New Shot Against Newborns' Severe RSV has 80% Efficiency, But May Not Be Available This 2023 Due to Insurance Loophole

The issue preventing Beyfortus is an insurance loophole.

New Shot Against Newborns' Severe RSV has 80% Efficiency, But May Not Be Available This 2023 Due to Insurance Loophole
12-day-old Andreas wears a respirator as he lies with his mother in an intensive care unit at the pediatric ward of Berlin's Saint Joseph hospital on December 13, 2022. - Corona, flu, RSV - three infections are currently plaguing hospitals. JOHN MACDOUGALL/AFP via Getty Images

A new shot for newborns' severe RSV (respiratory syncytial virus) may not be available this 2023 despite having high effectiveness against the respiratory virus.

Experts said that the main thing preventing the efficient Beyfortus is a simple loophole in health insurance companies. Here's what the CDC and AAP discussed during their recent meeting.

This Effective RSV Shot for Newborns Has 80% Effectiveness

According to CNN's latest report, the high-anticipated Beyfortus is considered to be the latest weapon of parents and health experts against severe RSV cases.

Beyfortus is an antibody called "nirsevimab," which was approved by the U.S. Food and Drug Administration in July. Both parents and pediatricians were filled with joy after knowing that the new medicine had been approved.

This is because over 80,000 kids under the age of 5 are hospitalized in the U.S. because of the serious respiratory virus. The U.S. Centers for Disease Control and Prevention estimated that as many as 300 babies die annually.

"Every pediatrician is jumping for joy that this preventative tool is available for newborns because we see what happens when a healthy baby gets this terrible infection," said Dr. Sallie Permar.

Based on its clinical trials, the new RSV immunization shot has an 80% effectiveness, as reported by OPB. Due to this performance, numerous doctors and other health experts consider it as a game-changer for infant patients.

Why Beyfortus May Not Be Available This 2023

New Shot Against Newborns' Severe RSV has 80% Efficiency, But May Not Be Available This 2023 Due to Insurance Loophole
This file picture taken on 15 January 2004 shows a 15-month-old baby girl suspected of suffering from avian flu strain A receiving treatment at the Hanoi's Central Pediatric Hospital. The World Health Organization confirmed Saturday that a fourth person had died from bird flu. STR/AFP via Getty Images

Unfortunately, the Beyfortus may not be available this 2023, as confirmed in the recent meeting of the American Academic of Pediatrics and CDC Director Dr. Mandy Cohen.

This is because of uncertainties about health insurance coverage. Under the Affordable Care Act, insurance providers are required to cover the cost of Beyfortus and other immunizations without any financial assistance or payments from patients.

However, a loophole in this law prevents the fast distribution of the Beyfortus. The issue here is health insurance companies are allowed to add new products to their plans for a year.

Because of this, it is unclear how fast these health insurance providers will act or how much of Beyfortus supplies they will cover.

"We are so thrilled to have something available, but to then have it be so close but then still not getting it into arms, it's tragic," said Dr. Permar, who is the chair of the Department of Pediatrics at Weill Cornell Medicine and New York-Presbyterian Hospital.

She added that they are still making efforts so that the new RSV shot can be rolled out effectively. But, Permar clarified that it may take more time than expected.

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