With SMH Infectious Disease experts Manuel Gordillo, MD, & Jamie Kisgen, PharmD
** NOTE: As of Jan. 4, 2022, Florida is experiencing a statewide shortage of monoclonal antibody treatments (mAB). To check the status of Sarasota Memorial's mAB supplies and find out if appointments at our outpatient mAB clinic are available, call 941-262-0135.
** The following content was last updated Dec. 30, 2021, and was originally published Dec. 7, 2021. Information related to the COVID-19, vaccines and treatments is continually evolving. For the most up to date info, we recommend visiting the CDC’s website and the FDA website.
******
Earlier this year, as COVID-19 cases skyrocketed and the Delta variant ran rampant, many who tested COVID positive rushed to get monoclonal antibody therapy to keep their symptoms from getting worse or landing them in the hospital.
Now, as COVID-19 variant concerns grow, many patients treated with monoclonal antibodies have questions about the investigational therapy: Does it impact booster shot eligibility? Does it protect against reinfection? Is it effective against the Omicron variant?
Below are the most common questions sent to Sarasota Memorial’s Ask An Expert team, along with answers from our medical experts Infectious Disease Specialist Manuel Gordillo, MD, and Infectious Diseases Pharmacy Manager Jamie Kisgen, PharmD, BCPS, BCIDP.
Monoclonal Antibody Therapy FAQ
What is monoclonal antibody treatment?
Given via an infusion or injections under the skin, monoclonal antibodies (mABs) are medications designed to reduce symptom severity and prevent hospitalizations in patients with mild to moderate COVID-19.
They do this by targeting the specific spike protein of the virus that causes COVID-19 (SARS-CoV-2), making it difficult for the virus to reproduce and cause harm, while boosting the immune system’s ability to respond to the virus.
The U.S. Food and Drug Administration has authorized 3 mAB products for treating mild to moderate COVID-19 in non-hospitalized patients:
The Lilly and Regeneron mABs also are FDA authorized as prevention therapies for people with known recent exposure to the virus.
Do I need to get a COVID-19 vaccine booster shot, if I received monoclonal antibodies?
Yes, COVID-19 booster shots are highly recommended for all vaccinated adults — including people who’ve had COVID-19 and those who were treated with monoclonal antibody therapy, Dr. Kisgen said. Any natural immunity, or protection your body developed, from the infection or the mAB treatment will wane over time. Your best bet for preventing COVID re-infection is getting a booster, or getting vaccinated if you haven’t yet.
How long should I wait to get a COVID-19 shot after having monoclonal antibody treatment?
If you received monoclonal antibodies, you should wait at least 90 days to get a COVID-19 shot, whether that’s for primary vaccination or a booster shot, according to the Centers for Disease Control and Prevention (CDC).
“Monoclonal antibody treatments may neutralize the spike protein in COVID-19 vaccines, rendering them ineffective,” Dr. Gordillo explained. “So, the federal recommendation to wait 90 days is considered best practice, even for those who did not get vaccinated before receiving the monoclonal antibody.”
Monoclonal Antibody Treatment in Sarasota
Who can get monoclonal antibody therapy?
To be eligible for outpatient monoclonal antibody treatment, patients must be:
- Within 10 days of symptom onset / COVID-19 diagnosis.
- At high risk for developing severe COVID-19 or being hospitalized.
Monoclonal antibody (mAB) therapy also can be given as a preventative to those recently exposed to COVID-19 and high risk for severe COVID-19 / hospitalization.
The U.S. Food and Drug Administration recently expanded its emergency use authorization (EUA) for monoclonal antibodies, removing the age limitation for one of the mAB products: Eli Lilly’s bamlanivimab + etesevimab. This combination can now be used for outpatient treatment and post-exposure prevention of pediatric patients under age 12, who are at high risk for developing severe disease. Click here to learn more.
Where can I get the monoclonal antibodies?
The Sarasota Memorial outpatient monoclonal antibody clinic temporarily closed due to a shortage of mAB supply. The clinic likely will reopen, if the state government allots us more supply. For the latest information about Sarasota Memorial's outpatient monoclonal antibody supply or clinic, call 941-262-0135.
The state provides free mAB injections at locations throughout Florida for people who are high-risk and have contracted or been exposed to COVID-19. Click here for info about the state sites.
Do I need to wait to get a flu shot, pneumonia vaccine or any vaccination other than the COVID-19 shot, after I've had monoclonal antibody therapy?
No. There is no need to delay getting flu or pneumonia vaccinations after monoclonal antibody treatment, according to Dr. Gordillo.
Monoclonal antibodies only target and neutralize the COVID-19 / SARS-CoV-2 spike protein, which is replicated in COVID-19 vaccines, not any other vaccine.
Do monoclonal antibodies protect recipients from COVID reinfection for the 90 days we have to wait before getting a COVID-19 shot?
While in that 90-day window, you have protection from the monoclonal antibody treatment, in addition to any vaccine you previously received, Dr. Gordillo said. But you should also continue to practice otherCOVID-19 prevention methods as recommended by the CDC.
Is there any leeway in the 90-day wait time for a COVID-19 booster after a monoclonal treatment?
The CDC’s recommendation of 90 days is best practice, but it’s a precaution, not a hard and fast rule, explained Dr. Kisgen.
“As of now, there are limited data on the impact of monoclonal antibodies on vaccine response and even less on boosters,” he said. “If someone receives a booster shot of the vaccine before that 90-day wait window is over, there’s no need to repeat the dose.”
“They have already received 2 doses of the vaccine, as well as a dose of monoclonal antibodies. Based on recent analysis, the protection provided by monoclonal antibodies may last even longer than initially expected.”
Is the monoclonal antibody treatment effective against the Omicron variant?
The Omicron variant is still relatively new, so we have very little hard data on how it’ll respond to monoclonal antibodies, Dr. Gordillo said.
Scientists across the world are working hard to learn more about this variant of concern, he added. And from what we’ve seen in recent reports, the mAB Sotrovimab has been effective against Omicron in lab tests, but Regeneron may not be. And the effects of the Lilly monoclonal mAB on Omicron are still being studied.
Have a question for an SMH expert?
Get answers from the medical experts you trust. Email it to askanexpert@smh.com.
Sarasota Memorial’s blog posts, newsletters and podcasts are published for informational purposes only. Always talk to your doctor about concerns related to your personal health.
Sarasota Memorial Senior Digital Communications Specialist Ann Key manages the health system's Healthe-Matters blog and newsletter, as well as its social media and other wellness content channels. Have a health question or a wellness topic you'd like a local expert to weigh in on, let her know: Send an email to AskAnExpert@smh.com.