Credit: (AP Photo/Ted S. Warren)

In the United Kingdom, immunocompromised people are taking to social media to urge the government to buy more Evusheld, a potentially lifesaving therapy that can protect at-risk individuals from COVID-19 when vaccinations don’t do the trick.

But in the United States — especially in New Jersey  — Evusheld is available and while some advocacy groups have raised concerns about access issues, supply appears to be meeting demand. The two-drug cocktail is available for a wide range of immunocompromised individuals, including those receiving certain types of chemotherapy or other cancer treatments, organ transplant patients and people with uncontrolled or untreated HIV/AIDS. Evusheld, while not a vaccine, helps protects those people from getting the coronavirus or getting very sick if they are infected with COVID-19.

Since federal regulators authorized the use of Evusheld on an emergency basis in December, New Jersey has received nearly 41,000 courses of the medication — including a September allocation of close to 5,200 courses, according to the state health department. About 8,600 courses have been administered, officials said, and with two shots required per person, that means 4,300 New Jerseyans are better protected against the impact of COVID-19.

“Evusheld is distributed to providers including through several specialty pharmacies that service long-term care facilities. Consumer and provider education about therapeutics continues to be a priority,” Nancy Kearney, a spokeswoman for the health department, said. “The department continues to onboard new providers to the therapeutics program and has reached out to long-term care facilities to communicate the benefits of Evusheld for their residents.”

New Jersey hospitals are also providing the therapy, which was created to protect those whose immune systems did not mount an effective response to COVID-19 vaccines and are therefore less protected against infection, sickness and death. RWJBarnabas Health, one of New Jersey’s largest hospital systems, had administered 1,380 doses of Evusheld and continues to provide this therapy to those who request it, according to a spokesperson.

Location, location, location

According to the federal government’s COVID-19 therapeutic locator tool, Evusheld is available at hospitals, community clinics and doctors’ offices in all but three New Jersey counties (Salem, Sussex and Warren.) In Gloucester County, the treatment can be found at just one site — Inspira Medical Center in Mullica Hill — while all other counties list two or more locations and Essex County has nearly a dozen.

Although the findings are still limited, drugmaker AstraZeneca Pharmaceuticals said recent trials showed Evusheld lowered the risk of symptomatic COVID-19 by 83% over six months, when compared to a placebo. The company has increased the dosing to better protect against new coronavirus variants. New federal guidelines released in August recommend patients repeat the two-shot treatment course after six months. The cocktail is available to adults and kids over age 12.

“Vaccination remains the most effective way to prevent SARS-CoV-2 infection and should be considered the first line of prevention,” the National Institutes of Health notes in its COVID-19 treatment guidelines. “However, some individuals cannot or may not mount an adequate protective response to COVID-19 vaccines. Others may not have been fully vaccinated because they have a history of severe adverse reactions to a COVID-19 vaccine or its components.”

For these immunocompromised individuals — between 2% and 3% of the population nationwide and up to 270,000 New Jerseyans — Evusheld may be a key part of living with COVID-19. Dr. Amit “Bobby” Mahajan, a pulmonologist and medical director at Inova Health System and the national spokesperson for the American Lung Association, said not all of these individuals will need Evusheld, as some may find adequate protection in COVID-19 vaccinations.

Mahajan said easy access to Evusheld was “a real worry” for clinicians at the start, but regulators and physicians have carefully targeted the therapy to those who would get the greatest benefit. “Our cancer docs and our administrators went through all the patients at our cancer center and strategized who needed it most. And luckily, we were getting enough doses that we could meet that need.”

“We have not had any (access) issue in terms of our patients,” Mahajan said. “In the U.S. we have very good access to this drug.”

Exploring alternative therapies

But Mahajan said more work needs to be done to develop additional therapies to protect immunocompromised individuals given the ongoing pandemic, now well into its third year. “They really need to be looked at more, just like we looked at kids (and COVID-19), and we were a little late on that,” he said.

Meanwhile in the U.K., residents in cancer treatment or immunocompromised for other reasons are crying foul after learning that access to Evusheld is ending. A government spokesperson announced in August the nation would no longer purchase the drug cocktail for its National Health System because of concerns about its true efficacy, according to published reports. Advocates said this is unfair, given that it is accessible in Europe, the U.S. and many other nations.