Evusheld for Covid
Last month, President Biden announced that the COVID-19 pandemic was over. Amazingly, he was vilified by his own people while most Republicans agreed with him, a turn of events rarely seen in today’s hyper-partisan political climate. Of course, he was right. COVID-19 is no longer a pandemic nor an epidemic. Rather, coronavirus is back to being endemic, meaning it’s always around, just like influenza, the common cold, and many other viral diseases. Remember, before it was COVID-19, the coronavirus was a known cause of the common cold, like rhinovirus. Deaths will still occur from COVID, just as they do from influenza and other viruses. Every winter here in the northern hemisphere during a normal flu season we will see at least 10 to 20,000 deaths. The deaths that occur due to these endemic viruses all have one thing in common. They mostly occur in people whose immune systems are impaired by age, illness, and/or medications. However, when it comes to COVID, our anti-viral arsenal has a unique weapon. There is a medication that can be given to vulnerable people to prevent COVID infections. That medication is tixagevimab-cilgavimab (Evusheld by AstraZeneca).
By now I’m sure that everyone has seen a picture of a coronavirus, be it a drawn depiction or an electron microscope photo. The most striking part of the virus is the sharp projections that cover the outer shell making it look like a mad porcupine. These are called spike proteins. The spike proteins serve two purposes. First, they allow the virus to attach itself to a cell, much as a boat uses an anchor to stay in one position. Then, once the virus is anchored to a cell, the virus dumps the genetic material it carries into the cell via the spike proteins. The genetic material takes over the cell, repurposing it to create a virus factory, making thousands, if not millions, of new viruses. Evusheld, which is a monoclonal antibody, attaches itself to the ends of the spike proteins, capping the ends and preventing the virus from attaching to a cell. Evusheld is not a treatment for COVID-19 and should not be confused with antiviral medications that are given during a COVID infection. It should not be given during a COVID infection, nor should it be given to someone who was recently exposed to an individual with a COVID infection. Administration of Evusheld should be deferred for 2 weeks following COVID-19 vaccination.
On December 8, 2021, the FDA issued Emergency Use Authorization for Evusheld. Eligible patients include adults and children aged 12 and older who weigh at least 88 pounds, are moderately to severely immunocompromised due to illness or medications AND may have an inadequate response to COVID-19 vaccination OR cannot be vaccinated due to a history of severe reactions to the vaccine. Evusheld is given by two consecutive injections during a single session at a doctor’s office or health care facility. If ongoing protection is needed the injections may be repeated every six months. Evusheld side effects are similar to those seen with anti-viral vaccines.
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