SCOTT SIMON, HOST:
There's a new shot available this fall that could protect babies against respiratory syncytial virus, or RSV. But as Amelia Templeton reports from Portland, Ore, it is so new and expensive, some babies might not get it in time or at all.
AMELIA TEMPLETON, BYLINE: RSV is the leading reason babies under 12 months end up in the hospital. And last winter, RSV hit Oregon and other places really hard.
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UNIDENTIFIED NEWSCASTER #1: No pediatric ICU beds available in the entire state of Michigan.
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UNIDENTIFIED NEWSCASTER #2: Pediatric rooms are full right now with children who are struggling to breathe.
TEMPLETON: But doctors say this year could be better. There's a new shot pregnant moms can get before giving birth, but the window for getting that is quite narrow. So many pediatricians have focused on the other new option - nirsevimab. It's a dose of man-made antibodies that lasts about six months. That's long enough to get infants through their first RSV season, when they're the most vulnerable. It can cut the risk of hospitalization by 80%. Emily Bendt got excited when she heard the CDC had approved the new immunization. That was two months ago, when she was pregnant.
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TEMPLETON: Now she's at home on the couch in Vancouver, Wash., with her new baby, Willow. But her excitement has turned into frustration. Just hours earlier, at Willow's two-week checkup, she had asked the pediatrician for nirsevimab.
EMILY BENDT: She literally just shrugged and was like, well, it's coming, but we don't know when. And that was literally the end of the discussion.
TEMPLETON: Bendt's been searching online, too, for clinics or pharmacies offering nirsevimab and found nothing for Willow.
BENDT: It feels a little bit like I'm waiting for her to get sick at any time.
TEMPLETON: Nirsevimab did start shipping this month, but because of the price tag, many pediatricians have been reluctant to order it. At $495 per dose, it's the most expensive standard childhood shot. And because of a quirk in the Affordable Care Act, insurance plans have a year before they have to cover it. Dr. Sean O'Leary is with the University of Colorado med school.
SEAN O’LEARY: So when all of a sudden you have a new product that you're supposed to give to your entire birth cohort and you've got to pay $500 that may or may not get paid back, that's just not financially viable.
TEMPLETON: Some insurers have come out and said they'll pay for it, but not all. And there are even problems with the government program that supplies free vaccines to low-income kids.
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TEMPLETON: At Mid Valley Children's Clinic in Albany, Ore., 70% of the patients are on Medicaid, so all their shots are free under this program called Vaccines for Children, or VFC. In the back, there's a fridge with tens of thousands of dollars of childhood vaccines in it.
UNIDENTIFIED NURSE: This is our main fridge, so all of our VFC is on these pink lines.
TEMPLETON: The VFC boxes have hot-pink stickers to help nurses keep track and give them only to the kids who are eligible. Pediatrician Eddie Frothingham is thrilled that nirsevimab is coming to this clinic. He's seen how sick babies get every winter.
EDDIE FROTHINGHAM: The idea that we could have something that prevents most of that is just very exciting.
TEMPLETON: But Frothingham says it would actually be better if some of the free doses were going to the hospital that's right across the street. That way, babies could get nirsevimab right after birth, even before they head home.
FROTHINGHAM: Many of our newborns go home to caring, affectionate, loving siblings who are actively dripping snot at the time that the child is born. So the sooner we can protect them, the better.
TEMPLETON: But the hospital across the street is not signed up for Vaccines for Children. In fact, only 12% of U.S. hospitals that deliver babies are enrolled in VFC. Now many are trying to enroll for next year. But this fall, most hospitals won't have free nirsevimab on hand, and that will mean delays getting it to newborns across the country.
For NPR News, I'm Amelia Templeton in Portland, Ore.
SIMON: This story comes from NPR's partnership with Oregon Public Broadcasting and KFF Health News. Transcript provided by NPR, Copyright NPR.
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