Millions of Americans are getting their COVID-19 shots every day, but the U.S. is still going to need better treatments that can nip mild or moderate cases of COVID-19 before they become serious.
There are a number of reasons that people could still get sick after they are vaccinated. There will be “breakthrough” cases, since the COVID-19 vaccines are not 100% effective. Some people won’t get vaccinated, putting others around them at risk. And new variants or mutations of the virus could make vaccines less effective than they are right now.
Plus, people who have been vaccinated and then later undergo certain types of treatments such as for lymphoma could see their antibody-making B-cells wiped out.
As of Thursday, more than 12% of the U.S. population has been vaccinated, according to the Centers for Disease Control and Prevention . The U.S. is currently averaging about 53,000 new cases a day — a rate that, while far below January’s peak, is still high enough to worry public health authorities.
“A lot of people have the impression that vaccination is going to solve the problem,” said Dr. John Brooks, a medical epidemiologist at the CDC. “But just look at influenza. We know that every year there are people who are breakthrough infections, and that is if they had the vaccine.”
When it comes to the flu, there are four treatments that can be prescribed to patients, including GlaxoSmithKline’s /zigman2/quotes/209463850/composite GSK -0.08% Relenza and Roche Holdings AG’s /zigman2/quotes/206324342/delayed CH:ROG +0.57% Tamiflu , an oral antiviral approved by the Food and Drug Administration in 1999.
Having Tamiflu-like medications at the ready to treat people with mild to moderate forms of COVID-19 and keep them from getting so sick they end up in the hospital or die could go a long way toward slowing the pace of the virus and moving the U.S. back toward normalcy.
Preventing hospitalization and death from COVID-19 are two endpoints that companies like Eli Lilly & Co. /zigman2/quotes/200106384/composite LLY -0.46% and Regeneron Pharmaceuticals Inc. /zigman2/quotes/203149337/composite REGN -1.43% have focused on while testing their monoclonal antibodies in clinical trials.
Lilly got its first emergency-use authorization for a stand-alone antibody treatment, bamlanivimab , and then another one for bamlanivimab and etesevimab together , while Regeneron’s antibody cocktail, called REGEN-COV, is authorized for teens and adults who are at high risk for hospitalization.
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But there have been road bumps when it comes these therapies. They may not be as effective against variants like the B.1.351 strain, which was first identified in South Africa. And patients have had to go to infusion centers to receive those treatments as it’s not scientifically possible to package monoclonal antibodies into the kind of oral medicines one can pick up at a local pharmacy. (This part of the equation may soon change, with the White House on Wednesday announcing $150 million in funding to ensure more equitable access to these therapies.)
“The ideal therapy would be one that’s easy to take, easy to get a hold of, and not expensive,” Brooks said. “Monoclonals are wonderful. They really do seem to help people. But they require an intravenous infusion.”
‘The mere existence of a vaccine is not enough’
Monoclonal antibodies, which have been the only authorized treatment options for people with milder forms of COVID-19 during the course of the pandemic, show tons of promise, both as treatments for patients who have tested positive for the virus and also to prevent infections. (None of the antibody treatments has been authorized to prevent COVID-19 for instances of pre- or post-exposure at this time.)
Several drug makers beyond Lilly and Regeneron are currently running clinical trials for antibody-based treatments, including Vir Biotechnology Inc. /zigman2/quotes/214486077/composite VIR -1.16% , in partnership with GSK and AstraZeneca /zigman2/quotes/200304487/composite AZN +0.20% , which announced Tuesday that the U.S. just bought a half-million doses of its still-experimental antibody cocktail.
“The mere existence of a vaccine is not enough,” a spokesperson for Vir said in an email. “It has to be available, widely taken, and effective year after year after year, even against emerging variants. Now more than ever, we need treatments that are active against currently circulating variants of concern, as well as any new variants that emerge.”
But executives at Lilly and Regeneron say they have seen limited utilization of their antibody treatments since the first authorizations were handed out back in November.