by Emily Alpert Reyes, Los Angeles Times

Credit: CC0 Public Domain

When Megan Costello heard on the radio this fall that a newly approved vaccine for pregnant people could protect their babies from RSV, the Los Angeles resident immediately started asking how she could get the shot.

As a person with asthma, Costello said, she takes any kind of respiratory infection very seriously. So does her husband, whose family lost a child to pneumonia.

The one-time shot would protect her son against respiratory syncytial virus, which has long been the leading cause of hospitalization for infants in the United States.

But despite her eagerness to get vaccinated, the 38-year-old architect kept running into stumbling blocks—and ultimately missed her chance to get the shot while pregnant. Meanwhile, health officials were warning that another set of new immunizations for RSV—those given directly to infants—were in short supply.

Pediatricians "have been waiting for many decades to have an immunization to prevent RSV, and now we have two, but both have these huge barriers to delivery right now," said Dr. Sean O'Leary, a pediatric infectious-disease specialist at the University of Colorado Anschutz Medical Campus who researches barriers to vaccination.

The shots have been hailed as a game changer for RSV, an illness that crowds pediatric wards in fall and winter and causes tens of thousands of young children in the U.S. to be hospitalized annually. The virus can sicken otherwise healthy infants and cause pneumonia and inflammation of the small airways in the lungs. According to estimates from the national Centers for Disease Control and Prevention, RSV leads to the deaths of 100 to 300 children under age 5 in the U.S. each year.

But babies can now be protected from RSV in two ways: They can be immunized with an antibody called nirsevimab, or their mothers can get a vaccine called Abrysvo during a specific window in the third trimester of pregnancy and pass protection on in utero. (The shot was initially recommended for seniors and became available to pregnant people this fall.)

Most babies need only one or the other, and amid a shortage of nirsevimab, the CDC has urged medical providers to encourage pregnant people to get vaccinated. The American College of Obstetricians and Gynecologists recommends Abrysvo for patients who are between weeks 32 and 36 of pregnancy from September to January, the time of year when RSV spreads.

Yet some pregnant patients eager to get vaccinated have met with obstacles. Computer systems at some pharmacies initially balked at booking shots for the newly eligible patients, pregnant women reported. Insurers are not required to cover newly approved vaccines right away. And medical offices and pharmacies did not necessarily have the shot on hand.

"It has taken many months for people to be able to find it reliably at local pharmacies," and it's still rare to get it at a doctor's office, said Dr. Mya Zapata, an OB-GYN at UCLA Health. The vaccine's availability "wasn't clear and transparent," and many patients had to call around or rely on word of mouth to find it.

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