Infant formula shortages: What to do if you’re impacted

The nationwide infant formula shortage has caused stress for many families. The Washington State Department of Health (DOH) has compiled resources to assist families trying to find nutritionally appropriate food for their babies. The information below comes from the American Academy of Pediatrics (AAP), the U.S. Department of Health and Human Services, the Washington WIC program, the Centers for Disease Control and Prevention, and the U.S. Food and Drug Administration.

While the shortage has been persisting since the pandemic, it has worsened due to supply chain issues, the February recall of several baby formula products due to possible contamination, and the voluntary closure of a facility in Michigan by Abbott Laboratories – the country’s largest manufacturer of infant formula. Though Abbott reached an agreement with the U.S. Food and Drug Administration (FDA) on the steps needed to restart production, it will still be weeks before any formula products from that facility become publicly available.

If you are struggling to find infant formula and have concerns about your child’s nutrition, your first step is to check out the links and resources provided to get accurate information. If you still have concerns about your child’s health, contact your child’s primary care provider’s office and ask to speak with a nurse, medical assistant, or health educator on your child’s care team.

“Your child’s doctor and care team are a great source of information for any concerns about your baby’s health and nutrition,” says Dr. Tao Sheng Kwan-Gett, Chief Science Officer, Washington State Department of Health. “They may be able to make recommendations about switching to a formula that’s easier to find or give tips on where to go when your usual sources of formula are out of stock.”

For people needing connection to health care providers, call the Help Me Grow WA hotline at 1-800-322-2588 for referrals and to apply for food and health resources in Washington. Additional support and resources are also available to participants in federal and state nutrition programs.

For WIC participants and families, contact your local WIC clinic to get infant formula benefits replaced or change baby formulas. WIC has expanded the types of formula they provide to offer more choices for families participating in the program. They can often tell you which stores have formula in stock. If you can’t reach your local clinic, call the state WIC office at 1-800-841-1410 Monday to Friday, 8:00 am – 5:00 pm. Check the Washington WIC web page for more information on approved replacement infant formulas.

For participants in Basic Food (SNAP), visit the Parenthelp123 web page or call 1-800-322-2588.

In this urgent situation, the AAP says it’s ok for most babies to switch to any available formula, including store brands, unless your baby is on a specific extensively hydrolyzed or amino acid-based formula for certain medical conditions. Contact your child’s primary care provider to ask about specialty formula alternatives.

Though it might be tempting to try to make homemade formula, the AAP cautions not to do this because formula recipes might not have enough vital nutrients or could contain too much salt or other elements that could be harmful to your baby.

Also, at the request of the FDA, Abbott is releasing limited quantities of metabolic nutrition formulas that were previously on hold following Abbott’s recall of some powder infant formulas from its Sturgis, Mich., facility. These products have been tested, are safe for distribution, and were not included in the recall. These products also require a medical referral. Patients, caregivers and healthcare professionals in need of these products should contact Abbott at +1-800-881-0876 to provide necessary information.

If you suspect you have recalled formula on hand, you can check to see which formulas are recalled at Washington WIC.

Some additional tips to help with your infant formula search:

  • Check smaller stores and drug stores or buy online from reputable distributors and pharmacies.
  • Contact manufacturers directly:
    • Gerber’s MyGerber Baby Expert: reach a certified nutrition or lactation consultant by phone, text, Facebook Messenger, web chat, or video call, who can help you identify a similar formula that may be more readily available
    • Abbott’s Consumer Hotline: call 1-800-986-8540
    • Abbott’s urgent product request line: ask your OBGYN or your infant’s pediatrician to submit an urgent product request by downloading and completing the form – PDF
    • Mead Johnson/Reckitt’s Customer Service line: call 1-800 BABY-123 (222-9123)
  • Check out community resources:
    • Locate your nearest Community Action Agency (CAA). Your neighborhood CAA may be able to provide you with formula or connect you with local agencies that have formula in stock.
    • United Way’s 2-1-1: dial 2–1-1 to be connected to a community resource specialist affiliated with United Way who may be able to help you identify food pantries and other charitable sources of local infant formula and baby food.
    • Feeding America: call your local food bank to ask whether they have infant formula and other supplies in stock.
    • Human Milk Banking Association of North America(HMBANA): certain HMBANA-accredited milk banks are distributing donated breast milk to mothers in need; please note that some may require a prescription from a medical professional. Find an HMBANA-accredited milk bank.

