I'm sorry to hear you are having this problem with Cigna. Unfortunately, I had the same problem with my son, also with Cigna. When Aidan was four months old, our primary care pediatrician tried to get Cigna to approve him for the Synagis vaccine. They denied, and our CF Center treatment team told us they did not recommend Synagis and refused to help in our primary care peds appeal process. So, our appeal was denied. Now Aidan is seven months old and currently in the hospital with RSV. Luckily, he is recovering, but our CF center team still states he doesn't need the vaccine, even though they say he can still get RSV again this season. Anyway, I encourage you to engage your CF doctor in advocating for you if at all possible. If they won't help, you might consider another CF center......that's what we're looking at now.....