Colds, Flu, and the RSV Virus in Underserved Communities, by Cherylyn Harley LeBon

lebon_smIt’s cold and flu season again, and people desperately want to remain healthy, avoiding bugs that can linger and keep them down for two or three weeks.

For example, there are regularly six daily absences in my daughter’s class — with some children out with the flu for an entire week. Our pediatrician’s office announced extended hours to meet demand.

According to a Centers for Disease Control and Prevention (CDC) report, the flu arrived early this season. Doctor visits to treat influenza-like symptoms are up — the worst since 2003.

The flu and similar illnesses create not only physical burdens, but monetary ones as well. A typical flu season costs America approximately $10 billion. This one is worse. Add the costs of implementing ObamaCare and we’re talking about real money.

For minority communities, the impact of the flu is quite severe. Low flu vaccination rates within the black and Hispanic communities cause higher hospitalization rates for these groups. The CDC estimates blacks 65 years old and older lag behind whites in getting flu shots by approximately 21 percent. Hispanic Americans 65 year old or older similarly trail whites by 19 percent.

And children are extraordinarily vulnerable. They are at greater risk if their parents or guardians aren’t vaccinated. Unfortunately, this only increases the health risk for black and Hispanic children.

It’s why a recent decision by the American Association of Pediatrics (AAP) is troubling.

Respiratory Syncytial Virus (RSV), something most children catch before their second birthday, is a leading cause of pneumonia and infant hospitalization. In 2009, the AAP changed its recommendations for RSV treatment — shrinking the pool of eligible infants and reducing the dosage of the medication palivizumab (also known as Synagis) used to treat RSV.

Pavilizumab is administered by regular shots during flu season. While one can learn precautions to prevent RSV, the shots are essential for high-risk children such as premature infants and those with chronic lung or heart conditions.

The education seems to be sticking, with pediatricians urging new parents who may mistake this devastating virus for a cold to take proper precautions against RSV.

Treatment, however, is another story.

Under the auspices of “cost-cutting,” the number of babies eligible for treatment for RSV is reduced. In effect, the AAP is potentially increasing the RSV exposure threat for some at-risk infants.

According to the CDC, infants of non-Hispanic black mothers are more than 1.5 times more likely to be born pre-term compared with infants of non-Hispanic white women. This means the policy change disparately hits the black communities. In addition, those infants still eligible for treatment face another hurdle since the AAP has also reduced the suggested number of doses to below FDA-approved levels.

Such action seems unwise and tone deaf. But it may be a glimpse of our future. The AAP’s actions seem similar to the expected role of the dreaded IPAB — the Independent Payment Advisory Board. This is the board that, as part of ObamaCare, may end up making health care decisions for families that should be made by physicians and their patients.

The National Medical Association — a professional association of black physicians — and the National Black Nurses Association have expressed concern about the AAP’s guidelines regarding RSV prevention and their impact on black infants and other minority children. They recommend additional research be aimed toward the maximum possible protection for infants and children at risk. They would also like to see the inclusion of more minority children in clinical trials. To date, their concerns have not been addressed.

Like so many aspects of life, cost is a consideration when it comes to health care. The decision of a panel to reduce dosages for babies in at-risk communities cannot possibly guarantee the best outcome — especially when it could also increase hospitalizations.

There needs to be a thoughtful, cost-effective method to protect our most vulnerable children while also allowing parents to make the best health decisions for their families.

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Cherylyn Harley LeBon is co-chairman of the Project 21 black leadership network. She is a former Senior Counsel to the U.S. Senate Judiciary Committee. Follow her on Twitter @HarleyLeBon.  Comments may be sent to [email protected].

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