Transplant Australia has urged all transplant recipients across Australia to speak to their transplant unit about two new COVID treatment options to improve their level of protection against COVID infection and its effects.
The first is called EVUSHELD and is a combination of two antibodies that are injected separately into each buttock muscle on one occasion. Recent data has shown it is effective for at least six months. It reduces your risk of becoming infected with COVID and is not an alternative to full immunisation. Its greatest value is likely to be to for transplant recipients who have not mounted a good antibody response to vaccination against COVID. This probably applies to about 30% of transplant recipients. Over the last week we have been in contact with the larger transplant units throughout Australia. There are no accurate numbers, but the consensus is that at least 40% of transplant recipients in Australia have been infected with COVID since March 2020. The mortality has been remarkably low and mainly in the unvaccinated or incompletely vaccinated transplant recipients
EVUSHELD has been available in Australia for several months. It is suitable for a wide range of immunosuppressed patients that include transplant recipients. It is not new and many of you will have already been offered the antibody injections at your transplant unit. Initial supplies were limited it was initially used with caution following differing individual State based guidelines. Recent and waiting-list lung and heart transplant recipients were prioritised for good reason along with any new recipients of other organ transplants.
Much has changed over the last week because of the realisation that that use of EVUSHELD is an important hospitalisation avoidance strategy. Recent data in transplant recipients has been encouraging and previous challenges with supply and State guidelines are now being revised to ensure that all transplant recipients can gain access to EVUSHELD if they want it and your transplant clinician agrees.
The suggestion from Transplant Australia is that you speak to your transplant unit. Many are now providing EVUSHELD antibody injections in regular clinics on a booking basis. It may soon be available from GPs. Several transplant units may opt to undertake a blood test to measure your antibody response to full immunisation against COVID before prescribing EVUSHELD.
EVUSHELD does not replace the need to continue to be vigilant by wearing face-masks indoors and crowded outdoor settings. EVUSHELD is an extra layer of protection above and beyond full immunisation and may give you more confidence to go about your daily lives. Transplant Australia is very mindful of the impact this extended pandemic is having on everyone’s mental well-being.
The second important and very effective treatment option is for those who just acquired COVID infection. MOLNUPIRAViR (= Lagevrio) is a combination oral anti-viral therapy best administered within five days of infection. The sooner, the better. Access is easy and can be prescribed by a GP. Essential is a positive PCR. If you have a positive rapid antigen test (RAT), follow it up immediately with a formal PCR test.
Transplant has asked recipients who are having trouble accessing EVUSHELD to let them know by emailing contactus@transplant.org.au
Chris Thomas Richard Allen
CEO Medical Director
Transplant Australia
Please note that currently access to Evusheld is still quite restricted in some states. I received this information from my renal unit in South Australia today (12/09/2022).
“EVUSHELD remains a medication under the authority of the National Stockpile. As such, each state jurisdiction makes determinations in relation to which patient group are able to access this medication.
SA Health access criteria for kidney (solid organ) transplant recipients currently remain restricted to those who;
have received a kidney transplant within the past 12 months (Tier 1)
are more than 12 months post receiving a kidney transplant AND who are aged over 70 years (Tier 2)”
Unfortunately each state has different eligibility rules to access Evusheld so that’s why its important to talk with TX doctor.