After Maggie McHugh got vaccinated against COVID-19, she was tested for antibodies to the coronavirus. She, like many others who have weakened immune systems, found she barely had any.
“It was a very depressing time,” the Garden City woman said. “It was like the whole world was going forward and I was left behind. I was kind of stuck in this pre-vaccine life.”
What to know
The federal government recently authorized a two-injection antibody treatment called Evusheld for people with weakened immune systems, for whom the COVID-19 vaccine may not be effective.
Those eligible for the treatment include people receiving chemotherapy and with blood cancers such as leukemia and lymphoma, organ transplant recipients, and people with autoimmune diseases.
The federal government has distributed about half-a-million of the 1.2 million Evusheld treatments it purchased.
Last month, McHugh, 41, received injections of Evusheld, a drug to reduce the risk of COVID-19 infection in immunocompromised people that the Food and Drug Administration authorized in December. Clinical trials showed that the two-injection treatment, manufactured by U.K.-based AstraZeneca, reduces the risk of developing COVID-19 by 77%, and that it’s effective for six months.
Evusheld is the only FDA-authorized treatment of its kind.
“I was beyond excited,” McHugh said. “To think that I could be finally be rid of the fear I’ve been hanging onto for two years meant so much to me.”
McHugh, who has rheumatoid arthritis, is one of about 7 million U.S. adults who are immunocompromised, because of disease, medications or both, according to the Centers for Disease Control and Prevention.
Vaccines are less likely to be effective in people with weakened immune systems, who represent a large share of vaccinated people who have been hospitalized with COVID-19, according to the CDC.
Evusheld is designed “to give people the antibodies that they cannot make themselves,” said Dr. Jeffrey Schneider, chief of hematology and medical oncology at Perlmutter Cancer Center at NYU Langone Hospital-Long Island in Mineola.
The FDA authorized Evusheld only for immunocompromised people and for the small number of people with a severe adverse reaction to the vaccine.
“The vaccine is clearly better than this,” Schneider said. “We want this for people who don’t respond to the vaccine.”
An Evusheld treatment is two consecutive injections of monoclonal antibodies, which are laboratory-created proteins designed to block the ability of the coronavirus to attach to human cells. Monoclonal antibodies sometimes are administered after infection with COVID-19, to reduce severity, but Evusheld, given to prevent infection, is designed to be longer-lasting.
The U.S. government has been distributing about 50,000 to 75,000 free Evusheld treatments each week since late December, with the total expected to reach about half a million by Sunday, according to the U.S. Department of Health and Human Services.
The department and AstraZeneca did not respond to requests for a timetable on future distributions. The government bought 1.2 million treatments of Evusheld.
Initially, as distribution was still ramping up, demand exceeded supply. New Hyde Park-based Northwell Health prioritized those most likely to be severely immunocompromised — including organ transplant recipients, people with autoimmune diseases such as lupus and rheumatoid arthritis, and patients with leukemia, lymphoma and other blood cancers.
But as the number of COVID-19 cases has declined in New York, so has demand for Evusheld, and Northwell several days ago opened the drug up to cancer patients receiving chemotherapy, said Dr. Richard Barakat, physician in chief for the Northwell Health Cancer Institute.
Barakat said most patients on chemotherapy who have been approached about receiving the treatment have declined, even though he and other doctors recommend it because chemotherapy weakens the immune system.
“I would think it’s a bit of vaccine fatigue,” he said. “It’s like, ‘I already had my vaccine, I already had my booster. I don’t want to take more.’ “
In the NYU Langone Health system, eligibility is still restricted to the highest risk patients, with plans to broaden access as new Evusheld shipments arrive, Schneider said.
Ilene Rothschild, 67, of East Meadow, has lymphoma, a cancer of a part of the immune system, and she was on chemotherapy when she received her vaccine booster shot in August.
About three months after her booster, “They told me I had virtually no antibodies, which was really disappointing,” she said.
She saw her vaccinated friends begin to go out more, but she declined their invitations to join them.
“I just stayed in the house,” Rothschild said. “It’s kind of jealousy: Why is it protecting you and it’s not protecting me?”
Shortly after receiving her Evusheld injections, she traveled to Maryland to spend five days babysitting her son’s two children, unmasked. Previous visits were outdoors.
“I was much more calm this time, and it was because of the Evusheld,” she said. “It was a peace of mind.”
Still, because of her weakened immune system, Rothschild remains at higher risk for severe COVID-19 and is “still a little nervous.” She and her husband won’t eat indoors at restaurants, and she won’t go shopping.
McHugh also remains cautious. But she, her husband and their three children recently went out to eat for the first time since the pandemic began.
“It felt like the best thing in the world,” McHugh said. “And it was just burgers and fries at our local spot in Garden City. I just felt like a quote-unquote normal person.”
Pre-Evusheld, “We were very sheltered,” she said, although her husband traveled for work and her kids were in school. Even a trip to the beach “was a very stressful activity,” with masks on and sitting as far as possible away from others, she said.
McHugh contracted COVID-19 twice, and the first time “caused a massive rheumatoid flare-up.” She was sick for a month and a half, enduring severe pain and fatigue and a reversal of the improvement in her rheumatoid arthritis.
With Evusheld, she has less fear of another bout of severe illness, enough so that she is traveling to California to visit her sister and, for the first time, her sister’s baby.
“I booked a flight the other day to go out there and see her,” McHugh said. “That means so much.”
David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.
