Across NH, an adult-strength shortage of children's medications
Jan. 4—At drug stores close to home, shelves empty of children's medicine are a headache and a worry. For a frantic parent, they present a desperate situation.
Chrissy Lavoie of Manchester had a sick 10-year-old returning to school this week and no children's cough or cold medicine or pain or fever relievers available to purchase last week. An ongoing pediatric medication shortage has walloped families as cough, cold and flu season barrels through New Hampshire like a major winter storm.
"Unfortunately, there's nothing here," Lavoie said on Thursday after scouring Rite Aid and CVS pharmacies on Mammoth Road, her usual go-to stores. "All I can do for him is cough drops. I'll stick to using cough drops until he goes back to school."
Her son wasn't sick enough to go to urgent care, Lavoie said. She hoped for a lightning-quick recovery or a doctor's appointment.
After two years of social distancing and remote learning at home, small children's immune systems aren't used to battling the full menu of viruses in circulation, according to care providers.
Doctors and pharmacists across New Hampshire say late fall and early winter have been more intense than usual for kids with respiratory ailments, including RSV, the flu or the latest variant of COVID.
"For the past few weeks, both our country and local communities have been dealing with one of the busiest flu seasons in many years. At the same time there have been significant increases in many other infections," said Dr. Oliver Salmon, a pediatrician affiliated with Speare Hospital in Plymouth.
The system-wide shortages affect availability of antibiotics, such as amoxicillin and cefdinir, flu treatments like oseltamivir, and pain and fever reducers such as acetaminophen and ibuprofen, which are staples in many home medicine cabinets. The scarcity is especially pronounced in liquid and chewable forms that young children swallow more easily, and in prescription flu treatments, Salmon said.
"Often some local pharmacies are out of a specific medication, while others still have some," Salmon said. "But other times there is nowhere locally to find a specific medication."
Major chains and independent pharmacies usually are able to get over-the-counter and prescription drugs to meet surges in demand. But this winter, shelves at drug stores across the country are mostly empty of common everyday remedies for kids, both name brands and generics — especially for the most fragile demographic: little ones under 2, who take medicine in small doses and in liquid form carefully dispensed with a measurement syringe.
Stockpiling hurts
So far this winter, according to providers and drug store staff, children's illnesses are more severe and more numerous at the same time that strategic medications — from those to treat fevers and ear infections to key prescriptions for ADHD — are unavailable, on long-term back order or impossible to find within an hour's drive.
"There's not much to see here," said John Fitzherbert, pharmacist at a busy Rite Aid on Mammoth Road, walking through an aisle lined with "Sorry, Out of Stock" labels instead of cough and cold remedies. A sign taped in place stated, "We apologize for our lower-than-normal level of inventory. We are experiencing higher than normal demand."
"Every manufacturer. It's all the same. It's a pretty severe cold and flu season," said Fitzherbert, the worst he could recall in 10 years. Stockpiling by anxious customers has compounded the problem. "The cough and cold shelf is empty. When this stuff hits the news, they come buy whatever they can."
Lavoie said staff at a nearby CVS told her that some people have bought up to 30 to 40 bottles or boxes of children's remedies at a time, potentially to resell online. Jacked-up prices are common.
A CVS Health spokesperson for the chain's pharmacies nationwide said last week that CVS is limiting purchases of common over-the-counter medications to two containers per customer.
For more than three weeks, children's Tylenol, particularly in liquid form, and generic acetaminophen, have been missing from stores. At CVS on Mammoth Road, clerks recently were unable to find children's Tylenol at any affiliate within 30 miles, said Liam McIntyre, a shift supervisor at CVS. Adult remedies have sold out, too.
"This year is shaping up to be a really bad cough and cold medicine shortage," McIntyre said.
The shortage affects independent retailers, too.
"No liquid Tylenol. No liquid Advil,," said pharmacist Ken Gillis, owner of Ken's Pharmacy on Elm Street. "Every once in a while we get something," including generics or lesser-known brands, but "it's few and far between — spotty at best.
"With so many children ill, it took manufacturing by surprise. They haven't been able to keep up with demand."
Bad time for an earache
"Pediatric antibiotic suspensions, those we commonly use for ear infections, have been in critically short supply for the past few weeks," said Dr. Michael Matos of Wolfeboro Pediatrics, whose practice is part of Huggins Hospital.
Some experts suggest crushing pills into soft foods, Matos said, but that traditionally hasn't worked well. When Matos has a young patient with an ear infection, he calls their pharmacy to ask what's in stock. "Then I prescribe based on what's available," he said.
Certain ADHD medications have been "dwindling for months," Matos said, and families are having a harder time getting prescriptions filled. Often they leave the drug store with 10 or 15 pills, instead of the 30 prescribed, because that's all the pharmacy has.
"I have already shifted some patients to medications they have tried and failed because their ideal medications aren't available," Matos said. "It is not a good situation for the children, their families, or their schools."
"By the time we hear about shortages from the major channels, it's too late," said Huggins Hospital's pharmacy director, Dustin Butler. "This doesn't give us time to prepare or stock up. One day (the computer system) will show full availability, and the next it will be out of stock.
