As the respiratory syncytial virus, known as RSV, drives up pediatric emergency visits and hospitalizations this winter, children’s medication is becoming a new shortage causing worry among parents.
"It’s very concerning, I think, to all of us," Dr. Tia Babu, an infectious disease expert at the University of Washington, told FOX Television Stations. "We’re watching with bated breath right now as infectious disease physicians."
What is the ‘tripledemic’?
The shortage is fueled largely by what many have been referring to as the "tripledemic" — a collision of three viruses that have been putting a strain on the healthcare system. Doctors warned the surge of these viruses would happen simultaneously this winter — and it appears the U.S. is now in the midst of it.
"Unfortunately, it seems like we are," Dr. Babu shared. "We are seeing increases in RSV, influenza, and COVID-19 is starting to slightly tick up in our country right now."
While experts are not sure what is causing the earlier-than-usual peaking of these viruses, theories include decreased mitigation measures (less face masking, social distancing) and increased indoor activity.
Why is there a children’s medicine shortage?
That tripledemic is what is currently driving consumer demand for children's cold, flu and pain relief products.
"We anticipate that high levels of respiratory virus activity may continue for several more weeks, or possibly even months," a spokesperson with the Centers for Disease Control and Prevention told FOX.
Drug manufacturer Johnson & Johnson told FOX Television Stations that they "continue to experience high consumer demand driven by an extremely challenging cold and flu season."
"We recognize this may be challenging for parents and caregivers, and are doing everything we can to make sure people have access to the products they need, including maximizing our production capacity, running our sites 24 hours a day, 7 days a week, and continuously shipping out product," the company stated. "We will continue to partner with retailers to provide these products to consumers."
The Consumer Healthcare Products Association (CHPA) points to supply and demand as the reason behind the current shortage, writing, "The reason for the scarcity of OTC children’s pain relievers at certain retail locations is a direct result of the recent and rapid increase in demand driven by a rise in pediatric cases of respiratory illnesses including the flu, COVID, and RSV."
They continued, "Manufacturers are producing at full capacity and directing product inventory to where it is needed most. However, we understand it might be frustrating for parents to quickly locate these products from their usual pharmacy or retailer due to intermittent out-of-stocks."
Unlike the baby formula shortage earlier this year, Johnson & Johnson is not currently facing supply chain challenges or ingredient issues with its children’s medication.
A spokesperson with the U.S. Health and Human Services told FOX, "HHS has been closely tracking the increased demand of certain medicines due in part to multiple illnesses circulating this winter season and has been working with states for months to mitigate any strain to health care systems, especially as it relates to concerns about medication availability. Every operating division across HHS is engaged and playing a pivotal role in addressing these concerns."
Where can I find medicine for my sick kid?
Amid the children’s medication shortage, it may be more difficult to track down Children’s Tylenol and other painkillers.
While products may be less readily available at some stores, Johnson & Johnson said they are not experiencing widespread shortages of Children’s Tylenol or Children's Motrin.
"Parents may have to make a few stops to find what they need and should also consider additional self-care alternatives to aid comfort and relief at the direction of their health care provider," the CHPA continued, adding, "We want to further reiterate the importance of responsible purchasing practices. Media coverage surrounding this issue could prompt parents to ‘stock up’ if a product shortage is perceived or feared – which could eventually cause widespread supply shortages for U.S. consumers."
Johnson & Johnson, infants medication on a shelf at a pharmacy October 11, 2007 in the Brooklyn borough, of New York City. (Photo by Spencer Platt/Getty Images)
CVS told FOX Business it's seeing increased demand for cold, flu and pain relief products but that it's working with its suppliers "to ensure continued access to these items." If a store has a "temporary product shortage," CVS says its teams have a process in place to replenish the supply.
Rite Aid, which it said is facing constraints on children's Tylenol due to an ingredient supply chain issue, told FOX Business that its pharmacists are readily available "to provide recommendations for equivalent products and alternative treatment options."
The drugstore chain also carries pediatric products that are not impacted by shortages such as Genexa Kid’s Pain and Fever and Kindermed Kid’s Pain and Fever.
