By Dr. Joy Martinez, Staff Writer
People trying to find over-the-counter medication for their sick children are finding empty shelves, as a spike in respiratory illnesses pushes pediatricians and emergency rooms to the max. “We’re facing an onslaught of three viruses — COVID, RSV and influenza. All simultaneously,” says Dr. William Schaffner, an infectious disease specialist at Vanderbilt University. “We’re calling this a tripledemic.”
Because of this tripledic, as you’re walking past the cold and flu medicine aisle, you might notice the shelves are bare or very close to it. Children’s Tylenol, Motrin, or Advil are particularly difficult to find.
Unlike our current status, our neighbor to the north – Canada – has issued emergency orders to address a shortage of acetaminophen and ibuprofen, known by the name brands Tylenol and Advil, and similar products. Meanwhile, U.S. manufacturers and retailers emphasized that supplies should rebound within weeks. On the prescription side, increased demand for the antibiotic amoxicillin has caused shortages in the United States, Canada and parts of Europe.
Currently, the FDA is not reporting any shortages of Children’s Tylenol or its generic name of acetaminophen, and there are also no reports of shortages of Children’s Motrin or its generic name ibuprofen.
Johnson & Johnson makes Children’s Tylenol and Children’s Motrin. The company says there is no nationwide shortage — just rapidly increasing demand.
“Consumer demand for pediatric pain relievers in the U.S. is high, but there are no supply chain issues and we do not have an overall shortage in the U.S.,” company spokesperson Melissa Witt said in an email. The company says it is “experiencing high consumer demand and are doing everything we can to make sure people have access to the products they need.”
Not everyone agrees.
On social media, families say they’ve hunted for hours for oseltamivir, the generic version of Tamiflu, and the first-line antibiotics amoxicillin and Augmentin. Inhalers of the drug albuterol, which is used to open airways in the lungs, are also in short supply, according to the American Society of Health-System Pharmacists, which maintains a list of drug shortages (ASHP).
“ASHP tends to be slightly ahead of the FDA reporting on shortages,” says Stephanie Field, M.B.A., director of pharmacy business operations at Corewell Health West. “If ASHP shares it, then it will soon be on the FDA list.”
Nationally, sales of children’s internal analgesics — including acetaminophen and ibuprofen — were up more than almost 30 percent over the prior year according to data from the Consumer Healthcare Products Association (CHPA), a trade group that represents manufacturers of over-the-counter drugs.
“In my 25 years of being a pediatrician, I’ve never seen anything like this,” said pediatric infectious disease specialist Dr. Stacene Maroushek of Hennepin Healthcare in Minnesota. “I have seen families who just aren’t getting a break. They have one viral illness after another. And now there’s the secondary effect of ear infections and pneumonia that are prompting amoxicillin shortages.”
According to the US Centers for Disease Control and Prevention (CDC), more than half of the nation has “high” or “very high” respiratory virus (RSV) activity. Most of that is due to influenza, which hit early and hard this year. Respiratory syncytial virus, or RSV, is also playing a role. Nationwide, about 1 out of 5 tests for RSV was positive over the last week, a rate much higher than any point over the past two years.
There have been almost 8 flu hospitalizations for every 100,000 people this season, the cumulative hospitalization rate hasn’t been this high at this point in the season in more than a decade. Demand for medicine is high.
The companies that make generic drugs don’t usually keep stocks of their medications on shelves. Instead, they manufacture them based on orders placed earlier in the year. This year’s orders didn’t anticipate the enormity of the season for respiratory illnesses. In response, they are ramping up production, but it takes time to get more product in stock.
There is also the issues of stocking up at home. People may also be buying more of these medications to be prepared in case their child becomes sick, says Danelle Fisher, M.D., a pediatrician and chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, CA. “People are buying it because they’re nervous and seeing more respiratory illness in other kids,” she says. “When there are times when you know things could get bad, people tend to stock up.”
So what to do if you have a fevered child, and are struggling to find Children’s Tylenol or a similar product?
Dr. Fisher says, “But if your child is happy, eating well, and drinking well, I don’t care what the number is on the thermometer—you don’t have to treat it.”
Some doctors agree – like Dr. Sean O’Leary, a professor of pediatrics at the University of Colorado School of Medicine and Children’s Hospital Colorado, who explains the demand or shortage isn’t the issue, as you don’t even need to use medicine. The chair of the Committee on Infectious Diseases for the American Academy of Pediatrics (AAP) supports this assessment.
“These medicines are not curative. They don’t alter the duration of the illness or anything like that. They are essentially purely for comfort,” he says. “Fevers from common respiratory viruses in and of themselves are not harmful.”
He offers a scenario. “If [a child’s] temp is 103, but he’s running around the room having a good time playing, you don’t need to do anything with that. That’s not going to hurt him. Fever is representing our body’s immune response to an infection. On the other hand, if he doesn’t have a fever, but his throat is hurting, something is bothering him, he’s pretty fussy — then that’s where things like ibuprofen or Tylenol, acetaminophen can be helpful.”
It’s important to note that not all doctors share this outlook, and not every child’s health is the same. Be sure to consult your physician before making treatment decisions or changing treatment plans.