High Demand for Pediatric Fever-Reducing Products Challenges Pharmacies

While there technically isn't a shortage of OTC pediatric fever-reducing products, high demand has put a significant strain on supply - some much that some chains are limiting purchases. Here is some information on how pharmacists can help parents and caregivers looking for liquid analgesic formulations.

DEERFIELD, IL – Pharmacies, even the largest chains, are having challenges related to the increased demand for over-the-counter pediatric fever-reducing products.

Some have put in purchase limits. "While Walgreens continues to have products to support our customers and patients, we have put into effect an online-only purchase limit of 6 per online transaction to prevent excess purchasing behavior," the company said in a press release in late December. In-store purchases were not limited at that point. It advised customers to check its website for updates on the availability of individual store inventory.


CVS, meanwhile, told media outlets that it was limiting purchases to two children's pain relief products in CVS stores and online.

The reason is the so-called tripledemic, where the U.S. is experiencing high rates of COVID-19, influenza and respiratory syncytial virus all at once. In November and early December, pediatric hospitals were over-capacity in many areas. Public health officials have cautioned that the post-holiday period could be as bad or worse.

In terms of products to help with symptoms, the Consumer Healthcare Products Association (CHPA) said recently, “Manufacturers continue operating at maximum capacity to replenish children’s pain and fever reducers to meet current extraordinary demand. While there is not a widespread shortage and our member companies are continuously shipping out products to retailers to replenish supply as quickly as possible, we recognize that limited products on store shelves is frustrating for parents and caregivers. With demand for these products increasing by 65% from this same time last year, we also understand why some retailers have voluntarily set limits on purchases to ensure the availability of these products to as many consumers as possible.”


While manufacturers are trying to meet demand at pharmacies, they also are “doing everything possible to make sure hospitals have children’s pain and fever reducers on hand,” the CHPA points out.

The group advises that pharmacists might remind customers that store brands contain the same active ingredients as their name-brand counterparts and that they might consider different product options for children over age two if a liquid medicine is out of stock.

A spokesperson for the national Centers for Disease Control and Prevention told a Washington, DC, tv news outlet, "We anticipate that high levels of respiratory virus activity may continue for several more weeks, or possibly even months.”

In a CDC webinar at the end of November, Fatimah Dawood, MD, a medical epidemiologist from the CDC, said, “As we just heard, there are many respiratory viruses that circulate year-round in the United States, typically, with more activity in the fall and winter. During the past two years, viral respiratory illness activity has been impacted by the COVID-19 pandemic. Circulation of other respiratory viruses besides the virus that causes COVID-19 has often been atypical. As an example, flu circulation has been unusually low over the past two seasons, whereas flu typically causes a large portion of respiratory illnesses each fall and winter. Now, however, we are seeing a surge of non-SARS-CoV-2 respiratory viruses in the United States. At the same time, we anticipate the SARS-CoV-2 viruses may continue to circulate at high levels this fall and winter.”

“Typically, circulation of RSV starts in the fall and peaks in the winter,” added Heidi Moline, MD, MPH, of the CDC. “In most people, it causes a mild illness, but in young children and older adults, it can cause severe respiratory disease. This fall and winter, we have seen an increase in severe respiratory illness in children, which has strained pediatric hospital resources and bed availability nationwide.

She noted that, while RSV seasons typically peak from December to February, this year has had an early season, reaching a winter peak level in October and November. “We do see differences in RSV circulation by which part of the country we're in,” Moline pointed out. “RSV detections are actually beginning to decrease in the Southeast and South Central parts of the country. We are also seeing signs that the mid-Atlantic, New England, and the Midwest regions may also be plateauing.”

Another difference this year, according to the CDC, is that more older children are being hospitalized for severe RSV.

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