RSV - Synagsis question

hi there,

my twins were born at 36 weeks - and my boy had NICU time - mostly due to low blood sugar and body temp issues.

The NICU opted to give him a synagsis shot and he is now due for his second shot - but my medical group denied it because their criteria is: born b/t 32 and 35 weeks and bronchial (sp?) problems - neither of which Jake has. Also, Becca was not given a shot...The Nicu said Jake had low birth weight (which Becca also had) a sibling (again, same for Becca) and born at 36 weeks....again same for bEcca.

For those whose children are born around the same time as Jake - do you get the shot? If so, what was the deciding factor?

Thanks in advance.
Miriam

 

hi there,

my twins were born at 36 weeks - and my boy had NICU time - mostly due to low blood sugar and body temp issues.

The NICU opted to give him a synagsis shot and he is now due for his second shot - but my medical group denied it because their criteria is: born b/t 32 and 35 weeks and bronchial (sp?) problems - neither of which Jake has. Also, Becca was not given a shot...The Nicu said Jake had low birth weight (which Becca also had) a sibling (again, same for Becca) and born at 36 weeks....again same for bEcca.

For those whose children are born around the same time as Jake - do you get the shot? If so, what was the deciding factor?

Thanks in advance.
Miriam

 

Ellie was born at 36 weeks. She had no NICU time. She does not get the Synagis shot.

 

Mine were born much earlier and are getting they synagis shots every month. Most insurance companies won't cover the shots if your baby/ies were not born prematurely or have medical issues. If he was just in the NICU for low blood sugar and body temp. issues they probably won't cover it. I'm actually surprised they covered it while in the NICU. It's sad, every baby should be able to get the RSV shot.

 

Just so you know, it is a VERY expensive shot, over 1000, so if your insurance won't cover it, it will cost a lot of money out of pocket...
and it is based on weight, so I know my boys had to get two shots per visit when they got older. (they were 31 weekers)

I don't have any advice, since mine were preemies and did qualify for the shots. I hope it works out for you!

 

Mine are 31 weekers, so they did qualify for the shot. It is VERY expensive and gets more expensive each month as they get bigger. They now get 2 shots versus one at each monthly visit.

 

I wish I had better advice for you. My babies were born about 35 week and I was told they had to meet 3 things for my insurance to cover the shots.
1. They had to be bore 35 weeks or younger
2. They had to have school age brothers and sisters at home.
3. They had to be multiples.

Not sure if that is true or not but that is what my doctor told me. So my girls do get the shots and the insurance compant pays for it.

 

thanks, i did know it was expensive...i'm just trying to determine if we should worry about not getting for him - we aren't planning to pay for it.

Miriam

 

You don't need the shot. Your boys aren't high risk. They are very expensive shots $1500 dollars a shot. Just keep the boys in the house if you are worried about them getting RSV.

Erin

 

If he was born at 36 weeks and has healthy lungs and immune system, he probably doesn't neet the shot. They maybe just gave it to him for the month to give him some protection while he "caught up". Maybe b/c he couldn't regulate his body temp his immune system was compromised and that is why they opted to give it to him in the NICU. Mine were in for two weeks, but they didn't get a shot until a month later. Now we don't do it b/c the insurance only covers 90% and we can't afford the balance.

Other factors to consider are is he in day care? Is there a history of Asthma? Does he live in a crowded living condition? School-age siblings at home?

Keep in mind, it isn't a vaccine, it's just anitbodies to boost the baby's immune system until he can handle getting the virus on his own, and he probably will by the time he is three.

So, if you really think he needs it, you can probably get your ped to write a letter and take it up with the insurance company.

 

I know we had to go through a lot of questioning in order to get approved for the shot. Mine were born at almost 31 weeks. The shots are $1400 per child and they get a series of five shots. I am sure if you wish to buy the shot yourself, you probably could, however, I know insurance companies are very tight about approving the shots.

 

Mine were born at 35 weeks. From what I understand, 32-35 weeks is a real grey area. Other deciding factors are smokers in the home? Will the babies attend daycare? Are their siblings in the home that attend school/daycare?

We just about have it approved through my insurance. The only thing is, a home health nurse has to come and administer the shot to them (even though I'm an RN and they are shipping the med to my house). It's going to cost $35.00 per child each time and it's given every month until May (I think).

My twins are in a nationwide study right now (we will have to remove them if the Synagis gets approved)-- but the study is to show that 32-35 weekers would benefit from the shot. It's just an observational study, basically just trying to prove that they will get sick if they do not get the shot. Hopefully it will help future preemies, if they can prove how well it works.

Crystal

 

hi,
everyone here has some really good information for you. Our girls were born 12/23/06 at 36 weeks also and they did not need any nicu time. The dr offered the shots to us, but as an icu nurse myself, the girls really don't have any risk factors, and will not be exposed in the 1st few months, so I opted not too. you really just need to decide for yourself what would be best for your little guy. Most insurance companies will not pay for the shots if not high risk.

steph

 

Mine were born at 35 weeks. Both had a little NICU time. My DS had more NICU time and was on a CPAP for breathing. I think this is one of the main reasons we receive them. My ped. had to work hard to get them . . . they were denied at first. They thought maybe DS would get them and not DD; however, both are receiving the shots. Thank goodness. However, they are very painful for the little ones and painful for the mommy and daddy listening to the sad cries.

 

mine are 31 weekers and they both get the shot. with yours being older i dont believe they are at that high of risk. i would take the advice of the dr and say they really dont need them.

 

thanks for all the replies - i spoke to a dr. at our peds office today and she felt Jake wasn't at signficant risk based on the factors - so we aren't going to fight it.

Miriam

 

Mine are 33 wkrs, Trent was on cpap and oxygen. They spent 2 wks in nicu. They have older siblings in school. They are multiples. They go to daycare (at the gym, but still, daycare). But, since they were born in february and not january my insurance company says they are old enough this year to deal with rsv on their own without the shots. When they were born the excuse was the fact that at the time they were not in day care. We've been avoiding the gym for the last few months because every time we go they get sick.

I've had 2 other kids that were 36 wkrs, one had a winter bday, he didn't qualify for synergis, he ended up hospitalized with a breathing issue that was NOT RSV. so, the shots don't cover everything that can make your baby sick.