Your COVID-19 questions: March 24, 2022

What is the current situation with access to the Paxlovid (an oral antiviral) and monoclonal antibody treatments for COVID-19?

All agents to treat COVID-19 infection in high-risk patients are more readily available now, a consequence of increased supply and decreased demand as the cases wane. Paxlovid can be prescribed by any provider through Epic to a patient who has tested positive for COVID-19 and is at high risk of progression to hospitalization. It does need to be prescribed within 5 days of symptom onset. There are some serious drug interactions and so consideration needs to be given to stopping or adjusting the dose on some of them, and in some cases, to not prescribing it at all. Our pharmacists are able to help out with this screening so it is best to prescribe the medication through the BJH Pharmacy. The advantage of Paxlovid is the ease of treatment since it is an oral pill.

Monoclonal antibodies are indicated for the same population of high risk patients and can be prescribed up to 7 days from symptom onset. There are no drug interactions to consider, though the treatment is more involved as it is done by infusion only at certain centers. WashU Med providers can find details on qualifying criteria for treatment, guidance on selecting the right agent, and specific ordering information at:
— Maya Jerath, MD, PhD, professor of medicine

When will Moderna’s vaccine for children under five be available?

The trials for both Pfizer and Moderna in children are ongoing. In children less than 5 years old, Pfizer is evaluating the efficacy of a third dose as their original two-dose data in the 2-to-5 year olds did not appear to have the efficacy observed in the older age groups. Potentially in April they will submit these data to the FDA but that is not confirmed.

Moderna is also in the midst of their ongoing vaccine trials for children in all age groups down to 6 months of age. WashU Med led one such trial in St. Louis, where 160 area children from the ages of 6 months to 11 years of age received the two-shot Moderna vaccine or placebo at St. Louis Children’s Hospital. Moderna said on Wednesday that it would seek emergency authorization of its coronavirus vaccine for children younger than 6, after interim results from its clinical trial showed that volunteers in that age group had a similar immune response to young adults when given a dose one-fourth as strong.
— Jason Newland, MD, professor of pediatrics

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