Relactation or induced lactation is also possible and can be an alternative to using formula, but it does take time and effort. La Leche League International has resources on how to stimulate milk supply.

“No family should be in a position where they are worried about how they are going to feed their children,” says Kwan-Gett. “We need to prioritize food security so that every family can be sure that their child is getting nutrition for optimal growth and development.”

Please visit DOH’s new nutritional guidance resources page for more information on what to do and actions to take that are safe for your child.

Children ages 5-11 now eligible for Pfizer-BioNTech COVID-19 booster dose

Booster doses of the Pfizer-BioNTech vaccine are now available for children ages 5-11. The Washington State Department of Health (DOH) expanded booster dose eligibility to include everyone 5 and older following guidance and recommendations from the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices, and the Western States Scientific Safety Review Workgroup.

“The CDC’s announcement is welcome news as we continue to do everything we can to keep Washingtonians of all ages safe,” said Umair A. Shah, MD, MPH, Secretary of Health. “This pandemic is not over and we must continue to use the tools at our disposal. This includes masking, therapeutics, vaccinations and – of course – boosters. Keeping yourselves and those around you safe is of utmost importance, and this recommendation is another step in that direction.”

The expansion of booster eligibility comes as COVID-19 cases are continuing to steadily rise across the county. The myth that COVID-19 is always a mild disease in children needs to be dispelled. Since the beginning of the pandemic, more than 4.8 million children ages 5-11 have been diagnosed with COVID-19, with 15,000 hospitalized and, tragically, 180 deceased.

DOH’s updated booster dose recommendations are as follows:

  • Children ages 5-11 should receive a booster dose five months after completing their primary vaccine series of Pfizer-BioNTech vaccine. Immunocompromised children should receive their booster at least three months after their primary series.
  • Everyone 12 and older should receive a booster dose five months after completing their primary vaccine series of Pfizer or Moderna, or two months after receiving the single-shot Johnson & Johnson (J&J) vaccine.
  • Everyone 50 and older should receive a second booster dose four months after receiving their first booster dose.
  • Individuals 12 and older who are moderately or severely immunocompromised should receive a second booster dose four months after receiving their first booster dose.
  • Those 18 and older who received a primary vaccine and booster dose of the J&J vaccine four months ago can receive a second booster dose of an mRNA COVID-19 vaccine.

To make a vaccine or booster appointment, visit Vaccine Locator, Vaccines.gov, or call the COVID-19 Information Hotline at 833-VAX-HELP. Language assistance is available. Those with further questions are encouraged to visit DOH’s COVID-19 Vaccine Frequently Asked Questions webpage or talk to their trusted health care provider.

Should You Worry About Data From Your Period-Tracking App Being Used Against You?

It’s estimated that millions of people in the U.S. use period-tracking apps to plan ahead, track when they are ovulating, and monitor other health effects. The apps can help signal when a period is late.

After Politico published on May 2 a draft opinion from the Supreme Court indicating that Roe v. Wade, the landmark decision that guarantees the constitutional right to an abortion, would be overturned, people turned to social media. They were expressing concerns about the privacy of this information — especially for people who live in states with strict limits on abortion — and how it might be used against them.

Many users recommended immediately deleting all personal data from period-tracking apps.

“If you are using an online period tracker or tracking your cycles through your phone, get off it and delete your data,” activist and attorney Elizabeth McLaughlin said in a viral tweet. “Now.”

Similarly, Eva Galperin, a cybersecurity expert, said the data could “be used to prosecute you if you ever choose to have an abortion.”

That got us wondering — are these concerns warranted, and should people who use period-tracking apps delete the data or the app completely from their phones? We asked the experts.

Read the full article from KHN.

Childhood immunization rates decline during the pandemic

A new report shows routine childhood immunization rates decreased during the pandemic, dropping by 13% in 2021 when compared to pre-pandemic levels. The drop was most noticeable in young children.

