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A drug that helps immunocompromised people fight COVID is in short supply

A MARTINEZ, HOST:

While vaccines have helped protect many people during the omicron surge, serious breakthrough infections have surged among people whose immune systems don't respond well to vaccines. There is some good news, though. A new drug called Evusheld could protect them, although it's been very hard to get. NPR's Pien Huang reports.

PIEN HUANG, BYLINE: Dr. Vivian Cheung takes steroids to manage a rare genetic disease. Cheung, a pediatrician and researcher who lives in Maryland, says those drugs also suppress her immune system, which puts her at high risk of getting very sick from COVID.

VIVIAN CHEUNG: Except for work, I don't go out at all, so I haven't been inside of a grocery store for over a year.

HUANG: So last month, when the FDA authorized Evusheld, she couldn't wait to get it.

CHEUNG: So I think that like many people, I thought, wonderful, you know? Finally, I will have coverage against COVID.

HUANG: Evusheld, from the drug company AstraZeneca, is a combination of antibodies. For those who don't respond well to vaccines, like Cheung, Evusheld puts COVID-fighting proteins directly into their bodies. A company study shows the drug reduced the risk of getting COVID by 77% and lasted for six months, but the drug is in short supply. Dr. Camille Kotton treats organ transplant patients at Mass General Hospital in Boston.

CAMILLE KOTTON: A lot of these people kind of came in in the past few weeks with severe, life-threatening, sometimes deadly COVID.

HUANG: She says their first shipments of Evusheld covered less than 1% of their immune-compromised population. The federal government controls distribution. It's ordered a total of 1.2 million doses and shipped about 300,000 so far. But around seven million people in the U.S. can benefit from the drug. The scarcity has forced doctors to rank their patients by risk. Dr. Raymund Razonable runs the monoclonal antibody treatment program at Mayo Clinic in Rochester, Minn. Mayo divided eligible patients into five tiers based on medical need.

RAYMUND RAZONABLE: They are considered equal when they are in that Tier 1 category, and it's just basically by luck, right? They happen to get randomly picked by, you know, the computer system.

HUANG: Razonable says it'll probably take months to get through the 3,000 people in that most vulnerable tier. The government allocates Evusheld based on each state's adult population, and the approach doesn't prioritize where the need is greatest. So in some places, Evusheld is easier to get. Dr. Anne Zink, medical officer for Alaska, says her state has lots.

ANNE ZINK: We have not had the same demand, so we have not had to go to a lottery system. In fact, we are doing the opposite. We are trying to reach out to oncologists and to teams and be like, do you know this is out there?

HUANG: Zink, who's incoming president of the Association of State and Territorial Health Officials, says the country's fractured health system leads to inequities. People who know where to go and what to ask for are most likely to survive. Back in Maryland, Dr. Vivian Cheung did a lot of sleuthing to get her Evusheld.

CHEUNG: I called the Department of Health. They were nice enough to give me a list of all the hospitals that received doses.

HUANG: She faxed doctor's notes to various hospitals and zeroed in on the University of Maryland hospital, which had the most doses.

CHEUNG: I started literally calling colleagues who work there, having friends to call colleagues who work there and finally got a dose.

HUANG: Getting the drug hasn't changed her daily life. She still doesn't go to the grocery store. But it's given her some peace of mind and some guilt.

CHEUNG: I know the system. I know people who can pull strings for me. It's just wrong, right? Like, everything about this is wrong.

HUANG: Cheung now advocates online for Evusheld doses for others. She says it's helping her feel like she's earned hers.

Pien Huang, NPR News.

(SOUNDBITE OF SABZI'S "TASHAKORE") Transcript provided by NPR, Copyright NPR.

Pien Huang is a health reporter on the Science desk. She was NPR's first Reflect America Fellow, working with shows, desks and podcasts to bring more diverse voices to air and online.