The U.S. Food and Drug Administration told FOX it recognizes the potential impact that increased demand of certain products may have on health care providers and patients.
"While the agency does not manufacturer drugs and cannot require a pharmaceutical company to make a drug, make more of a drug, or change the distribution of a drug, the public should rest assured the FDA is working closely with numerous manufacturers and others in the supply chain to understand, mitigate and prevent or reduce the impact of intermittent or increased demand of certain products. The FDA understands that manufacturers expect availability to continue to increase in the near future," the agency continued.
What children should and should not use instead
Now, doctors and health officials are warning parents not to give their children adult medication — even when children’s medications are in short supply.
The FDA is urging parents to only give children the proper dose and strength of the medicine.
Johnson & Johnson also advises on their website that "young children should not take adult medication." Instead, parents can look out for the children’s versions of generic brands of Acetaminophen and Ibuprofen, which can be used to treat symptoms.
"It’s probably a very dangerous maneuver, number one, because children and infants are dosed very differently than adults," Dr. Jay Schauben of the Florida Poison Information Center told News4jax.com in Jacksonville.
"And just by cutting tablets in half, you may not be giving them the correct dose — you may be overdosing them, or you may be underdosing them," he also said.
The FDA, on its website, tells parents: "Give the right medicine, in the right amount, to your child. Not all medicines are right for an infant or a child."
Acetaminophen, while effective in reducing pain and fever, can also cause liver damage and death if taken in too high an amount.
This means that accidentally overdosing a child could have tragic consequences, notes the Tylenol website.
"Severe liver damage may occur if you take more than 4,000 mg of acetaminophen in 24 hours, with other drugs containing acetaminophen, and/or three or more alcoholic drinks every day while using this product," the site says.
Dr. Darshan Patel, section chief of pediatric emergency medicine at Maria Fareri Children's Hospital in New York, says if a child has a high-grade fever, which is considered to be at least 101 degrees, parents should focus on keeping their child hydrated and controlling their fever, which includes using medicine.
However, "antibiotics are not always necessary," he added. To cool a child down, parents can remove excess clothing or blankets, and they can also put cool compresses under their armpits, according to Patel. One thing he doesn't recommend, are cold baths.
In terms of medication, parents should keep an eye out for generic medicine such as acetaminophen and ibuprofen rather than brand names for the drugs such as Tylenol, Advil or Motrin, Patel also echoed.
Dr. Kathy Merritt, a pediatrician at Chapel Hill Pediatrics in Chapel Hill, N.C. said generic medicine has "tended to be in better supply at some stores."
If the child has a low-grade fever and is otherwise feeling OK, meaning they are playing or drinking fluids, "it is OK not to treat the fever with antipyretics or fever medications such as acetaminophen or ibuprophen," Patel said.
If "you have a viral infection, fever is your friend," he added. "The body is acting normally to increase the temperature to help fight the viral infection inside."
There is currently no antiviral medication to treat RSV, but health officials say parents should seek medical attention if their children are having difficulty breathing.
RSV on the rise
CDC surveillance has shown an increase recently in RSV detections, RSV-associated emergency department visits and RSV hospitalizations in multiple U.S. regions, with some regions nearing seasonal peak levels.
"The burden on our hospitals right now is extremely high," Babu added.
According to Children’s Mercy, RSV typically occurs in the winter, starting around November. In 2020, there was very little RSV in the Kansas City area and in the U.S. It was likely related to people wearing masks, washing hands and distancing, which all decrease the spread of respiratory viruses, including the viruses that cause COVID-19 and RSV.
Yet, earlier this month, the hospital said they reached capacity with sick kids, FOX 4 in Kansas City reported. The medical staff has been treating RSV and flu cases since October.
"We have activated our emergency plans," Chief Emergency Management Medical Officer Dr. Jennifer Watts told FOX 4. "We activated those a few weeks back. We continue to find overflow spaces. We continue to develop creative ways in order to take care of kids. We are making plans in order to address these issues, but it certainly is concerning watching those numbers rise."
Doctors said the spread of RSV can also be prevented by washing your hands for at least 20 seconds, keeping away from people who are sick and covering coughs and sneezes.
FOX Business and FOX News contributed to this story.