Evusheld Feels like Winning the Immunocompromised Lottery

It feels like I recently won the lottery. No, not the lottery with money involved, but the lottery to receive a dose of Evusheld. This therapy provides me hope that I may be better protected (finally) and able to avoid contracting Covid-19.

The past two years have been challenging while I’ve mostly avoided people besides my doctors, pharmacists, physical therapist, immediate family members, and curbside delivery workers at grocery stores. I’ve been fearful of contracting Covid-19 and passing it on to loved ones for two years now.

The Covid-19 vaccines didn't work for me

As a person who has been on Rituximab for over 12 years, my body failed to produce antibodies after three doses of two different mRNA vaccines to the Covid-19 virus. I know this because I’m part of a study at Johns Hopkins that measures vaccine response in immunocompromised people. Also, my rheumatologist ordered the same laboratory test to have the results in my medical record.

Unfortunately, I developed no detectable antibodies and have felt quite vulnerable.

Evusheld may help those who are immunocompromised

Evusheld is a treatment designed for the pre-exposure prophylactic (prevention) of Covid-19 in certain individuals. It involves the combined injections of two monoclonal antibody therapies (tixagevimab and cilgavimab). The shots are administered in each buttocks muscle.1

Evusheld received emergency use authorization (EUA) from the Food and Drug Administration (FDA) on December 8, 2021, but access to the therapy has been severely limited.1 As of January 28, 2022, approximately 350,000 doses have been distributed throughout the United States, and in the state I live in, with a population of 8.6 million people, 5,000 doses have been received so far.2

My rheumatologist told me about the treatment in mid-December and believed I would be a good candidate. She recommended that I seek out the treatment but didn’t have any advice on doing so. Until last week, it looked like I might not be able to gain access to the promising therapy for a long time.

Who is eligible to receive the injections?

There are several restrictions on the authorized use of Evusheld. First, recipients must also be at least 12 years old and weigh at least 88 pounds. Evusheld is intended only for individuals not currently infected with SAR-CoV-2 (i.e., Covid-19) AND who have not recently been exposed to an individual infected with the virus. This is not a treatment for Covid-19.1

It is approved for emergency use only for:1

  • Individuals who are moderately to severely immunocompromised due to a medical condition or use of immunosuppressive medications or treatments AND who may not mount an adequate immune response to Covid-19 vaccination, OR
  • Individuals for whom vaccination with any available Covid-19 vaccine, according to the approved or authorized schedule, is not recommended due to a history of severe adverse reactions to a Covid-19 vaccine and/or component(s) of the vaccine.

How does one access Evusheld?

This had been the big question for me for weeks. You can’t just walk into your doctor’s office, pharmacy, or local emergency department and ask for this treatment.

Initially, my rheumatologist referred me to my primary care physician (PCP). My PCP didn’t know where to access Evusheld and sent emails asking questions to the state’s health department. I tried on my own to learn more but wasn’t initially successful. It seemed like only oncology patients were being offered the treatment.

The day after I saw friends in Boston posting online about receiving Evusheld at their local hospital, I received a phone call from my rheumatologist’s nurse.

The nurse explained that I qualified for the treatment. Yes, yes, I knew that. The nurse said that my doctor would be sending a prescription for Evusheld to a specific pharmacy located about an hour from my home (depending upon traffic) on the cusp of a rural area. Once the pharmacy received the order, they called me and we scheduled an appointment for 2 days later.

I received my shots last Friday!! Woohoo!!

Is Evusheld available in your area?

When I spoke with the pharmacist during my appointment, I learned that they had received more doses than a large hospital near my home, where my PCP has privileges. There is a website available for healthcare providers to search for available supplies of Evusheld, Paxlovid, or molnupiravir, but even that doesn’t make navigating the process easier for everybody.

A few days after I received Evusheld, my PCP called to tell me that she was still trying to figure out how to gain access to the medication for me. It seemed that although the hospital where she has privileges reportedly had 48 doses still available, she was encountering roadblocks making access nearly unobtainable.

I was very happy to tell her that I had already received Evusheld.

What was treatment like?

Evusheld involves two intramuscular shots to be given in the buttocks. To be honest, the pharmacist did not ask me many questions. Since I had already researched the therapy, I easily signed the consent form with no real questions of my own to ask.

Because Evusheld poses a risk of anaphylaxis in some patients, you are supposed to be observed for an hour following the shots. In my case, the pharmacist released me after about 10 minutes. I chose to sit in my car for another 20 minutes just in case I felt anything unusual and didn’t feel safe driving home.

The only side effects I experienced included some very mild facial flushing for a couple of hours, some soreness in the muscles down one leg, and a tiny bit of nasal dripping for less than a day. This was nothing compared to the side effects I experienced following each Covid-19 vaccination.

For detailed information regarding Evusheld, I recommend that you visit the manufacturer's website.

Has your rheumatologist mentioned that you are a candidate for Evusheld? If so, have you received treatment? Please share your stories in the comments below.

Be well,
Lisa

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