RSV and Synagis Question

My son was born at 31 weeks gestation. When I took him in for his 6 month appointment, I inquired about another round of Syn. My doc response was that we could make a request, but not to get my hopes up. We would have to "prove" that my son was at risk. I thought just be being a preemie put him at risk, but here are a few other risk factors: I am a school teacher and am exposed to numerous germs I have school aged children who are exposed also THere is a history of asthma in the immediate family My husband is a smoker My son has RDS when he was born Am I being overly cautious or do I have valid concerns? If my concerns are valid how do I fight the insurance company? Any advice would be greatly appreciated. Elizabeth

10 Replies

  • Keep trying with your doctors office and the insurance company. My doctors office was intrigal in getting my son approved this year! We did not qualify last year. My son was born at 39 weeks at 4 lbs, 14 oz in mid October of 2006 and got RSV in January when he weighted 8 lbs. He lost 1 1/2 pounds with RSV, it took over 4 months for him to gain back the weight he lost. My pedi fought really hard this year with my insurance company because he supposedly didn't qualify because wasn't a preemie although he had all the usual problems that a preemie does. We started in June fighting to get him approved for the 9months that RSV season is in my area. We are so lucky that we finally got approved in late September. He is still only 11 lbs and 12 oz at 15 months, another bout of RSV would be devistating to him weight wise. Keep fighting and make sure that you have a pediatrician that is willing to fight with you, if not, change doctors!!! It's so important to have a health care provider that is on your child's side, especially if they have any long-term issues.
  • SYNERGIS SHOTS
    WE WERE UNABLE TO GET THE SHOTS THIS YEAR, BECAUSE KAITLYN WAS CONSIDERED "TOO HEALTHY". FIGURES THAT ALMOST TWO MONTHS POST ONE YEAR CHECKUP KAITLYN COMES DOWN WITH BROCHIOLITIS. THANKGOD NOT SEVERE ENOUGH TO WHERE SHE HAD TO BE RE ADMITTED, BUT WE WERE DOING HOME NEBS FOR 2 AND HALF WEEKS. I UNDERSTAND YOUR FRUSTRATION WITH NOT GETTING THEM, BOTH ME AND MY HUSBAND ARE PARAMEDICS, SO WE DEFFINATLY GET THE GERMS ON US; I HAVE A 9 YEAR OLD STEP-SON, SO HE GETS THE JUNK FROM SCHOOL; SHE USED TO GO TO A SITTER, BUT AT LEAST SHE WAS ONLY ONE OF 3 KIDS THERE; SOMETIMES HER GRANDPA WATCHES HER DURING THE WEEK AND HE'S A SMOKER; SHE WAS A 32 WEEK PREEMIE, AND SHE WAS UNDERWEIGHT. BUT WE STILL DONT QUALIFY. THAT'S INSURANCE FOR YA! THEY'D RATHER NOT PAY A $1000 SHOT, BUT $8000
  • I know that this was posted in July, but I just read it,a nd it is just now getting into winter.

    I would CERTAINLY try to get your doctor to allow a shot if at all possible (if he already hasn't). Your baby has many of the same risk factors that mine had, and he had RSV within 5 days of getting out of the NICU after birth. My son was born at 34 weeks, there is a family history of asthma, I as well work with children in a school, and my son had RDS as well. I would really look into it, because if I would have been given the option with my son, it would have saved a lot of time, money, and suffering in the hospital.
  • Re: RSV and Synegis Question
    I think that if you're visiting family then just make sure that everyone is well and that they wash up!! I'm also a fan of the hand sanitizers and the Clorox wipes for when you're out and about. There's nothing embarrasing about wiping down a buggy before putting your child in there!! Good luck with this fall/winter season!!
    Tracy :grin:
  • In reply to Audrie's Mom:

    Re: RSV and Synegis Question
    I know how you feel about protecting your little one. My son was born at 27 weeks. A week before he was scheduled to get the rsv shot we had to take him to the emergency room because he sounded congested. The doctors sent him home only to have him return the next evening in respiratory distress. He was diagnosed with rsv and spent 10 days in the pediatric icu. That was really a scary thing to see your child go through and knowing that there was nothing i could do to help him. Thank God he pulled through but at times he still sound congested. I am also trying to get back to work and am worried about bringing him out of the house to the babysitter. I am afraid to do to much travelling with him. I really don't want to see him go through that again.

    what suggestions have you come up with. How is the daycare working out
  • We are one family that did beat the odds and got synagis shots for 2 years. Unfortunately she did get RSV while being on the shots. Although they do say that may have lessened the bout of RSV she had.
    Give it all you got, and know you've done your best!

