Parents looking for cold, flu and fever medications for their kids may find empty shelves. Increased demand for over-the-counter products, like Tylenol and Motrin, is causing temporary shortages for some pharmacy chains. And experts tell TODAY.com that ongoing surges of flu, respiratory syncytial virus (RSV) and COVID-19 among children are likely to blame.
In fact, compared to last November, sales of children’s pain-relief and fever-reducing products are up by 65% this year, according to a statement from the Consumer Health Care Product Association. As a result, major drugstores like CVS, Walgreens and now Kroger are now limiting the sales of those products per person.
"That demand is really unusual, unlike what we've seen in years, so we are seeing some of those mismatches," Dr. Ashish Jha, White House COVID-19 response coordinator, said in a Dec. 16 interview on TODAY. "But the supply is working great, manufacturing is going great and we're going to keep plugging away at making sure that there's plenty of supply across the country as we enter the holidays."
Despite the efforts of drug manufacturers and the White House, parents are continuing to share anecdotes about bare drug store shelves.
Meet the experts
- Dr. Shelly Vaziri Flais, pediatrician and spokesperson for the American Academy of Pediatrics.
- Brigid Groves, pharmacist and senior director of practice and professional affairs at the American Pharmacists Association.
- Dr. Vineet Arora, dean for medical education at the University of Chicago Pritzker School of Medicine.
- Dr. Natalie Azar, NBC medical contributor and associate professor of rheumatology at NYU Langone Health.
Tylenol and Motrin shelves look "ransacked," parents say
Mo Manklong, mom to 15-month-old Rex, had to scour multiple Florida stores to find medicine for her son, she told TODAY in a segment aired Dec. 22. She considers herself lucky that she had the time and resources to do so.
"It’s shocking, right? It feels really wild to have to go to multiple stores to find something that is really, really just like a household item," she said.
“I don’t understand why we don’t make sure that we collectively all have access to these very basic things that we all need," she added. "It’s food, it’s water, it’s medicine. I feel like we should be beyond this."
When Dr. Vineet Arora stopped by her local drug store in Chicago a few weeks ago to pick up some supplies for her sick 2-year-old son, she was shocked to see how bare the shelves were.
"The children's Tylenol and Motrin looked ransacked," Arora tells TODAY.com, adding that she also couldn't find the digital thermometer or Pedialyte popsicles she'd been looking for.
Arora, who is the dean for medical education at the University of Chicago Pritzker School of Medicine, says the scene reminded her that her friends and colleagues in pediatrics are "getting crushed" and made her feel for fellow parents.
She decided to tweet a photo of the empty shelves.
"It's really difficult being a parent right now," Arora says. "And then not having the supplies that you need to take care of your kid when they're sick is even worse."
Arora’s son had just recently recovered from RSV when he got sick again, she tells TODAY.com. This time, he was diagnosed with COVID-19.
Dr. Eve Bloomgarden, an endocrinologist at NorthShore University Health System, found a similar situation when looking for medications. "Children's medicine section of local store 1," she tweeted alongside a photo of empty shelves on Dec. 13. "Store 2 and 3 similarly empty," Bloomgarden added. "The kids are not ok."
A spokesperson for Johnson & Johnson tells TODAY.com that the company is experiencing "high consumer demand" right now. "We are doing everything we can to make sure people have access to the products they need, including maximizing our production capacity, and running our sites 24 hours a day, seven days a week."
"Some products may be less readily available due to this increased demand but we are not experiencing an overall shortage of Children’s Tylenol or Children’s Motrin in the United States," the statement continues. "We will continue to work with our retailers to provide these products throughout the cold and flu Season.”
An 'unprecedented' respiratory virus season
"It's absolutely been bonkers since mid-September," Dr. Shelly Vaziri Flais, a Chicago-based pediatrician and spokesperson for the American Academy of Pediatrics, tells TODAY.com. In her 20 years of practice, Flais says she's "never seen a fall of this nature, in terms of RSV and influenza."
In seven states, pediatric hospital beds are 90% full or more, TODAY.com reported, and HHS data show that about U.S. hospitals are at nearly 80% capacity — the highest this stat has been since the HHS started keeping track in early April 2020, per an NBC News analysis.
Most children get RSV before the age of 2. But COVID-19 precautions that were in place over the past few years may have prevented the spread of other illnesses, too, including RSV, TODAY.com previously reported. So the current thinking is that we're seeing a few years' worth of pediatric RSV cases and hospitalizations at once. On top of that, RSV began to hit earlier in the season than usual and is affecting kids at the same time as flu and COVID-19.
After a few years of unusually mild flu seasons, cases are peaking sooner into the season than normal — and show no signs of slowing down.
Hospitalizations for the flu doubled over the last two weeks of November. So far this season, there have been 15 million flu illnesses, 150,000 hospitalizations and 9,300 deaths, 30 of which were in kids, according to Dec. 16 data from the Centers for Disease Control and Prevention. All three stats surpass the totals for the entire last flu season and are up from the previous week (13 million illnesses, 120,000 hospitalizations and 7,300 deaths, TODAY.com previously reported.)
COVID-19 is increasing, too: Over the past two weeks, COVID-19 cases have grown by about 40% and deaths have more than doubled, per an NBC News tally. And, given the post-holiday COVID-19 waves of 2020 and 2021 — as well as the emergence of new omicron variants this year and more people ditching precautions like masking and testing — experts recently told TODAY.com they expect to see COVID-19 numbers rise after the winter holidays, though it's not clear how large the surge will be.
