Tuesday, April 23, 2024

Getting the Evusheld Vaccine as an immune-suppressed patient

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Story by Will Chappell

I’ve got a full decade of dealing with the medical system under my belt, I work in the media, I’m highly technologically literate— yet getting Evusheld was still a stressful, slow and somewhat difficult process.

The United States Food and Drug Administration issued an emergency use order for Evusheld on Feb. 2, 2022.

Evusheld is a monoclonal antibody shot developed by AstraZeneca and designed to offer prophylactic protection against Covid-19 to immune-suppressed and compromised patients for a six-month period.

Being immune-suppressed myself, I began following the drug’s rollout and watching to see when it would become available to me.

In early March, I saw on the government’s website that Vanderbilt, where I receive my care, had received several hundred doses of the treatment. I reached out to my transplant nephrologist to inquire about the possibility of getting a shot.

She responded saying she had put the order in and that the allocation of shots was being handled by the Infectious Disease department at the medical center. This meant she couldn’t tell me when I would be eligible for the shot, but she believed it should be soon. 

That week, I started seeing increased media coverage about the difficulty of finding doses, unreliable federal databases and even the pending funding shortfall threatening the continued supply of the drug.

I began to get nervous about my prospects of getting the shot and decided to be as proactive as possible in my quest for it. But this would prove easier said than done.

Unlike the vaccines, Evusheld requires an order from a doctor as well as administration at an infusion clinic. This meant that instead of being able to call around to different pharmacies and distribution centers to try to find a dose, I would need the assistance of my doctor to get a shot from Vanderbilt, the only distributor in town.

So, after giving the system some time, I messaged my nephrologist again at the beginning of last week to see if there had been any update.

Her nurse responded that Vanderbilt did not have any immediate plans to open up Evusheld doses to transplant patients, and now they didn’t have any doses.

I was taken aback. Online, the government’s website said that Vanderbilt had received several hundred doses that week, and I saw no possible reason for the about-face in offering them to transplant patients who clearly need them.

I responded that online it appeared they had doses, but if that wasn’t the case, what help would they be able to offer me in getting the treatment on my own.

This time, my nephrologist responded and was much more helpful. I told her I would be willing to travel interstate to get the shot, if necessary, and she said that she would begin asking colleagues in other places if they had access to the treatment. She also said that she would message the infectious disease clinic to see if they had any further updates on transplant patients’ eligibility.

The next day, I received an excited call from my nephrologist. She said that after messaging the infectious disease department the previous afternoon, they had said that transplant patients were still ineligible.

But the next morning, they had sent out a memo updating Vanderbilt’s Evusheld protocols, opening the shot up to transplant patients.

I was relieved to hear this and, with the help of my nephrologist, got an appointment scheduled and received the two shots of Evusheld on Tuesday. 

The treatment is effective immediately, and after more than two years, I can finally start seeing friends indoors and venturing out into public again.

I’m incredibly grateful to my nephrologist for following up on my behalf, and glad to be protected but at the same time my experience getting the shot leaves me worried.

It feels like most Americans have chosen to move past the pandemic in the past several months. Mask mandates have been lifted in liberal states and sporting venues, restaurants and bars are full.

On the one hand, I understand. After two years of stress and lifestyle modifications, it’s natural for people to be tired of altering their lives. The vaccinated face a low probability of serious infection, and the unvaccinated never cared about such risks. Most people can safely return to something resembling life as normal with little risk, making it hard to ask them not to do so.

On the other hand, this pandemic is not over and no amount of “covid fatigue” or wishful thinking will change that. Around a thousand Americans are still dying every day from this disease, and though Omicron’s wave has crashed and receded, new variants will inevitably come.

With all of that in mind, I’m not asking for people to return to lockdowns or refrain from social gatherings, but I would like to ask that in the process of moving forward, the higher risk not be left behind.

I’ve got a full decade of dealing with the medical system under my belt, I work in the media, I’m highly technologically literate— yet getting Evusheld was still a stressful, slow and somewhat difficult process.

Other immune-compromised or suppressed patients with less technological sophistication or who are dealing with more severe ongoing medical issues should have an easier time getting the treatment than I did.

I understand that the drug protocols for Evusheld are necessarily more complicated than they were for vaccines but increasing the available supply and ensuring its continued availability should be the top priority.

If a patient wants Evusheld, it should be available to them.

Further, if there is any practical way to have the drug administered in doctor’s offices to patients and remove the referral process, that would be ideal. I’m not a doctor and want the drug to be administered safely, but the treatment consisted of two shots administered by a nurse who then monitored me for an hour. If there’s a way that shot administration could be achieved at a regularly scheduled doctor’s visit, that would be ideal.

After two years of isolation, I can finally start doing some more normal activities again. I’m looking forward to bowling, visiting the Tennessee State History Museum and maybe even going to a baseball game this summer.

But that freedom comes with a six-month expiration date, and I’ll need another course to ensure protection in the fall.

I hope I will be able to get the shot again, avoid a return to isolation and that the Biden administration will find a way to facilitate an easier distribution of this life-changing drug to those who need it. 

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