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Antibody treatment is rising in Virginia, raising hopes — and concerns — from providers

‘You’re giving the person antibodies in a vial. Whereas with a vaccine, you’re getting active immunity.’
The drugs have been authorized since late November, but demand has shifted rapidly since the...
The drugs have been authorized since late November, but demand has shifted rapidly since the rise of the delta variant.(NIH)
Published: Sep. 27, 2021 at 2:58 PM EDT
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For the last nine months, Augusta Health has been mounting an intensive immunization campaign, administering more than 85,000 doses across its small community in Virginia’s Shenandoah Valley.

“Given that we don’t have unlimited resources, we’ve chosen to focus most recently on the vaccination efforts,” said John Mack, chief operating officer of the hospital system. But faced with surging COVID-19 hospitalizations and a community positivity rate that’s spiked to 31 percent, Augusta made the decision to open its own monoclonal antibody clinic on Monday out of its Waynesboro primary care office, hoping to administer between 16 and 20 infusions a week to eligible patients.

“We are at critical staffing,” Mack said. “At this point, all of our ICUs are full. And so any reduction in unnecessary hospitalizations is something Augusta Health wants to ensure we provide.”

It’s not the only health system grappling with strained capacity and an ongoing wave of severe COVID-19 cases. But combined with Virginia’s stubbornly stagnant immunization rates — with under 60 percent of the population fully vaccinated as of Thursday — it’s one of the latest to turn to monoclonal antibodies, a laboratory-made treatment, for relief.

The drugs have been authorized since late November, but demand has shifted rapidly since the rise of the delta variant. One week in mid-June, a single provider ordered 40 doses through the Virginia Department of Health, said Dr. Brooke Rossheim, a public health physician specialist for the department. By the first week of September, 44 different facilities had ordered a total of 1,700 doses.

“And I will tell you, I know there have been requests that have come in from new providers to give out the treatment,” Rossheim said. “So I have no doubt the number now is even higher.”

The irony of the growing demand isn’t lost on some doctors. Like mRNA vaccines, research on monoclonal antibodies isn’t new, but their use for the treatment of COVID-19 is currently allowed under an emergency use authorization from the U.S Food and Drug Administration (the Pfizer vaccine, on the other hand, is now fully approved). Like vaccines, they target the spike protein of the virus, attaching and neutralizing its ability to attach and spread among host cells.

“They’ve been shown in a clinical trial to actually decrease the need for hospital admission and medical utilization for people who are treated and at high risk for disease,” said Dr. Debbie-Ann Shirley, the medical director of UVA Health’s COVID-19 clinic. Their effectiveness has led to global calls to expand access, with many describing them as an often “life-saving” therapy.

Still, hospitals and doctors across Virginia emphasized that monoclonal antibodies are no replacement for vaccines. While they can stop the virus from replicating in 70 to 80 percent of cases when given correctly — keeping disease mild to moderate — the results are temporary. Rossheim said the therapy is often referred to as “passive immunity,”

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.(Virginia Mercury)

The Virginia Mercury is a new, nonpartisan, nonprofit news organization covering Virginia government and policy.

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