Section 5: Vaccines, Treatments, and Testing



Vaccines, Treatments, and Testing

treatments

Treatments

To stay updated on the latest treatments, please visit Combat Covid, a a one-stop resource created by the US Department of Health and Human Services (HHS) to help win the fight against COVID-19. Combat COVID has the latest on COVID-19 news, vaccines, treatments, and research. The following information is taken largely from this website.

COVID-19 Treatment Overview

In general, most treatments for COVID-19 largely include antiviral medications and monoclonal antibodies. Antiviral medications work by stopping the virus from multiplying in the body. Monoclonal antibodies work by stopping the virus from spreading in the body. One medication consisting of two monoclonal antibodies, Evusheld (tixagevimab co-packaged with cilgavimab and administered together), is used for the prevention of COVID-19 in certain high-risk adults and pediatric individuals (12 years of age and older) who have not been exposed to COVID-19.

Since COVID-19 is a new virus, treatments need to be studied and tested before they can be recommended. As certain treatments – such as antiviral medications and monoclonal antibodies – show effectiveness in clinical trials, these may receive “Emergency Use Authorization,” or an “EUA” from the United States Food and Drug Administration (FDA). This allows a new, urgently needed medication to be prescribed prior to its official approval, which requires more time. As more studies are completed, an effective medication, whose benefits outweigh the risks, may advance from having an EUA to receiving full approval from the FDA.

Since the start of COVID-19, several antiviral medications and monoclonal antibody treatments have been considered, many of which have been granted an EUA. Over time, some have been fully approved, some remain under an EUA, while others are no longer found to be effective. Particularly due to the Omicron and other variants, some of the treatments that were initially effective, are not effective against these variants, and their use has been greatly limited. All of those that continue to be prescribed have specifications in terms of age, degree of symptoms, comorbidities, and whether or not an individual has been hospitalized.

Other treatments are also available. COVID-19 convalescent plasma may provide more antibodies to help fight the virus and reduce inflammation, although more studies are needed to confirm its efficacy. It received an EUA in August 2020, and since that time, several guidance updates have been issued. Baricitinib, with the brand name of Olumiant®, is a rheumatoid arthritis medication that reduces inflammation through an immune response. Corticosteroids are another type of medication that may be used to help reduce inflammation through an immune response.

Specific COVID-19 Treatments

According to Combat Covid, a COVID-19 resource created by the US Department of Health and Human Services (HHS), the following medications are currently prescribed for individuals either at home or in the hospital. (Listing current as of June 2022.)

WHEN AT HOME WITH COVID-19

Symptoms for 5 days or less

  • Paxlovid (nirmatrelvir tablets; ritonavir tablets) is an antiviral medication taken orally to treat mild to moderate symptoms of COVID-19. It must be given within 5 days after the first symptoms of COVID-19 appear and is for adults and children who are 12 years of age and older.
  • Lagevrio (molnupiravir) is an antiviral medication taken orally to treat mild to moderate symptoms of COVID-19. It must be given within 5 days after the first symptoms of COVID-19 appear and is for adults 18 years and older.

Symptoms for 7 days or less

  • Bebtelovimab is a monoclonal antibody for adults and children 12 years or older who have tested positive for COVID-19, have mild to moderate symptoms, are not in the hospital, and are at high risk for serious COVID-19. Bebtelovimab must be given within 7 days after the first symptoms of COVID-19 appear.
  • Veklury® (remdesivir) is an antiviral treatment for people staying in the hospital as well as for people who are not in the hospital. Individuals who are not in the hospital must go to an IV infusion center to receive this treatment. Veklury must be given within 7 days after the first symptoms of COVID-19 appear.

WHEN IN THE HOSPITAL WITH COVID-19

  • COVID-19 convalescent plasma is blood plasma taken from people who have recovered from COVID-19. It contains antibodies that treat SARS-CoV-2, the virus that causes COVID-19; it also contains other components that may improve a person’s immune response to the virus. Convalescent plasma is for people staying in the hospital who have a weakened immune systems or are receiving treatment that may weaken their immune system.
  • Olumiant® (baricitinib) is an FDA-approved treatment of COVID-19 in hospitalized adults requiring supplemental oxygen, non-invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO). Through an EUA, children ages 2 to 18 with the same requirements noted above may also be given this medication.
  • Actemra® (tolcilizumab) is a monoclonal antibody treatment for adults and children (2 years of age and older) who are receiving corticosteroids and who require supplemental oxygen, a ventilator, or ECMO. Actemra may decrease the risk of death for people in the hospital with COVID-19.
  • Veklury® (remdesivir) is an antiviral treatment for people staying in the hospital as well as for people who are not in the hospital. Veklury must be given within 7 days after the first symptoms of COVID-19 appear.

Over the Counter (OTC) Symptom Management

Health officials recommend over-the-counter medicine such as acetaminophen (Tylenol®) to treat fever. As always, consult your healthcare provider if you feel sick.

vaccines

Vaccines

Given the serious nature and risks associated with COVID-19, MSAA, along with all of the MS organizations within the MS Coalition, support the MS community getting the COVID-19 vaccine in coordination with one’s healthcare provider.

The Centers for Disease Control and Prevention (CDC) has created a tool to provide the latest COVID-19 vaccine information as well as help you to find the closest location to receive a vaccine or booster. For a list of nearby vaccination sites, you may also search vaccines.gov, call (800) 232-0233, or simply text your zip code to 438829.

