'Never events' become more common as Pfizer's Vicilin LA runs out

The request was urgent. In late March, a woman in Gila County, Arizona, was diagnosed with syphilis and was pregnant. She needed a penicillin shot 30 days before giving birth if possible, but the corkscrew-like bacteria circulating in her body increased the risk of premature delivery. Without timely treatment, her pregnancy may lead to miscarriage, stillbirth, or death of the infant, and even if the infant survives, the child may live with complications such as bone deformity, brain damage, blindness, and hearing loss.

All of this can be prevented with one of the oldest antibiotics in the book, specifically the injectable penicillin sold under the brand name Bicillin LA.

It is the only treatment approved in the United States for syphilis during pregnancy, and there has been a nationwide shortage since July 2025. But Pfizer, the only company selling it, had protocols in place for just this scenario. It is an emergency request system “to be used only for patients with confirmed congenital syphilis and its risk.”

That’s what was happening in Gila County, where public health officials filed a request on Friday, March 27th. Pfizer confirmed receipt the following Monday, according to an email obtained by STAT. However, more than a week later, on April 7, the medicine still had not arrived.

“How can we get this patient Vicilin as soon as possible? These delays make emergency call lines not a viable option for public health response,” leaders of the National Coalition of Sexually Transmitted Infection Officers wrote to representatives of Pfizer, which intervened to help secure the drug.

“Did they submit a medical request form first? We checked with customer service and they couldn’t find it. If we can get this medical request, we will process it,” a Pfizer representative responded the same day.

However, by the time this exchange took place, it was already too late. “The mother gave birth, but we missed the opportunity to prevent congenital syphilis,” an Arizona Department of Health Services official wrote, adding, “Yes, the county filled out a medical request form.”

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That was the outcome everyone was trying to avoid. In February, the National Association of State Health Officers asked Pfizer to donate a portion of its Vicilin LA stockpile to state health departments in case this type of emergency arises. But Pfizer didn’t do that. And in early June, nearly four months after the coalition’s proposal, the company said it was still considering the idea of actively administering the vaccine. The incident in Arizona realized the fears that spurred the proposal in the first place.

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