• Prioritize administration of anti-SARS-CoV-2 monoclonal antibodies in accordance with available NIH guidance when there are logistical constraints, including the current lack of supply.
• The following guidelines summarize available NIH prioritization guidance and outlines characteristics associated with higher risk of progressing to severe COVID-19 disease:
  • Prioritize the treatment of COVID-19 over post-exposure prophylaxis of SARS-CoV-2 infection while these therapies are in short supply.
    
  • Among fully vaccinated COVID-19 cases, limit use to those who are > 70 years* of age OR who are moderately-to-severely immunosuppressed.
    
  • Among partially or unimmunized COVID-19 cases, prioritize administration to the following groups:
    • Older age (e.g., > 65 years)
      
    • Obesity (BMI > 35* kg/m2, or if age 12-17, BMI ≥85th percentile)
      
    • Pregnancy
      
    • Chronic kidney disease
      
    • Diabetes
      
    • Immunosuppression
      
    • Cardiovascular disease
      
    • Hypertension
      
    • Chronic lung diseases
      
    • Sickle cell disease
      
    • Neurodevelopmental disorders
      
    • Complex genetic or metabolic syndromes
      
    • Severe congenital anomalies
    • Medical-related technological dependence
  • Administration within < 7 days* of onset offers the greatest yield in preventing severe disease.

*In consultation with local medical leadership, these three asterisked and italicized criteria were added to or modified NIH guidance to further optimize allocation of this currently scarce resource.