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Drug, immunization, device shortages

January 11, 2024

Supply chain issues, manufacturing difficulties and increased demand have contributed to supply issues with a variety of drugs, immunizations and medical devices. AAP News has been covering the shortages and alternatives for patients. Recent articles can be found below. Shortages should be reported to the Food and Drug Administration

Jump to Adderall, amoxicillin, Bicillin, cancer medications, erythromycin ointment, nirsevimab (Beyfortus), tracheostomy tubes.



Pharmacist dispensing pillsLatest status from the FDA 

FDA, DEA call on drug manufacturers to address shortages, increase ADHD medications
Aug. 1, 2023 — Agency leaders noted manufacturers are not producing as much as allowed and called on those who do not wish to increase production to relinquish their remaining 2023 allotment so other manufacturers can increase production.

Additional ADHD treatment options available during Adderall shortage
Oct. 17, 2022 — An AAP expert provides alternatives drugs to treat attention-deficit/hyperactivity disorder while the immediate release formulation of Adderall is in shortage.

FDA: ADHD medication Adderall in shortage
Oct. 13, 2022 — Teva Pharmaceuticals reported intermittent manufacturing delays impacting the immediate release formulation of Adderall.



Doctor handing over prescription

Latest status from the FDA

New resource provides alternatives to amoxicillin suspension during shortage
Nov. 22, 2022 — Pediatricians who can't find amoxicillin oral powder for suspension should first turn to other formulations of amoxicillin. When amoxicillin can't be used, several alternatives can be considered.

Expert: Using antibiotics judiciously will help maintain supply during amoxicillin shortage, prevent resistance
Nov. 1, 2022 — Pediatricians grappling with a shortage of amoxicillin have other antibiotic options but should be judicious in using them to prevent resistance.



Newborn baby cryingLatest status from the FDA and from Pfizer

FDA allows importation of antibiotic during Bicillin shortage
Jan. 11, 2024 — The FDA is temporarily allowing importation of Extencilline (benzathine benzylpenicillin), which can be used to treat syphilis. 

Long-acting injectable penicillin in short supply
June 20, 2023 — Bicillin L-A and Bicillin C-R prefilled syringes are in short supply. Bicillin is used to treat pregnant women with syphilis and babies with congenital syphilis. It also has been used as an option for treating strep throat, especially during the shortage of amoxicillin. 


Cancer medications

Young girl with cancer in hospitalPediatricians advocating for increased production of cancer medications amid shortages
Nov. 1, 2023 — Health care providers are seeing shortages of vinblastine, dacarbazine, methotrexate, cisplatin, carboplatin and other drugs used to treat cancer in children.


Erythromycin ointment

Mother with newborn babyLatest status from the FDA

AAP: Use ceftriaxone to prevent newborn eye infection during erythromycin ointment shortage
Jan. 8, 2024 — Erythromycin ointment is used to prevent ophthalmia neonatorum caused by Neisseria gonorrhoeae. The infection usually is transmitted during passage through the birth canal and can lead to blindness. 


Nirsevimab (Beyfortus)

Doctor giving baby a vaccine in the thighCDC: Immunize all eligible children against RSV ‘as quickly as possible’
Jan. 5, 2024 — Clinicians can return to the original recommendations for using RSV immunization nirsevimab (Beyfortus) in infants and young children as supplies increase.

Sanofi to release 230,000 additional doses of RSV immunization nirsevimab
Dec. 14, 2023 — The additional supplies will include both 50 mg and 100 mg doses and will be distributed in January.

Additional supplies of RSV immunization to be released; shortages remain likely
Nov. 16, 2023 — Federal health officials are releasing more than 77,000 of the 100 milligram (mg) doses after identifying a batch awaiting final clearance and expediting processing.

CDC: During nirsevimab shortage, prioritize infants at risk, encourage maternal vaccination
Nov. 9, 2023 — During an AAP webinar, CDC officials continued to recommend prioritizing infants at highest risk, referring patients to other providers and encouraging vaccination during pregnancy.

Sanofi pausing new orders for nirsevimab; CMS sets payment rates
Nov. 7, 2023 — Sanofi is pausing orders for 50 milligram (mg) doses of respiratory syncytial virus (RSV) immunization nirsevimab (Beyfortus) and will have limited supply available when it reopens ordering.

CDC offers guidance on prioritizing infants for limited nirsevimab supplies
Oct. 23, 2023 — The interim recommendations focus on the youngest children and those most at risk of severe RSV disease.

CDC reopens limited nirsevimab ordering through VFC program
Oct. 19, 2023 — The CDC will use an allocation system that initially will target awardees who have not yet ordered or who ordered a small amount.  

CDC relaxes VFC rules for nirsevimab, COVID-19 immunizations
Oct. 18, 2023 — VFC program providers will not be required to keep a private stock of nirsevimab or COVID-19 vaccines during the 2023-’24 respiratory virus season if they are not vaccinating privately insured patients.

Supply issues plague nirsevimab ordering
Oct. 17, 2023 — Ordering nirsevimab through the Vaccines for Children program has been put on hold, and the 100-milligram formulation also is not available for ordering from Sanofi.

CDC director addresses COVID, RSV concerns; announces new CPT codes during AAP town hall
Oct. 5, 2023 — CDC leaders discussed new flexibilities in the Vaccines for Children Program, payment for counseling families on nirsevimab and what to do if an infant's insurance coverage is unclear when administering the immunization.

New VFC program flexibilities may improve access to nirsevimab
Oct. 3, 2023 — The CDC updated the provider agreement on inventory and borrowing rules, incorporating some of the strategies the AAP has been advocating for to ensure equitable access.


Tracheostomy tubes

Tracheostomy tube diagramTracheostomy tube shortage likely to impact pediatric patients; FDA offers guidance
Nov. 1, 2022 — The shortage of tubes, including Bivona tracheostomy tubes manufactured by ICU Medical, is more likely to impact pediatric patients because the supply of alternatives may be limited. 

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