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For the Public

What is Antiviral Medication?

Antiviral medications may help you recover from COVID-19 faster, or prevent you from becoming seriously ill. The medication can boost the immune system, helping it fight off COVID-19 infection. Vaccinations remain the best way to protect a person from COVID, and are a preventative measure to reduce severity of illness and risk of hospitalization or, even, death. Antivirals are prescribed after a person has tested positive for COVID-19 and within 5 days of symptom onset.

What is Monoclonal Antibody Therapy?

Monoclonal antibodies are laboratory-produced molecules that act as substitute antibodies that can restore, enhance or mimic the immune system. Monoclonal antibodies are designed to block viruses by not allowing them to attach and enter human cells, thus neutralizing the virus. Monoclonal antibodies may be effective for the treatment of COVID-19 patients who are at high risk for progressing to severe COVID-19 and/or hospitalization.

Monoclonal antibody treatment is for people who have tested positive for COVID-19 and have mild to moderate symptoms. These treatments are allowed by the U.S. Food and Drug Administration (FDA) under an Emergency Use Authorization (EUA) while clinical studies continue to look at their usefulness and safety. Recently the FDA approved the use of monoclonal antibodies to treat certain high-risk adult and pediatric patients who have been exposed to COVID-19.  This treatment method is known as post-exposure prophylaxis, or PEP. 

When administered to non-hospitalized patients as soon as possible after testing positive for COVID-19 and within 7 days of symptom onset, monoclonal antibody therapy may reduce symptoms and risk of hospitalizations and emergency room visits associated with COVID-19. 

The use of sotrovimab, REGEN-COV and bamlanivimab + etesevimab have had their emergency use authorization paused, as they did not demonstrate effectiveness against the BA.2 sub-variant.

  • Anyone over 12 years of age and over 40 kg who have tested positive for SARS-CoV-2. The FDA has indicated in their emergency use authorizations that these medications are intended for those who are at increased risk of hospitalization or death who are not hospitalized when treatment is started. Those who are immunocompromised or not up to date on the COVID-19 vaccine are particularly at risk and those with any of the following conditions identified in the FDA EUAs:

    • Older age (for example ≥65 years of age)
    • Obesity or being overweight (e.g., BMI >25 kg/m2), or BMI ≥85th percentile pediatrics
    • Pregnancy
    • Chronic kidney disease
    • Diabetes
    • Immunosuppressive disease or immunosuppressive treatment
    • Cardiovascular disease (including congenital heart disease) or hypertension
    • Chronic lung diseases (e.g., COPD, moderate to severe asthma, etc.)
    • Sickle cell disease
    • Neurodevelopmental disorders (e.g., cerebral palsy) or other complexity conditions
    • Medical-related technological dependence (e.g., tracheostomy, gastrostomy)
    • Other conditions identified by the CDC for the person at risk for disease severity

     

  • For treatment: Monoclonal antibody therapy is not authorized for use in patients:

    • Who are hospitalized due to COVID-19, or
    • Who require oxygen therapy due to COVID-19, or
    • Who require an increase in baseline oxygen flow rate due to COVID-19 in those on chronic oxygen therapy due to underlying non-COVID-19 related conditions.

    Monoclonal antibodies may be associated with worse clinical outcomes when administered to hospitalized patients with COVID-19 requiring high flow oxygen or mechanical ventilation.

    For post-exposure prophylaxis: Monoclonal antibody therapy is not authorized for patients:

    • As a substitute for vaccination against COVID-19.
    • Pre-exposure prophylaxis for prevention of COVID-19.

  • Clinical trials for monoclonal antibody therapy have shown a decrease in hospitalizations and emergency room visits and a decrease in the amount of virus in an infected person's blood. Studies are still ongoing.

  • Currently, the monoclonal antibodies available for use are administered through intravenous (IV) infusion.

     

  • The federal government is distributing antibody supplies at no cost to patients. However, healthcare providers may bill insurance companies to administer the drug.

  • MDHHS is committed to ensuring health equity and to seeing that everyone has fair access to COVID-19 therapeutics. MDHHS has provided guidance to hospitals and those administering medications to guide decision making on how to distribute medication supplies fairly among eligible patients.

     

  • If you received monoclonal antibody (mAb) therapy or convalescent plasma after COVID-19 exposure or infection, you do NOT need to delay your COVID-19 vaccination. CDC has revised this guidance based on encouraging evidence that patients who received these treatments still mounted a robust immune response to mRNA vaccination soon after treatment. Getting vaccinated is a priority, and you are able to get vaccinated once your illness is over.