According to the CDC, the federal government provides COVID-19 vaccines free of charge to everyone living in the United States, regardless of their immigration or health insurance status. This site explains that you cannot be billed in any way for a COVID-19 vaccine or booster, and warns individuals to beware of scams.

The CDC also offers helpful vaccine guidance including: how to prepare for your vaccination, what to expect at your appointment and immediately after, and things such as how to schedule your second dose, or what to do if you’ve lost your vaccine card. Follow CDC guidelines about what you can and cannot safely do once you are fully vaccinated.

Vaccine Background

In December 2020, the Pfizer-BioNTech and Moderna “mRNA” COVID-19 Vaccines were granted Emergency Use Authorization (EUA), each requiring two doses. In February 2021, the Johnson & Johnson (J&J) was the third vaccine granted EUA, but this latter “viral vector” vaccine only required one dose. All three were initially authorized for individuals 18 years of age and older.

Over time, these authorizations were expanded to include an extra dose for certain immunocompromised individuals, as well as booster doses given at specified intervals for everyone receiving the initial vaccinations. The Pfizer-BioNTech vaccine was the first to be authorized for children between the ages of 5 and 17, but as of June 2022, both the Pfizer-BioNTech and Moderna vaccines have received Emergency Use Authorization for children as young as 6 months and up through age 17.

While the number and timing of doses for children as young as 6 months remains at two primary doses with the Moderna vaccine, the Pfizer-BioNTech vaccine has a third dose in the primary series for children ages 6 months through 4 years. The first two doses are given three weeks apart, and the third dose is administered no less than eight weeks following the second initial dose in this youngest age group.

With regard to the J&J vaccine, which is also known as the Janssen COVID-19 Vaccine, the FDA and CDC recommended pausing the use of the J&J vaccine in April 2021, due to a concern that it may cause a rare but severe blood clot disorder. Although the pause on the J&J vaccine was lifted shortly thereafter, in May 2022, the FDA limited the use of the J&J vaccine to individuals 18 years of age and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate.

Vaccine Schedule Overview

(As of June 2022)

Pfizer-BioNTech

  • Recommended for ages 6 months and up
  • Primary Series: 2 doses given 3 weeks (21 days) apart; for ages 6 months through 4 years, a third dose if given after another 8 weeks 
  • When Fully Vaccinated: 2 weeks after 2nd (or 3rd) primary dose
  • Booster Dose(s): Everyone ages 6 months** and older is eligible at least 5 months after the last dose in their primary series. Any of the three COVID-19 vaccines* can be used for the booster dose in those 18 and older; only the Pfizer or Moderna vaccine may be given as a booster in those ages 6 months to 17 years. A second booster may be given to people 50 and older at least 4 months after their first booster.
  • A third primary series dose is allowed for certain immunocompromised adults as well as children ages 6 months and older.

Moderna

  • Recommended for ages 6 months and up
  • Primary Series: 2 doses given 4 weeks (28 days) apart
  • When Fully Vaccinated: 2 weeks after 2nd dose
  • Booster Dose: Everyone ages 6 months** and older is eligible at least 5 months after the last dose in their primary series. Any of the three COVID-19 vaccines* can be used for the booster dose in those 18 and older; only the Moderna or Pfizer vaccine may be given as a booster in those ages 6 months** to 17 years. A second booster may be given to people 50 and older at least 4 months after their first booster.

**Information on boosters for those ages 6 months through four years needs to be confirmed.

Johnson & Johnson’s Janssen*

  • Recommended for age 18 and up
  • Primary Series: 1 dose
  • When Fully Vaccinated: 2 weeks after 1st dose
  • Booster Dose: At least 2 months after the first dose for all people ages 18 years and older. Any of the three COVID-19 vaccines can be used for the booster dose. A second booster may be given to people 50 and older at least 4 months after their first booster, but it must be one of the other two vaccines (Pfizer-BioNTech or Moderna).

*In May 2022, the FDA announced that it has limited the authorized use of the Janssen COVID-19 Vaccine to individuals 18 years of age and older for whom other authorized or approved COVID-19 vaccines are not accessible or clinically appropriate.

For a more detailed vaccine schedule that includes the timing for individuals who are moderately or severely immunocompromised, please visit the COVID-19 Vaccine Immunization Schedule on the CDC’s website.

Testing

Testing

The Centers for Disease Control and Prevention (CDC) provide a COVID-19 testing overview for individuals to learn about the different types of testing available for COVID-19. Basic details and short informational videos are included.

A subsection on the CDC’s website provides information and instructional videos – both in English and Spanish – on the topic of “self-testing.” Also referred to as “at-home testing,” this section gives vital details on what this test is, when to take this test, what to do if you have positive or negative results, and where to get at-home tests.

In general, if you are experiencing symptoms, you should self-test immediately. If you have been exposed to someone who was positive for COVID-19, you should self-test within 5 days, and again in another 1-2 days if the first test was negative.

Individuals with a positive COVID-19 test need to stay home and isolate themselves from others for 5 days. They should notify anyone close to them who may have been exposed, and watch for any severe symptoms, such as trouble breathing, pain in the chest, or confusion. The CDC also recommends that you tell your doctor if you are positive for COVID-19, and contact them immediately if your symptoms worsen, you are an older adult or have other medical conditions, or if you have any questions about your isolation.

Check here for the latest COVID-19 statistics.