message the office with questions specific to this process.
In order to be as fair as possible, we will NOT be offering this dose at well visits. If you do not receive an appointment request in MyChart, unfortunately, we cannot offer the vaccine to you at this time.
Finally, if you want to try to find a dose of this vaccine in the community, we have found that some Safeway pharmacies are selling it, and we are happy to administer it to your baby in an office visit. Also, Jefferson County Public Health Department has recently had some supply (but we don’t know when they will run out). You could check at your local public health department as well. If we find other resources, we will let you know.
Please know we wish we could provide nirsevimab to every patient who medically qualifies, but this is the most fair process we can support.
Dr. Jay, Dr. Spero, Dr. Erin, Dr. Debbie, Dr. Liz, Dr. Katie, Dr. Lauren & Dr. Ali