UPMC receives limited supply of preventative antibody treatment for the most immunocompromised

George Spine Jr. thought it was a scam when he first got a call from UPMC around 7:45 a.m. Thursday offering a new antibody treatment meant to protect the most immunocompromised before they’re exposed to covid-19.

“I thought it was a scam, so I gave the girl a hard time,” he said.

Spine, 87, was among some of the first to receive AstraZeneca’s nearly approved Evusheld, the only monoclonal antibody product currently available that acts as a pre-exposure prophylactic.

Health care giant UPMC received about 456 doses of the two-shot preventative treatment at its Pennsylvania facilities – about a quarter of Pennsylvania’s allotment from the federal government.

It received an emergency use authorization from the Food & Drug Administration in early December, but shipments just arrived this week, UPMC officials said. EvuSheld is intended for the most immunocompromised patients who, because of underlying conditions or other medical reasons, will likely not mount a robust immune response against covid-19 even with the vaccination and a booster.

Those eligible include anyone 12 or older who weighs at least 88 pounds and is moderately or severely immunocompromised. It consists of two shots, one in the muscle of each arm. It essentially gives an individual antibodies that their immune system could not create on its own.

Spine, of Robinson, met those criteria. He said he feels safer having the preventative layer of protection.

“I have chronic lymphocytic leukemia, congestive heart failure, I can’t see out of my right eye – I thought it was a good deal,” he said. “I’m 87, maybe I’ll live to 88.”

Access to the product is limited, said Dr. Donald Yealy, UPMC’s chief medical officer.

“Not everyone who meets the criteria will get it,” he said. “We urge all eligible patients who are contacted with an invitation to get that injection now to help protect yourself from covid-19.”

The health care system has put a weighted lottery system in to place in order to equitably distribute the injections.

“What we know from experience and our ethical principles … is first come, first served is not ethical,” said Dr. Erin McCreary, a UPMC infectious disease pharmacist.

She said experience shows that those most able and willing to access health care resources are those who are also most likely to go to a health care provider first.

“That disadvantages your patients who are less likely to access health care, which could be your sickest of the sick from our more disadvantaged communities,” McCreary said, noting that it has been shown that covid-19 disproportionately affects people in minority and disadvantaged communities.

“The only way to this right is to put all of those patients in a lottery and have certain weights for patients that are disproportionately affected by disease in order to structurally account for that,” she explained.

From there, a random number generator lottery is used to determine which patients will be allocated the drug.

Peggy Stern, who lives near McKeesport, was another patient who received an early-morning phone call from UPMC offering the injections.

“I read up on all the information and it sounded like it would be very beneficial to me,” she said.

She said she called her oncologist, and he agreed with her assessment. She also called her primary care physician and said her doctor agreed, too.

“I feel very fortunate this was offered to me,” she said. “I’ll be glad when it’s available for more people. If it works out, that will be great – a miracle.”

Megan Guza is a Tribune-Review staff writer. You can contact Megan at 412-380-8519, [email protected] or via Twitter .

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