In response, the Washington State Department of Health (DOH), health care providers and other agencies are working with families to catch up and stay current on routine immunizations. “The pandemic has been difficult for everyone. Disruptions to schooling, childcare and in-person health care made it hard for some families to stay up to date on their shots,” said Tao Sheng Kwan-Gett, MD, MPH, Chief Science Officer. “We encourage parents and caregivers to schedule their well-child visits as soon as possible, to make sure their kids are happy, healthy, meeting developmental milestones, and ready for school.”

The new report, compiled by DOH, compares routine childhood vaccination rates in Washington from 2021 to averages from 2015-2019. Rates were found to have declined the most in younger children, however rates in teens increased. Key findings include:

  • Vaccinations decreased 9.6% in the 19–35-month age group.
  • Vaccinations decreased 3.9% in the 4–6-year age group.
  • Vaccinations decreased 3.6% in the 11–12-year age group.
  • Vaccinations increased 1.8% in the 13–17-year age group.

Children need to be up to date on immunizations to attend pre-school, kindergarten, school, or childcare this fall. Scheduling well-child visits early ensure children can attend educational programs on time and can reduce the stress of finding a last-minute appointment. DOH has online tools to help you determine if your child is up to date on state immunization requirements. Vaccine requirement charts for parents and caregivers are available in a variety of languages here. Washington state provides all recommended childhood vaccines at no cost to children through the age of 18.

The Department of Health has implemented a variety of efforts to boost childhood immunization rates to pre-pandemic levels. Some of these efforts include direct messaging through the Watch Me Grow Washington program for parents with young children, improving equitable vaccine access and support for tribes, and collaboration with local public health. “Vaccines are the best tools we have to protect kids from getting sick from preventable diseases,” added Dr. Kwan-Gett.

Sweeping, Limited, or No Powers at All? What’s at Stake in the Mask Mandate Appeal

The definition of “sanitation.” An old court case that involves an underwear manufacturer. Whether people had a fair chance to express their opinions about wearing masks on planes.

These disparate factors are in the spotlight as the Biden administration challenges a U.S. District Court ruling that overturned a federal mask mandate on public transportation. The outcome could determine the limits of federal public health officials’ power not only during the covid-19 crisis but also when the next pandemic hits.

Sound complicated? It is.

About the only thing that’s clear so far is that the Centers for Disease Control and Prevention’s mask requirement for people traveling on planes, trains, and buses is not likely to make a comeback anytime soon. The Department of Justice’s appeal of the Florida judge’s decision to the 11th U.S. Circuit Court of Appeals could take weeks or months.

What might that appeal contain, and why is it important? The government has not yet filed its detailed arguments, so KHN spoke with several health law experts about what to expect.

Read the full article from KHN.

Tuberculosis cases on the rise globally and in Washington state

Washington’s tuberculosis (TB) cases are on the rise, putting state and local public health officials on heightened alert. Widespread disruptions in public health and healthcare services and missed TB diagnoses due to similarities in symptoms between COVID-19 and TB are thought to have contributed to TB cases rising both locally and globally.

TB reporting decreased in 2020 during the first year of the pandemic. Though efforts to prevent COVID-19 may also reduce the spread of TB, the decrease could also have been due to delayed or missed TB diagnoses because of strains in the health care system. Some people with TB may also have been misdiagnosed as having COVID-19.

Cases then rose notably beginning in 2021, when 199 cases of TB disease were reported, a 22% increase from 2020. Thus far in 2022, 70 cases have been reported and officials continue to monitor the situation closely. Seventeen new cases of TB disease all have connections with each other and several Washington state prisons, making it the state’s largest outbreak in the last 20 years.

“It’s been 20 years since we saw a cluster of TB cases like this,” says Tao Sheng Kwan-Gett, MD, MPH, Washington State Chief Science Officer. “The pandemic has likely contributed to the rise in cases and the outbreak in at least one correctional facility,” added Kwan-Gett. “Increased access to TB testing and treatment in the community is going to be key to getting TB under control.”

