“Our recommendation to monoclonal antibody providers or individual facilities across the state is if they need to prioritize distribution of the treatment, the NIH guidelines are the recommended approach for that prioritization, including prioritizing those who are most likely to be hospitalized,” Bill Christian, a spokesman for the Tennessee Department of Health, told The Epoch Times via email.
“Ultimately, this comes down to providers’ clinical judgment to ensure those most at risk are receiving this treatment,” he added.
The COVID-19 Treatment Guidelines Panel, part of the National Institutes of Health (NIH), in early September recommended prioritizing people who are either unvaccinated or partially vaccinated if a shortage of monoclonals cropped up.
Because vaccinated people are less likely to require hospitalization after getting COVID-19, healthcare providers should consider prioritizing unvaccinated or partially vaccinated people who are at high risk of getting severe cases of the disease, Meredith Chuk, a Department of Health and Human Services (HHS) official, told state officials in a call last week. Another population that should be prioritized over individuals predicted to have an “adequate immune response” is those who are vaccinated but have weak immune systems.
Additionally, providers should make sure to prioritize using monoclonal antibodies to treat COVID-19 over using them on people who have been exposed to the disease but who have not yet tested positive for it.
“This is in the hands of the provider but NIH provides some considerations when there are logistical constraints,” Chuk said.
The federal government recently seized distribution of the treatments, which experts say are highly effective at keeping people out of hospitals if given soon after a COVID-19 diagnosis or exposure. State and federal officials have said the seizure resulted from concerns about supply. HHS is now strictly controlling how many doses each state gets in weekly shipments. The doses are administered under emergency use authorization (EUA).
The crunch has already led to some states not having enough doses to serve everybody who wants one, with others projecting a possible shortfall. That triggered the new recommendation in Tennessee.
“The EUA is only for people with these conditions, and that’s been the same since day one,” Tennessee Health Commissioner Dr. Lisa Piercey told The Tennessean. “The new thing is the NIH criteria of, well, even if you have those conditions, but you’re vaccinated, you don’t get it now.”
Many of those seeking monoclonal treatments are fully vaccinated, according to data from Florida.
Providers across Tennessee are still receiving doses, Christian said, adding that the federal government has not yet given an update on allocation this week.
Similar guidance was offered in Orange County, California, late last week. Dr. Regina Chinsio-Kwong, the county’s deputy health officer, advised providers to follow the NIH guidance.
No other counties or states appear to have issued similar recommendations, even though officials across the country confirmed to The Epoch Times they expect to have more demand than doses available in the coming weeks.
In Alabama, where at least one site ran out of the treatment last week, health officials are advising providers to prioritize patients “based on their risk of progression to severe COVID-19 disease,” Nancy Bishop, the state’s pharmacy director, told The Epoch Times in an email.
Kentucky Gov. Andy Beshear, speaking to a press conference on Monday, said sites would request a certain number of doses by the end of Monday each week and state officials would see how many doses they receive from the federal government before deciding on how many to send where.
“What that means is we will meet the legislative intent of having at least one provider in each of the area development districts,” he said. “But there’s not going to be enough anywhere—anywhere. There’s going to be too few everywhere, and we’re already seeing hospitals and other providers run out before the end of each week.”
Officials in Kentucky, Alabama, and other states are encouraging people to get vaccinated amid the shortage.