RSV Shot Question

I was wondering if any of your babies had the RSV shot? I cannot remember what it is called but my daughters are getting it on saturday. The doctor told us that it is a $1000.00 a shot and they get your insurance company approval before they give it to your child becuase it cost so much and they have to have this shot once a month through out flu season.I was just wondering if any of you know what I am talking about because I cannot remember the name of it.

 

I was wondering if any of your babies had the RSV shot? I cannot remember what it is called but my daughters are getting it on saturday. The doctor told us that it is a $1000.00 a shot and they get your insurance company approval before they give it to your child becuase it cost so much and they have to have this shot once a month through out flu season.I was just wondering if any of you know what I am talking about because I cannot remember the name of it.

 

Yes, my twins are getting it, and actually just got their 3rd one today. It is called synagis. They get one shot once a month through RSV season which is usually Oct.- April, but it really depends on when your insurance thinks the season is. It is very expensive, thank goodness for insurance.

 

My girls get it too, it is called Synagis. It gets more expensive each month because the bigger they get the more med they get. Mine will get them through April.

Thank God for insurance!

 

Yes, Synagis. What they didn't tell you is that it is $1,700 per VIAL and it goes by weight. One vial for the first 5 pounds and then one vial for each two pounds after that. We did it for one month, and the insurance would only cover 90% and they were each getting three vials, so we had to discontinue the treatment. We just keep them inside, wash hands often, and pray they don't get RSV.

And here's an added rant:

The insurance won't cover the shot - a preventative measure. But if they get RSV and need to be hospitalzed and have nebulizers, we only have to pay $200 per child, but it's going to cost them tens of thousands of dollars... STUPID!!!!

 

Please, before you get the shots, call your insurance company yourself, even if the ped. is calling. My ped office was told it was a covered benefit, so we got the shots.

We found out too late that only 7 units per 12 month period, not calendar year, are covered. Since the dose is weight based, we went through 7 units very quickly. We were never told that a shot can consist of more than one unit. This is how it worked out for us:

DATE_______________UNITS__WEIGHT_____AGE
April 29, 2005*******1****5-½ lb****2 months
November 28, 2005****2***15 lb******8 months
December 28, 2005****3***15-7 lb****9 months
January 26, 2006*****3***16 lb*****10 months
February 27, 2006****3***16-13 lb**11 months
March 28, 2006*******3****17 lb*****1 year

Our ins co never received January's bill until the ped resent it in April, so we had to pay for some of February's shot, all of March's, and all of January's. There's a foundation that paid $1500 for the March shot, but I'm fighting the ins co to get January's (another $1500) paid for.

So please call youself....ask how many units are covered in what period of time. In a recent call the rep told me weight didn't matter in the determinging of 7 units..DUH!! Weight is everything!!!

 

Yes, we got it the boys first two years and are so glad we did. never got RSV. I also never had problems with my insurance company...

 

The synagis is one EXPENSIVE shot! Ds got them for the first 2 years of life from October-March. Now the girls will get them the first 2 years as well. The shots vary state to state with the cost, some insurance companys wont cover it, some cover part of it, some cover all of it. Call your insurance company.
The state we just left the shots were $1500 per vile and here they are $2000 per vile. Like others mentioned its not just one flat cost, your babies will get more viles as they gain wieght. Its alot of money but worth it to keep them out of the hospital

 

My insurance would cover the VERY expensive shots 100% so I think it depends on your insurance coverage, but I think it's actually a requirement with most companies to get pre-approval. I opted to NOT get them the shots. I probably would feel differently if they were in daycare though. My son and daughter that are in school have to wash up before they can hold or play with the babies. So far so good they've only had one cold since birth.

 

my insurance company is so strict regarding the guidelines to get the shots that my kids aren't getting them...

 

My insurance company I had before wouldn't cover it, and it was $1,400 per kid per shot per month. I don't think so. Now, we have a new insurance company and they are checking into what coverage we would have for this. I should find out soon. Frankly, without coverage, there is absolutely no way we could afford it.

I also didn't know the weight thing, so I am sure the cost will be higher now. I also know RSV is an issue with preemies, but I can't shake the thought my first was a preemie, never had the shot, was born in the middle of RSV season (December), and never had an issue. I know that doesn't mean it can't be an issue, but it's just weird to me that in a couple years something that was completely no big deal is suddenly so urgent.

It was never brought up when the twins were born last year in early March. Now, they are 10 months old. I just can't believe RSV is as risky at their current age and weight. From what I've read, it's more an issue if it goes untreated, and is the biggest issue when they are newborns.

Anyway, I would sure prefer to have it covered and get it done to be safe. But any time something is this ridiculously expensive, I question whether it's THAT useful or some drug company pushing it to make a buck. I don't know what's in those things, but it takes some gall to justify one vial of something costing $2,000!

 

quote:
It was never brought up when the twins were born last year in early March. Now, they are 10 months old. I just can't believe RSV is as risky at their current age and weight. From what I've read, it's more an issue if it goes untreated, and is the biggest issue when they are newborns.


Babies, especially preemies, are at risk for RSV until age 2. It doesn't matter whether they are 2 months or 10 months they can still get RSV pretty bad. My niece was a full term baby born in July and got RSV in Jan. at 6 months and had to be hospitalized due to it. Weight has nothing to do with it. A cold can turn into RSV overnight.

And as PP have been saying it is dependent on weight. My DD had only been getting one shot the past 2 months. Well when we went in today for them she now needed 2 shots due to her current weight, that is why they weight them every time before the shot.

If your insurance company covers it that is wonderful. We are lucky that ours covers it 100%, it makes me feel much better about this winter. Now next winter is another story. I was told that my twins are too healthy and probably would not qualify even though they were born 3 months early.

I would definitely call your insurance yourself and see what is covered with it.

 

Thanks for all the information. I was told that my insurance will cover the shots 100% but I think I will call just to make sure. It does cost alot of money and I cannot afford to get stuck with a bill that high. I also have 3 other children and they never had an issue with RSV and i hope to keep it that way with the 2 new babies.

The drug compaines drive me nuts. If there is a shot that can save lives you would think that they would want to give it to as many babies as they could but instead only thouse who can afford it or have really good insurance can have it. i don't think that is fair at all.But I understand that it does cost them money to make the drug to. i just wish all of you could get the shots for your babies.

 

We tried to get my twins RSV shot but insurance declined twice... even after my pediatrician wrote a note stating they need to have it. BE SURE it's covered FIRST before getting the shots as they do cost at least $1000 each shot for each kid.

 

Oh, and the series typically runs from Nov - Mar/Apr