The solution that now comes.
Read partner piece The Slate is about what life is like for immunocompromised people who haven’t gotten good immune responses from their vaccines.
Allen of Dallas hasn’t been able to see his grandchildren for 18 months. Stacey, the professor, worries that trips to the supermarket will become more dangerous for her now that mask mandates are starting to wane, but the delta variant is still there. Karen doesn’t know if she can still work as a high school basketball coach without a mask. Amy wants her children to have a normal school year but is terrified that they will come back to her with the virus.
These are the epidemiological trials of people who are immunocompromised — those who have had organ transplants or some types of cancer, those undergoing chemotherapy or immunosuppressive drugs, those with hereditary immunodeficiencies, and those with other problems that suppress their immune system. All of these conditions can hamper the ability to fight COVID effectively – and they can also limit the body’s ability to respond to coronavirus vaccines. As a result, many immunocompromised people end up in an unenviable position: they are less protected from vaccines and more likely to die if they become ill.
I am an emergency room physician and among the 3 percent of Americans who are immunocompromised. Since I am taking a drug that weakens my immune response to vaccines, I have not generated protective antibodies after the COVID vaccination and may not produce any even with another booster dose. While my friends enjoyed their newfound freedom after vaccinations, I struggled to keep my spirits up during what seemed to be an endless pandemic, an experience I talked about in Article by JAMA and on Slate podcast what’s next earlier this summer. No travel or restaurants. No gatherings with more than a few friends, even outside. No chance of resting from my N95 ventilator for a few minutes during my 16 hour shifts. And perhaps most impressively, the inability to make any plans for the future — or to imagine a world in which the sudden and devastating illness of COVID didn’t bother me.
Then in August, my life changed in half an hour. Through an intravenous line, I got my first dose of a combination of two monoclonal antibodies, a drug that has received the most attention as a way to treat COVID (perhaps best known, by former President Donald Trump), but when taken prophylactically, can May help protect immunocompromised people from infection after exposure. At the end of July, the Food and Drug Administration expanded the emergency use authorization for Regeneron’s cocktail to include this type of use and has since approved a similar expansion for Cocktail made by Eli Lilly.
Monoclonal antibodies for routine prophylaxis in immunocompromised people – not just post-exposure prophylaxis for an infected person – likely to fade very.
These drugs work because the antibodies are proteins that bind to the coronavirus to prevent it from infecting the body’s cells. (monoclonal It simply means that the antibodies are identical to each other.) Most people make their own antibodies in response to vaccines. For me, the monoclonal antibodies I got were the ones my immune system failed to produce. Immunocompromised people who have been in close contact with someone infected with the coronavirus are eligible for the drug. And for those like me who work or live in environments like hospitals, prisons or nursing homes, where there is ongoing exposure to infected individuals, we can receive monthly doses, either intravenously or subcutaneously, to help keep us healthy.
I know the Regeneron antibodies I got aren’t perfect, and they haven’t been specifically researched in immunocompromised people – but they are very good. In study participants who had an infected individual, no evidence of previous MERS-CoV infection, and a negative nasal swab before they received the cocktail, the medication Reduced risk of developing symptoms by 81 percent. There were no more side effects than the placebo.
Monoclonal antibodies for routine prophylaxis in immunocompromised people — not just post-exposure prophylaxis for an infected person — likely go down the pipeline, too. Last week, AstraZeneca applied for an emergency use authorization for a batch of antibodies made by the company announce They were highly effective in preventing COVID in unvaccinated, high-risk populations — this researchers Hope may provide protection for up to a year after doses.
I was the first person to get antibodies to prevent COVID in the hospital where I am sick. I was at first because I am distinguished: I am fluent in the medical language, I have good communication, I have the ability to stand up for myself, and I am fortunate to have excellent doctors in a great academic medical center. Just like vaccines, antibodies are currently free to patients, paid for by the government – so while supply shortages are starting to play a role, barriers for immunocompromised people to accessing drugs have been largely due to logistics and a lack of awareness among both doctors and patients.
Although there is no data on how many people got monoclonal antibodies to reduce infection after exposure to the coronavirus but before getting sick, I’m sure it’s not much, either from my own experience as a doctor or from conversations with friends across the country who are doctors . Although the use of medicines in treatment has increased during the delta region rushes strengthImmunocompromised people need locations separate from COVID patients to receive the cocktail, with additional staffing and new protocols needed, and most hospitals and clinics not having these systems in place. The logistics of distribution and management are complex. Timing should be appropriate: ideally, antibodies should be administered as soon as possible after exposure. The facilities you can distribute are already stretched out. The drugs’ ability to protect immunocompromised people has not been much publicized, which is a notable failure of government messaging.
But we have overcome massive research and public health barriers as a nation to ensure access to other proven and effective prevention and treatment measures for the coronavirus, from remdesivir to vaccines. We need to do what it takes to provide monoclonal antibodies for prophylaxis as well, which shouldn’t only be available to very privileged people like me.
One day after getting the antibodies, I traveled across the country to see my extended family for the first time since the start of the pandemic. I played cards with my grandmother, cooked huge meals with my cousin, played hide and seek with the older kids, and pushed the two-year-old’s pram at supersonic speed while he screamed for joy. When I saw my aunt, it was the first time I hugged someone in a year and a half.
On my trip home, I thought of the hundreds of thousands of people who relate to me in common with the coronavirus in every aspect of our days. You have just experienced the joy of living away from this ghost, remembering the feeling of feeling that life is full of possibilities. They deserve it too.