ST. LOUIS — The Centers for Disease Control and Prevention (CDC) recommends a new vaccine for RSV, a very common respiratory illness among children and the elderly. Senior Investigative Reporter Paula Vasan discovered firsthand that while the vaccine is recommended during pregnancy to protect newborns, actually getting the vaccine is a major challenge, even though it’s available.
With a doctor’s note as a customer, Vasan tried getting the RSV vaccine and failed several times. She eventually got it, but she said it took lots of time and effort. She said she came across so many obstacles, and she knows she's not alone. That's why she turned to Dr. Mariea Snell, who leads the doctoral nursing program at Maryville University in St. Louis, for some answers.
“So we've had some great developments actually with the RSV vaccine. It's just recently been FDA approved for maternal administration …,” Snell said.
The vaccine is recommended between 32 and 36 weeks of pregnancy by the CDC and the American College of Obstetricians and Gynecologists, which "unequivocally supports" the vaccine.
The Food and Drug Administration approved the RSV vaccine in pregnancy between 32 and 36 weeks on August 21. The CDC recommended it on September 22. The vaccine was approved in May for people age 60 and older. The Arexvy RSV vaccine was approved for individuals over 60. The Abrysvo RSV vaccine was approved for pregnant people.
"It's been incredibly effective. It's prevented 57% of hospitalizations for RSV in those children, 5 and under. And the more data we get, the higher that gets," Snell said.
Respiratory Syncytial Virus or RSV is a leading cause of hospitalization among infants. The idea of the vaccine in pregnancy is to pass on antibodies. But Vasan discovered getting the vaccine was a series of obstacles.
“I feel upset about that ... I think that's devastating. It's devastating for the patients and our community," Snell said.
The vaccine is so new that many doctor’s offices don’t carry it yet. So Vasan turned to Walgreens. Initially, she found different stores in the area had different policies, but in the end, she was told this by around eight locations: With a prescription, they would give Vasan the vial of the vaccine. But she would have to figure out how to transport it safely and get it administered. Another pharmacist at a CVS told Vasan they’re only administering the RSV vaccine to people over the age of 60. Spokespeople at Walgreens and CVS have not responded to her seven emails over the past week asking about their policies.
“Creating barriers like that are unfortunate and will significantly impact people's ability to be vaccinated in these high-risk groups," Snell said.
A spokesperson with the Missouri Pharmacy Association told the I-Team the policy of giving a patient a vial to have them take it somewhere else is risky.
“I would be extremely hesitant to do or recommend this,” Ron Fitzwater, Missouri Pharmacy Association spokesperson, said.
He said “temperature variations” during transport could make the vaccine less effective. Ultimately, Vasan got the RSV vaccine from the Medicine Shoppe Pharmacy in Chesterfield, an independent pharmacy.
“So the reason for that is those independent pharmacies can create their protocols for doing things. They don't have a big, you know, executive board that they have to answer to make these decisions," Snell said.
Bryan Kiefer with the nonprofit Pharmacists United for Truth and Transparency said he believes other factors at chain store pharmacies could also play a role.
“That is probably because they are inundated with COVID-19 and flu right now … their staffing is very short … and with all the vaccinations and prescriptions they're filling, RSV is probably on the back burner," he said.
Both Kiefer and Snell told the I-Team that independent pharmacies may be able to react more quickly to public health recommendations.
In clinical trials of the RSV vaccine in pregnancy, most reported very mild, temporary side effects, if any. They include pain at the injection site and nausea. With RSV season coming up, medical professionals are urging pregnant people to talk with their doctors and get the vaccine. But, it may be harder than you’d expect.
Pfizer has a “find the RSV vaccine” link on its website. You can use the search tool to find out where the RSV vaccine may be available in your area. To find out whether locations will both have access to the RSV vaccine and can administer it, Snell recommends you start with your doctor’s office, and then call a mix of chain and independent pharmacies in your area.
“The information we’ve been provided from the CDC is extremely limited at this point. We understand that the vaccine availability is limited as well, and pregnant people need to work with their doctor to ensure they are recommended for the vaccine at that time. The state has not yet been involved in vaccine ordering and distribution,” Lisa Cox, a spokesperson with the Missouri Department of Health and Senior Services, said.
The I-Team reached out to BJC HealthCare, SSM Health, and Mercy Hospital to find out when they will have the vaccine available for pregnant patients, and whether they’ve heard of challenges among pregnant patients in getting the vaccine at certain pharmacies.
“On behalf of BJC HealthCare - our hope is to have the immunization for expecting mothers in the coming week for inpatients,” said Laura High, a BJC Healthcare spokesperson.
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