“Washington State Department of Corrections (DOC) identified a rise in cases in one of our facilities and immediately began working closely with the Department of Health and the Centers for Disease Control on testing, as well as ways to decrease the spread in the facility and out in the community,” said DOC Chief Medical Officer MaryAnn Curl, MD. “Testing of staff, and our incarcerated population at Stafford Creek Correction Center continues, which is how these cases were found. We’ll continue to communicate with staff, their incarcerated population and their families as appropriate.”

Knowing the facts helps to understand TB, which is preventable, treatable, and curable. Like COVID-19, TB is spread through the air when an infected person coughs or sneezes and the organism is breathed in by others. But unlike COVID-19, more prolonged exposure to someone with TB disease is typically necessary for infection to occur. Symptoms of TB disease can include coughing, with or without blood, and chest pain. General symptoms also include fever, night sweats, weight loss and tiredness.

If infection does occur the person exposed will most likely develop inactive TB or (also called latent TB infection), which does not have any symptoms and is not contagious. But if people with inactive TB do not receive timely diagnosis and treatment, the infection could develop into active TB disease which can then cause symptoms and be spread to others. An estimated 200,000 people in Washington have inactive TB.

Treatment for TB disease takes six months at a minimum. If treatment isn’t diligently followed, symptoms are likely to become more severe and patients risk continuing to be contagious, increasing the likelihood of TB further spreading within the community. Incomplete treatment can also contribute to the spread of antibiotic resistant strains of TB.

TB can infect anyone, but some people may be at increased risk for exposure including:

  • Those in close contact with someone who has TB disease.
  • People who are from, or frequently travel to, areas of the world where TB is more common.
  • People who live or work in a setting where there is more possible exposure to TB, such as homeless shelters, correctional facilities, and nursing homes.

DOH encourages people at risk for TB to get tested and, if the outcome is positive, to get treatment. More information about TB can be found at Facts About TB | Washington State Department of Health.

Recap of Recent COVID-19 News and Updates

Newest numbers. The Washington State Department of Health (DOH) reported a total of 1,493,194 confirmed cases as of 11:59 p.m. on April 26. There have been 12,686 COVID-19 deaths in Washington.

Data note: DOH is still experiencing delays in reporting cases, hospitalizations, and deaths as a result of prior slowdowns in our data systems during the omicron surge. We are clearing these backlogged cases, hospitalizations, and deaths as resources permit. The COVID-19 Epidemiological Curves tab is the most accurate representation of COVID-19 activity and is updated daily as new cases are identified and duplicates are resolved.

For the most recent number of cases by county, demographics, and more, visit the Department of Health’s dashboard.

Note: As of March 31, 2022, DOH will publish this bulletin on Thursdays only, and only if there is significant new information to share.

Reported COVID-19 reinfections in Washington state. This weekly report includes information on hospitalizations and deaths, demographics, trends over time, and vaccination status of people with a reinfection for which DOH has information about both infection events. Read the full April 27 report.

COVID-19 cases among children and youth in Washington. This weekly report provides information on COVID-19 in all children and youth, ages 0 to 19 years. Cases are broken down by educational service district (ESD) regions and age. Read the full April 27 report in English and in Spanish.

COVID-19 cases, hospitalizations, and deaths by vaccination status. This weekly report provides a brief overview of confirmed or probable COVID-19 cases, hospitalizations, and deaths among those who are not fully vaccinated in Washington state. Read the full April 27 report.

DOH SARS-CoV-2 sequencing and variants report. This weekly report summarizes genome sequencing coverage of Washington SARS-CoV-2 specimens from multiple laboratories from across the United States and our state. It provides a statewide view of sequencing capacity and data, including breakouts by county and demographics. Read the full April 27 report.

SARS-CoV-2 vaccine breakthrough surveillance and case information resource. This weekly report provides data and criteria on fully vaccinated people who test positive with SARS-CoV-2 and may or may not develop COVID-19 symptoms. Read the full April 27 report.

Who is in Charge of Your Apple Health Healthcare?

For individuals enrolled In Washington State Medicaid, also known as Apple Health, understanding who manages their medical care is not always easy.  In almost all cases, the management of care for people with Apple Health is delegated to an MCO, or Managed Care Organization. These are large for-profit organizations that often have a large infrastructure, making it confusing and difficult to find information or direction.