    Tracy
  • Elizabeth...you are by no means being overly cautious. My daughter was born at 28 weeks gestation. The doctor prescribed for her to have Synagis shots starting in October before she even left the NICU. I'm scared to death to send her to daycare (starting August 20th) because of RSV. Your doctor should be able to give you a scrip. for the shot. And "just being a preemie" does put him at risk. Please keep me updated on how things go. I wish you the best of luck. Let me know if I can help you any further
  • Elizabeth....I felt the same way you do. My son was born a month early, has a congenital heart defect, and I have a daycare in my home, and he only "qualified" for his shot in the NICU. After that, my doctor fought the insurance company and lost because it (by their terms) wasn't RSV season anymore and I should try back in September. Since then he has developed a few asthma/ allergy concerns that ofcourse are not linked to it but....I flipped out when he started to wheez and cough because I thought he may have had RSV and rushed him to the Ped.
  • Elizabeth,

    Unfortunately I don't have great news for you. My twin girls were born at 25 weeks gest. in Feb. 2001. Their first winter, at the age of 8 months at RSV season onset... they were both qualified for the vaccine.

    It was a hard winter for Hanna.. and she was sick A LOT.. but never with RSV. She has a BPD, and Asthma diagnosis. Rachel did great, and did not get sick.. at all.

    The following winter.. their second winter home, and at the age of 18 months only Hanna qualified for the vaccine. Rachel did not. She was a former 25 weeker, had two siblings.. one of which was chronically ill, and the other who was attending preschool. Our insurance, and the program wouldn't qualify her. Thank the Lord she did not get sick.

    I would say fight it if you can, but prepare yourself for the fact that the odds are not in your favor. There have been a few families here who did fight, and win... but I don't recall their situation, or their child's history.

    I wish you all the best, and a healthy winter!
    Karri
  • RSV and Synagis Question
    Hi Elizabeth - Recently this was posted by chynathedragon. I believe that there are many factors as follows - but most importantly - was / has your baby been sick? Good luck,
    Pam

    Many parents out there are learning about RSV preventative injections, Synagis, but it seems that there's not a lot of direct information out there about what the qualifications are for receiving them. I've compiled a list of some of the requirements children must meet in order to become eligible for insurance company approval. This list may not list every factor each individual insurance company considers, so make sure you check with them to see if they have other qualifications.

    Factors:
    1. Age
    * Gestational Age/Premature birth - 35 weeks of gestation or earlier, but only with additional risk factors
    * Chronologic age at the start of the RSV season
    * Younger than 24 months of age - Infants born at 28 weeks of gestation or earlier may benefit from prophylaxis up to 12 months of age; infants born at 29 to 32 weeks of gestation may benefit most from prophylaxis up to 6 months of age. Children over this age may have to meet other requirements in order to receive approval.

    2. Weight
    * Birth weight
    * Percentile on the growth chart
    * Underlying conditions causing low weight

    3. Health Factors
    * History of severe and/or chronic recent respiratory illness - Children with chronic lung disease (CLD) who have required medical therapy for their CLD within 6 months before the anticipated RSV season
    * History of recent respiratory distress
    * Health conditions dependent upon respiratory therapy or medications: eg - oxygen, albuterol, steroids, trachiotomy, suction, and/or other respiratory equipment dependency
    * Health conditions that show substantial risk of future respiratory distress
    - Chronic lung disease (CLD)
    - Pulmonary Hypertension
    - Asymptomatic acyanotic congenital heart disease (CHD): eg - patent ductus arteriosus or ventricular septal defect
    * Immunocompromised children - immune system deficiencies: eg - severe combined immunodeficiency or severe acquired immunodeficiency syndrome

    4. Costs and Other Factors
    * Risk of hospitalization cost compared to prophylaxis cost
    * Underlying conditions that predispose to respiratory complications (eg, neurologic disease in very low birth weight infants, lung development)
    * Number of young siblings
    * Child care center attendance
    * Exposure to tobacco smoke in the home
    * Anticipated cardiac surgery
    * Distance to and availability of hospital care for severe respiratory illness
    * Fragility of the medication itself - must be used within 20 minutes of mixing, must be transported and stored under strictest conditions, availability to health care provider, etc.
    * Doctor recommendation and/or Letter of Medical Necessity.

    Most, if not all, insurance companies require all children tthat receive Synagis to have precedence of respiratory illness, risk of future distress, and respiratory therapy dependency of some kind before they will even consider the other factors. It is not enough to simply be of the right age, weight, and have a gestational period of less than 35 weeks. RSV is dangerous to all children, especially premature babies, but it seems that the insurance companies want to reserve it for those who have chronic respiratory issues and are at future risk of distress.
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