Immunocompromised patients and COVID-19: Pre-exposure prophylaxis, testing, and treatment resources for King County healthcare providers
Health advisory
April 13, 2022
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- Be aware of treatment options including monoclonal antibodies (Mab), as well as oral antivirals. Make a plan with your moderately or severely immunocompromised patients including where they can be promptly tested, evaluated for, and access treatment in the event they become infected and are eligible.
- This NIH page provides up-to-date treatment recommendations: Clinical Management | COVID-19 Treatment Guidelines
- This WA DOH page also provides clinical information and guidance: Therapeutics Information for Health Care Providers
- This page details how providers and institutions can obtain access to MAb and oral antiviral therapeutics: Overview of WA State Order Process for COVID-19 Therapeutics
- This page can guide you to organizations that currently have access to MAb and oral antiviral therapeutics: COVID-19 Therapeutics Locator
- This NIH page provides up-to-date treatment recommendations: Clinical Management | COVID-19 Treatment Guidelines
- Be aware of pre-exposure prophylaxis resources and recommendations for moderately or severely immunocompromised patients
- Tixagevimab plus cilgavimab (Evusheld) is currently the only product authorized for PrEP
- Further information can be found on the WA DOH therapeutics web page as well as through NIH and IDSA:
- The following page details how providers and institutions can obtain access to monoclonal antibody (MAb) and oral antiviral therapeutics (molnupiravir & ritonovir- boosted nirmatrelvir [Paxlovid]) and Tixagevimab plus cilgavimab (Evusheld) PrEP Overview of WA State Order Process for COVID-19 Therapeutics
- This page can guide you to organizations that currently have access to MAb, including Tixagevimab plus cilgavimab (Evusheld), and oral antiviral therapeutics nationally and locally: COVID-19 Therapeutics Locator
- If your organization does not have the capacity to administer Evusheld, providers can submit referral orders to Birds Eye Medical, a company contracted by WA DOH for mAb assistance free-of-charge, by faxing a copy of this form to (360) 878-8330. You can also refer patients directly to the Birds Eye Medical website or to call (360) 688-7044, where they can schedule a Evusheld telehealth evaluation appointment and get scheduled for the soonest nearby Evusheld clinic, as available.
- Tixagevimab plus cilgavimab (Evusheld) is currently the only product authorized for PrEP
- Be aware that post-exposure prophylaxis is not currently recommended as all products authorized for this use are not effective against the predominant Omicron variant.
- Be aware of testing locations and resources in King County
- Prompt testing after exposure or development of symptoms is important to ensure eligibility for available treatments.
- COVID-19 testing locations and guidance - King County
- Increasing Community Access to Testing (ICATT) for COVID-19
- There are also State and Federal programs for individuals to order home based over-the-counter antigen tests for free so they can have them on hand after exposures or new symptoms arise:
- Federal - COVIDtests.gov
- State - Say Yes! COVID TEST
- Federal - COVIDtests.gov
- Be aware of locations within King County that can provide testing and rapid treatment with oral antiviral medications through the federal Test to Treat Program
- This page can help you and patients locate participating Test To Treat locations: COVID-19 Test to Treat Locator
- Prompt testing after exposure or development of symptoms is important to ensure eligibility for available treatments.
Moderately or severely Immunocompromised patients are at increased risk for severe disease, hospitalization, and death from COVID-19. Many conditions and treatments can cause a person to be immunocompromised including immunosuppressive medications for cancer or autoimmune disease, solid organ or bone marrow transplants, and infections like HIV. It is very important for immunocompromised patients to continue to use layered COVID-19 prevention measures including staying up to date with vaccinations (including extra dose of primary series and boosters when eligible), pre-exposure prophylaxis (PrEP), masking with high-quality masks (e.g., N95, KN95, KF94), avoiding crowded indoor settings, social distancing, and testing when appropriate after exposure or when symptomatic.
Given that moderately or severely immunocompromised patients have increased risk for severe disease, hospitalization, and death with COVID-19 infection, even when up to date with vaccination recommendations, it is important for healthcare providers to be aware of resources for vaccination, PrEP, testing, and treatment so these patients can rapidly access these lifesaving interventions.