With a more severe and earlier-than-anticipated surge in respiratory viruses, pharmacists are seeing shortages of prescription medications (including amoxicillin and Tamiflu), as well increased demand for over-the-counter drugs like children's ibuprofen and acetaminophen, Brigid Groves, pharmacist and senior director of practice and professional affairs at the American Pharmacists Association, tells TODAY.com.
While it's normal to see the demand for these products go up during the usual cold and flu season, "with the three (illnesses) that are really coming to a head this year," pharmacists are seeing an even higher demand for these products, Groves explains.
"The word 'unprecedented' always comes to mind," Groves says.
Is there an actual ibuprofen or acetaminophen shortage?
As it turns out, this is a surprisingly complicated question to answer. The Food and Drug Administration website, which compiles manufacturers' reports of shortages, does not currently list any of these children's medications as being in short supply, Groves explains.
And the website for the American Society of Health-System Pharmacists, which takes into account information from many different sources (including manufacturers), shows current shortages of prescription liquid ibuprofen and acetaminophen suppositories.
But even without an officially recognized shortage, it's likely that increased demand amid this severe respiratory virus season could leave some customers temporarily unable to find the medications they need, Groves says. In some cases, Flais says, parents are calling pediatricians to ask for prescription versions of common fever-reducing medications because they can't find the over-the-counter formulations.
There’s “just too much demand for the current supply,” pharmacist Don Arthur told NBC affiliate WGRZ in Buffalo, New York. Every cold and flu season brings the usual illnesses and demand for medications to treat them. But this year, COVID-19 is still present alongside the spike in RSV, he said.
Canada is dealing with a similar shortage of children’s medications, including acetaminophen and ibuprofen. And Arthur said the shortage “first appeared on our radar when we had patients calling us from over the border — Fort Erie, Niagara Falls, even as far as Toronto — because, apparently, up in Canada the liquid forms of Tylenol are unavailable,” he told WGRZ.
Both Walgreens and CVS have confirmed to TODAY.com in written statements that they're seeing elevated demand for these over-the-counter products right now.
Specifically, a CVS spokesperson tells TODAY.com that the company is seeing more customers looking for cold, flu and children’s pain relief products. “We’re committed to meeting our customers’ needs and are working with our suppliers to ensure continued access to these items,” the CVS spokesperson says. “In the event a local store experiences a temporary product shortage, our teams have a process in place to replenish supply.”
A Walgreens spokesperson tells TODAY.com, in part: "Walgreens is prepared and able to continue meeting the needs of our customers and patients. We are working with our diverse set of suppliers and distributors to ensure our patients have the products they need most.”
What do to if you can't find the children's medications you need
It's a stressful time to be a parent. And for those who had kids during the pandemic, this may be the first time you're experiencing having a sick kid, says Flais, who coedited AAP's "The Big Book of Symptoms." She says, "It's really new territory for a lot of families."
So, if you're having trouble finding the right medications for your child, know that your pediatrician is there to help answer questions. Don't hesitate to give them a call for guidance, Flais says.
In general, here are a few tips from the experts to help navigate this situation:
- Do not under any circumstances give kids adult medication without consulting a doctor.
- Do not give your child expired medication, even if it's an emergency. While the active ingredient may still be effective, coloring, fillers or other components may be dangerous, and there could be changes in the medicine's chemical composition.
- Check drugstore websites or call the pharmacy ahead of time to see what's in stock near you, Groves recommended. And consider reaching out to your local support community for help. "It takes a little bit of creativity and even reaching out to friends and family to see what's available," Flais says.
- For kids ages 2 and up, try substituting chewable medication for liquid versions. For older kids, around ages 11 or 12, try using this as an opportunity to teach them to swallow pills, Flais says. Some types of pills, like gel capsules, may be easier to swallow. (You can check the AAP website to find concentration conversions to make sure your child is getting the correct dose of ibuprofen or acetaminophen.)
- Substitute generic store-brand products if you can't find your go-to name-brand medications, Flais says.
- If you can't find acetaminophen or ibuprofen on its own, don't use a multi-symptom cold or flu medication in its place, Flais says. Many of them don't have sufficient doses of the right ingredients and may contain extra ingredients that can lead to severe side effects in some kids, she notes. Children should not receive aspirin, Flais says.
- Many of us are trained to automatically reach for fever-reducing medication as soon as we see a temperature spike, but that's not always necessary, Flais says. The most important thing is the kid's behavior. If they have a fever but are still playing and able to stay hydrated, they don't necessarily need medication. "I always tell families to treat the child, not the number," Flais says. However, babies under 3 months and kids prone to febrile seizures always need to be checked out when they have a fever.
- Remember that it's OK to manage other symptoms with home remedies rather than medications. Try a saline rinse for nasal congestion or honey (for kids at least 1 year old) for a cough, Flais says.
- Get you and your kids vaccinated for both flu and COVID-19, NBC medical contributor Dr. Natalie Azar urged in a Dec. 13 segment on TODAY. And, if you haven't already, get the updated COVID-19 booster, which is designed to provide better protection against the coronavirus variants circulating right now.
Parents should also avoid the urge to stock up on children's ibuprofen or acetaminophen "just in case" to ensure that people who need the medications urgently can get them, Groves says. Instead, you should only buy what you need.
"Be aware that this is a situation, but not alarmed," she adds.
For Arora, the scene was a reminder of how the public response to the pandemic has changed since it began — and that kids are now taking on much of the toll. "In 2020 we were stocking up on toilet paper, and in 2022 your kids can't get basic medication," she says. "And nobody seems to care."