There are five MCO’s under Apple Health in Washington.  They are Amerigroup Washington, Community Health Plan of Washington, Coordinated Care of Washington, Molina Healthcare of Washington, and UnitedHealthcare Community Plan.  All of these MCOs are available statewide, except UnitedHealthcare Community Plan, with is only available in the western half of the State.  For anyone in the foster care system, they are automatically enrolled in Coordinated Care of Washington and this coverage will follow them until they are 21. Health Care Authority has a Service Area Matrix to view what MCOs are available in each county.

Under some circumstances a person on Apple Health will not be put into an MCO. If an individual is American Indian/Alaska Native they can view their options on the Health Care Authority’s American Indians and Alaska Natives page. Other non-MCO Apple Health patients will have a distinct services card that looks the card shown:

For those patients, review the Health Care Authority’s Handbook on Coverage Without a Managed Care Plan for information about how to receive services.  It is also possible to call them at 1-800-562-3022.

For those who do not remember which MCO they or their children are signed up with, it might have been done automatically for them when the initial roll out happened in 2014 or when they first became eligible for Apple Health under the ACA.  The switch to managed care was fully implemented in 2020.  Here are three ways in which to find out which MCO is overseeing an individual’s care:

  1. Review your Provider One Card to see which MCO is listed. Individuals who are on MCO-managed Apple Health will have the name and/or logo of the MCO on the Provider One card, like the example

In this case, UnitedHealthcare is the MCO.  The PCP listed is the Primary Care Physician, or a patient’s main doctor, and the PCP phone number listed can be called to schedule visits and ask medical-related questions.

  1. If the provider card is missing, call: 1-800-562-3022 and choose option 1 for self-service, then option 1 for services card. They can help replace the provider card and help enrollees get the services they require.
  2. Call the Health Care Authority Customer Service Line at 1-800-562-3022.

It is important to note that everyone enrolled in Apple Health within one household must be on the same managed care plan. Provider One cards are usually sent out once a year to enrollees and there is a number on the card to call for customer service. Below is the Apple Health managed care plan contact information:

Amerigroup (AMG)1-800-600-4441
Community Health Plan of Washington (CHPW)1-800-440-1561
Coordinated Care of Washington (CCW)1-877-644-4613
Molina Healthcare of Washington, Inc. (MHW)1-800-869-7165
UnitedHealthcare Community Plan (UHC)1-877-542-8997

All Apple Health enrollees have the right to change their MCO at any time, with no fee and with no gap in coverage. The shift usually occurs by the 15 of the following month, but the Provider One portal can help if there are challenges. There are several ways to switch plans:

If considering changing to a different MCO, visiting other MCOs websites or calling their information line with some questions can be useful. It is helpful to see what hospitals, urgent care facilities, specialists, and therapists are covered. Not all physicians or medical facilities that take Apple Health are contracted with all MCOs.

View our video on Who is in Charge of Your Apple Health Healthcare?

Patients’ Perilous Months-Long Waiting for Medicaid Coverage Is a Sign of What’s to Come

Korra Elliott has tried to avoid seeing a doctor while waiting to get on Medicaid. She worries she can’t afford more bills without any insurance coverage. But in early March — five months, she said, after applying and with still no decision about her application — a suspected case of the flu sent her blood pressure soaring and landed her in the emergency room.

The 28-year-old mother of four from Salem, Missouri, is among the tens of thousands of uninsured Missourians stuck waiting as the state slogs through a flood of applications for the state-federal health insurance program. Missouri expanded the program last year after a lengthy legal and political battle, and it now covers adults who earn up to 138% of the federal poverty level — about $18,800 annually for an individual.

Missouri had nearly 72,000 pending Medicaid applications at the end of February and was averaging 119 days to process one, more than twice the maximum turnaround time of 45 days allowed by federal rules. Adding people to Medicaid is labor-intensive, and the jobs require training and expertise. The program covers many populations — children, people with disabilities, seniors, adults who are pregnant or have children, and some without children. Different rules dictate who qualifies.

Read the full article from KHN.