LupusChick recently spoke with Brian Labus, Ph.D., MPH, an Assistant Professor in the Department of Epidemiology and Biostatistics at the University of Nevada Las Vegas School of Public Health to answer your questions about what immunocompromised patients need to know about Evusheld for the prevention of COVID-19.
What is Evusheld?
Evusheld is a combination of two long-acting monoclonal antibody therapies — tixagevimab and cilgavimab. It is used to prevent COVID-19 infection in people who can’t produce a sufficient immune response to the vaccine or who can’t have the vaccine due to medical reasons.
How does Evusheld work?
Evusheld is delivered in a series of two intramuscular injections given back-to-back in the buttocks.
“The drug works by giving you the antibodies that your body naturally produces in response to the vaccine or an infection,” Dr. Labus said.
How effective is Evusheld?
In a clinical trial, Evusheld reduced the risk of getting symptomatic COVID-19 by 77%. Among the trial participants who received Evusheld, there were no severe cases of COVID-19, COVID-related hospitalizations or COVID-related deaths within six months of the trial.
How long does Evusheld last?
You should receive Evusheld every six months.
“The downside [to Evusheld] is that, unlike with vaccination, you don’t develop an immune memory and the protection wears off after about six months, requiring additional doses to stay protected,” Dr. Labus said.
Does Evusheld have any side effects?
Because Evusheld hasn’t been widely used yet, data on side effects is minimal. Possible side effects include allergic reaction, pain, bruising of the skin, soreness, swelling and possible bleeding or infection at the injection site.
In the clinical trial for Evusheld, some people — some of whom had received Evusheld and some of whom had not — experienced severe cardiac events, but these were rare. It is unknown if the events were related to Evusheld.
Who should get Evusheld?
To qualify for Evusheld, you must:
- Be at least 12 years of age or older and weigh at least 88 pounds
- Be severely immunocompromised due to illness or medication and be unable to generate an efficient immune response from the COVID-19 vaccine
- Not be currently infected with COVID-19 or had known exposure to someone with COVID-19
Who should NOT get Evusheld?
If you have had a severe allergic reaction to Evusheld, you should not receive additional doses. Because Evusheld is still being studied, it is unclear if there are additional groups of people who shouldn’t get it.
Can I get Evusheld if I’m pregnant or breastfeeding?
Because Evusheld is still being studied, it’s unclear if it has any effects on pregnancy or breastfeeding. If you’re pregnant, planning to become pregnant, or breast feeding, you should speak with your healthcare provider about the potential benefits vs. potential risks.
“Being infected with COVID during pregnancy results in increased rates of complications, so you have to weigh that against the potential risk of the medication itself,” Dr. Labus said.
If I’ve recently had COVID-19, how long do I need to wait before getting Evusheld?
It was explained to our journalism team, that if you recently had COVID-19 or were recently exposed to COVID-19, you should speak with your healthcare provider about how long you should wait before receiving Evusheld.
If I’ve recently had the COVID-19 vaccine, how long do I need to wait before getting Evusheld?
If you have recently received the COVID-19 vaccine, you need to wait at least two weeks before receiving Evusheld.
How can I get Evusheld?
The United States, the European Union and several other countries have approved Evusheld for emergency use, but many patients have reported difficulty accessing Evusheld. If you believe you qualify, you should speak with your healthcare provider. If you live in the U.S., you can also use the COVID-19 Therapeutics Locator to find places near you that have received shipments of Evusheld.
What is it like to receive Evusheld?
In June, we asked members of the LupusChick Facebook community about their experiences with Evusheld. This is what they said.
“My own healthcare network was limiting it for transplant patients, so I went online and found where it was in supply. I called the hospital infusion center, my PCP sent them the order, then I went and had the higher dose two shots. No adverse reaction except 24 hours of light flu symptoms. It should be more more easily available!” — Karen Swift-Shannon
“I had an extremely difficult time getting it. None of my doctors were familiar with it. I got it this month. No side effects for me whatsoever. I was surprised by that.” — Diana MacGillivary Bruso
“A headache and fatigue the day after, but not bad. I asked for it once I found out about it and my doc ordered it right away with the caveat that it adds a layer of protection and is not a vaccine. He didn’t know much about it, but was happy to order.” — Monique Lamaestra
“Mine was very easy to get. My pulmonologist is on top of things and knew with my conditions that I needed it — I had COVID twice before. It was two shots simultaneously and all I got was a metal taste in mouth — other than that, all good.” — Cindy Jo Wetzel
“I got mine in March. I’m a transplant patient (lungs and kidney). I [didn’t] have any side effects besides some mild bleeding from the needle poke because I’m taking a blood thinner. Everything is normal.” — Maria Paz Hechanova Manso
“No side effects. Got both of the shots in my buttocks, which I was not expecting, but other than that done well with it. Got it in April.” — Mikala Adelle
“I got mine last Thursday and didn’t have any side effects. I felt and feel fine!” — Andrea Chavez-Hill
“I was offered Evusheld when it first became available as a Rituxan patient. My hospital system was prioritizing those on B cell inhibitors without an antibody response from the vaccine. Other than a bit of muscular soreness in the hips where the two injections were administered, I had zero side effects! I’m so grateful I was able to get it.” — Carly Fain Goldin
“I have no side effects.” — Lyndsie Russell
“Very difficult to get! No one knew how to help… had to push to finally get it. Zero side effects but a minor headache day-of. Antibody tested two months out and my antibody line lit up! I’ve also stayed COVID-free.” — Brittany Elliott
“Around here they are limiting specialists to five patients each. I was lucky due to the chemo I do every six months — I was the first [patient] of my rheumatologist to get it. I had no side effects and, come fall before next chemo, I will get a vaccination booster.” — Lisa Kaye Steiner
“Easy to get from doctor’s suggestion. No side effects.” — Shelli Langenburg