As the rollout of the Respiratory Syncytial Virus (RSV) vaccine gains momentum, concerns are emerging regarding accessibility and potential costs for vulnerable populations.
"The cost for us is well over $400," said Dr. Kerry Fierstein, CEO of the Allied Physicians Group.
The monoclonal antibody treatment is meant to help fight off the potentially serious respiratory disease.
RSV season, which began this month and runs through April, claimed the lives of 300 children and 10,000 older adults last year alone, according to the CDC.
"The antibody and vax will be great," Dr. Fierstein said. "There’s just a lot that needs to happen and happen in the middle of RSV season."
But even though the vaccine is recommended for infants, young children, some pregnant women, and those 16 and over, insurance companies have one year before they have to offer it for free. This delay has raised concerns, as it places the onus on patients and parents to cover the costs.
"The fact that insurance wouldn’t cover this, it’s very upsetting honestly," said patient advocate Nicole Christensen of Care Answered. "Especially with the stats of deaths and hospitalizations with this illness, there were about 60 to 160,000 hospitalizations a year for RSV and 1 in 56 babies born in countries like the U.S. on time will be hospitalized within a year with RSV."
While some Medicare plans cover the vaccine, millions of seniors may get hit with a bill.
Doctors and patient advocates recommend speaking to your insurance company prior to avoid any surprises.