Evusheld – COVID protection for the immunocompromised

medically gloved hand holding syringe

What is Evusheld?

Evusheld is monoclonal antibody prophylaxis for immunocompromised patients who did not get adequate COVID protection from the vaccines. It is developed by AstraZeneca and has received emergency use authorization from the FDA. Evusheld contains two long-lasting monoclonal antibodies, tixagevimab and cilgavimab that target surface spike protein of SARS-CoV2. It is designed to prevent COVID and not as a treatment.

Evusheld is NOT an alternative to a COVID vaccination – get vaccinated!

Evusheld is given as an intramuscular injection to adults and children at or above 12 years (weighing at least 40 kg) who:

  • Do not have COVID or recent exposure to COVID

and

  • Are immunocompromised due to medical conditions or receiving immunosuppressive medications, and did not mount an adequate response to COVID vaccination

or

  • Cannot receive any of the COVID vaccines due to a history of severe allergic reaction to the vaccines or their components

For these individuals, Evusheld should provide COVID protection for about 6 months.

Preliminary studies suggest that Evusheld provides some coverage against the Omicron variant of COVID.

Evusheld is not an alternative to vaccination for those who do not meet the above criteria.

How do I get a Evusheld?

  1. Get a note from your doctors saying that you are eligible for #Evusheld,
  2. Check availability at rrelyea.github.io/evusheld/
  3. Contact the centers with doses persistently until you get the shots.
  4. Be persistent.

Q&A

Do you have any tips for getting to the right person at these places? Do you go to scheduling or another resource that could assist (understanding it may be different for each)?

Pharmacy or if they have an infusion center

How can I help everyone who needs Evusheld get it?

You can sign the petition at Change.org or Resist.bot

You can send a letter to US HHS Secretary Becerra with optional updates on Evulshed.

Does Evulsheld provide protection against the Omicron variant of COVID-19?

Evusheld is a combination of tixagevimab and cilgavimab – according to this study (Tixagevimab and Cilgavimab (Evusheld) for Pre-Exposure Prophylaxis of COVID-19), it is not great. But so far break-through infections are not common. It is too early to say. The advantage of Evusheld  is that it is a combination of two antibodies against the COVID spike proteins and so is more likely to be effective against different variants.

Testimonials

5 COVID Vaccines and No Immunity – My husband was treated with Rituximab this winter for a rare B-cell lymphoma. He has had 5 vaccines (2 before his treatment and 3 in the months following) and still has no neutralizing antibodies to the COVID virus….

We Must Protect the Most Vulnerable from COVID – While this is excellent news, the new agreement still falls far short of the doses needed to provide protection for the 7 million people who are immune compromised in the U.S. Furthermore, like vaccines, this treatment will likely have to be repeated (studies suggest every 6 months). An ongoing supply will be needed…

I got Evusheld. I took lots of calls, faxing of doctors’ notes…etc. I am grateful to @UMMC. Immunocompromised [patients] should not have to plea, hope for winning the Evusheld lottery, search everywhere for living-saving meds.

 

“…Our analysis indicates that ≈6% of the enrollees in a large US claims database had immunosuppressive conditions … which might represent some 12 million US persons if these rates are similar in the general US population “

Analysis of MarketScan Data for Immunosuppressive Conditions and Hospitalizations for Acute Respiratory Illness, United States

 

The government has fulfilled its promise to make vaccines available to everyone whose bodies can make good use of them. But now it must also cover everyone who cannot benefit from the vaccines.” @slsatel https://thedispatch.com/p/dont-forget-the-immunocompromised

It shouldn’t have to take an MD, tons of phone calls, and persistence to get the medicine you need.

Resources

COVIDSAFE.FYI – a great, totally unofficial resource that can help you find Evusheld, vaccines, and other COVID related information.

Immunocompromised Times newsletter.

FDA Fact Sheet for Healthcare providers

FDA Fact Sheet for Patients, Parents, and Caregivers

Online resource of current availability and providers – LIVE DATA

Prioritization and Scarce Resource Allocation of Evusheld for COVID19 PreExposure Prophylaxis in Certain High Risk Individuals (Michigan)

National Infusion Center Locator (for COVID antibody treatments – currently DOES NOT include Evusheld)

Allocation Criteria for Evusheld for Prevention of COVID (Michigan Medical)

Ethical Frameworkfor Allocation of Monoclonal Antibodies during the COVID-19 Pandemic – Minnesota Department of Health (at time of retrieval does not address Evusheld directly)

How Many Adults Are at Risk of Serious Illness If Infected with Coronavirus? Updated Data

Evusheld offers another layer of protection for patients who may not respond well to COVID vaccine –  Health News Florida – 31 January 2022

Acknowledgements

Vivian G. Cheung, MD, – for the description of Evulsheld and bringing this issue to my attention

Rob Relyea – for his amazing Evusheld tool and community participation

Editorial

While I received a lot of help, any errors are mine. – Editor

Questions, comments, suggestions?