Children’s medication shortages put strain on parents and pharmacies

Pharmacists and parents across the country are contending with empty shelves as they search for children’s pain relief medications amid the ongoing spread of RSV, flu and Covid.

The surge of respiratory viruses has overwhelmed hospitals and doctor’s offices — 76% of pediatric hospital beds were full nationally as of Monday, according to data from the Department of Health and Human Services — and a number of pharmacies are reporting shortages of children’s Tylenol and ibuprofen. CVS and Walgreens each announced on Monday that they are limiting the number of children’s pain relief medications customers can buy.

At CVS, both online and in-store purchases are capped at two medications per customer, while Walgreens limits online orders to six but does not have a cap in stores.

“It’s kind of a dry well,” said Brian Caswell, a pharmacist and owner of the Wolkar Drug store chain in Kansas and Missouri.

Chantel Jablonski and her son.
Chantel Jablonski and her son.Courtesy Chantel Jablonski

Caswell said shortages of children’s Tylenol and ibuprofen and their generic versions started a month or two ago. While some pharmacies were able to stock up, others, like his, are struggling to find any product at all, he said.

Worried parents have been coming in looking for bottles of medicine for weeks, Caswell added. For younger children who don’t have medicinal alternatives, he is suggesting options like a cold compress.

“Unfortunately, that’s about the only choices you have. There’s not too many out there,” he said. 

Johnson & Johnson Motrin brand children's pain relievers at a Stop & Shop store in Dobbs Ferry, New York, U.S., on Sunday, Jan. 23, 2022. Johnson & Johnson is scheduled to release earnings figures on January 25.
Johnson & Johnson Motrin brand children’s pain relievers at a Stop & Shop store in Dobbs Ferry, N.Y., on Jan. 23, 2022.Tiffany Hagler-Geard / Bloomberg via Getty Images file

So far, 30 children have died from the flu this season, according to data from the Centers for Disease Control and Prevention. Among the overall U.S. population, the agency estimates there have already been more than 150,000 flu hospitalizations and 9,300 deaths since October 1.

Hugh Chancy is president of the National Community Pharmacists Association, which represents over 19,000 independent pharmacies. He said member pharmacies are under tremendous pressure. Some, including one of his own five pharmacies in Georgia, also function as compounding facilities, where licensed pharmacists can create drugs to meet the needs of individual patients. Chancy said his staff is talking to physicians about “writing prescriptions so that we can compound something over the counter,” like ibuprofen and acetaminophen liquids.

“We’ve never had to do that. This is something that has just always been available, and now it’s not,” Chancy said. “I’ve been practicing for 34 years and this is the first time that I’ve ever had to worry about being able to recommend Tylenol, Advil or Motrin.”

Chantel Jablonski, a mother of an 18-month-old in Bryn Mawr, Pa., said the shortages have hit her family particularly hard. Her son has a rare genetic disease that has resulted in kidney disease, and his body can handle Tylenol but not ibuprofen, making it even harder to find the specific medication he needs.

“There’s nothing that the pharmacies can do for us and there’s a whole lot of stuff that they’re out of, from the infant’s Tylenol to Pedialyte, all these basic things that my medically complex kiddo needs,” Jablonski said. 

She has been relying on prescription versions of the medications from doctors, but now supplies of those are also running out, she said. Since October, Jablonski said, her son has had RSV, Covid, and been hospitalized for the flu.

Chantel Jablonski's son.
Chantel Jablonski’s son.Courtesy Chantel Jablonski

“Instead of being able to go down to the store for Pedialyte or Tylenol, we need to take him to the hospital for care because these things aren’t available to us anymore,” she said, adding that they waited more than five hours to be seen during one of those visits.

The Food and Drug Administration said in a statement Tuesday that it can’t require companies to manufacture medications, but that “the public should rest assured” the agency is working closely with drugmakers to “understand, mitigate and prevent or reduce the impact of intermittent or increased demand of certain products.”

The Biden administration announced Wednesday that it would make the prescription antiviral Tamiflu available to states in need through the Strategic National Stockpile. 

In the meantime, pharmacist Amir Khan at the Hammer Lane Pharmacy in Stockton, Calif., said his staff has had to be “creative” in trying to help customers navigate medicine shortages. He’s asked parents to consider crushing adult pills or chewables and putting them in applesauce or pudding for their kids.

Khan said “this is probably the worst” shortage of children’s medicine he’s seen, surpassing even peak Covid. 

Empty shelves at a pharmacy in Bryn Mawr, Pa.
Empty shelves at a pharmacy in Bryn Mawr, Pa.Courtesy Chantel Jablonski

Dr. Sean O’Leary, chair of the committee on infectious diseases for the American Academy of Pediatrics, suggested a few alternatives for parents who can’t find the medications they usually rely on.

For older children, you can use acetaminophen and ibuprofen chewables or they can be taught to swallow pills if there are no chewable or liquid versions available, he said. The academy also lists nasal spray, humidifiers and mentholated rubs as alternatives that can help keep kids comfortable.

Ultimately, over-the-counter pain relief medicines are “not curative” and they will not make the illness subside quicker, said O’Leary, who is also a professor at the University of Colorado School of Medicine. And low-grade fevers by themselves are not harmful, he added.

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