A: The new Omicron subvariants of the SARS-CoV-2 virus are likely to be resistant to the monoclonal antibodies in Evusheld. It is especially important that people get the bivalent COVID-19 booster vaccine to protect against infection.
Evusheld is a combination of two monoclonal antibodies called tixagevimab and cilgavimab. It is used to PREVENT (not treat!) COVID-19 infection for people who have weakened immune systems and are unable to mount a good immune response after vaccination. It is also available for people who cannot get the COVID-19 vaccines because of life-threatening allergies to the vaccine. The goal of Evusheld is to give extra lab-made antibodies to people who are unable to make enough antibodies to fight off infection on their own.
Unfortunately, there are new Omicron subvariants taking over the US: BA.4.6, BA.2.75.2, BA.5.2.6, BF.7, BQ.1, and BQ.1.1. These new variants have mutations in them that give them resistance to the antibodies in Evusheld. It is now estimated that more than half of all COVID-19 infections in the US are from one of these variants.
Evusheld is currently the only medication authorized by the FDA to prevent infection (called pre-exposure prophylaxis). Because it is all we have, it is still recommended for all eligible people. People are eligible if they are 12 years old and older and have moderately to severely weakened immune systems OR are not able to get a COVID-19 vaccine because of severe or life-threatening allergic reaction to the vaccine. If you are in one of these groups, talk with your clinician about Evusheld and the rates of the new variants in your area.
It is more important than ever to get the new, bivalent COVID-19 vaccine booster. The booster is expected to protect against the new strains. The booster is safe for people who are weakened immune systems.
As rates rise and we are facing a “tripledemic” of influenza, RSV, and COVID-19, taking precautions to protect ourselves and vulnerable folks in our communities is crucial. The classics (stay home when sick, wash hands, wear a mask indoors and in crowds, and increase ventilation) can all help and are still important tools in our toolbelt.
Stay safe. Stay well.
Those Nerdy Girls
Links:
CDC COVD-19 Summary of Variant Surveillance
NIH COVID-19 Treatment Guidelines Panel Statement on Omicron Subvariants
COVID-19 Preexposure Prophylaxis Guidance
NIH Special Considerations in People Who are Immunocompromised
