The RSV shot shortage isn’t just a supply problem

On October 13, the drug manufacturer Sanofi made a surprising announcement: Public demand for Beyfortus — the brand name of nirsevimab, the company’s new product aimed at protecting newborns from severe respiratory syncytial virus (RSV) infections — had wildly outpaced supply.

In some ways, that’s good news: This is the first RSV season that the drug has been available, and uptake has been high. Understandably so: RSV is the top cause of infant hospitalizations worldwide. Pediatricians have enthusiastically welcomed this fall’s avalanche of new vaccines and other products to help prevent the infection’s worst outcomes. And despite the fleeting rise in childhood vaccine hesitancy that took place during the pandemic, parents still trust and listen to pediatricians about vaccines.

But it also means some children have been unable to receive the immunization, and it reveals deeper, more structural problems with how the US administers childhood vaccinations.

In response to the shortage, the Centers for Disease Control and Prevention recommended on Monday that the drug be prioritized for the youngest and highest-risk babies due to the shortage. But Sean O’Leary, MD, a pediatric infectious disease specialist at the University of Colorado’s medical school, says the shortage should never have occurred.

O’Leary serves as the American Academy of Pediatrics liaison to the CDC’s Advisory Committee on Immunization Practices. “We were consistently told that there would not be a supply problem — that there would be plenty,” he said. “And so that piece was extraordinarily frustrating for me.”

There were several other barriers O’Leary knew might impede the Beyfortus rollout, though. Inadequate supply should be a temporary speed bump in the drug’s distribution, but a different and more entrenched obstacle will likely create challenges for Beyfortus access for a while, he said: “The ridiculous way that we pay for vaccines in this country.”