Covid Pill Is Coming, But It Will Not Replace Vaccine, Experts Say

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Antiviral pills from MSD (known as Merck in the United States and Canada) and Pfizer laboratories have been proven to be an important block to the worst consequences of Covid-19 when taken in the early stages of the disease. But doctors warn people who hesitate to get vaccinated not to confuse the benefits of treatments with the prevention provided by immunizers.

Although 72% of adult Americans have already received the first dose of the vaccine, according to a survey by the Kaiser Family Foundation, the rate of application has slowed because political partisanship in the US divides opinions about the value and safety of vaccines against the coronavirus.

The mandatory vaccination imposed by companies, states and the federal government helped to increase the number of immunizations, but also caused controversy.

Some disease experts fear that the arrival of oral treatments for Covid-19 will jeopardize new vaccination campaigns. Preliminary results from a survey of 3,000 US citizens by the City University of New York University’s School of Public Health suggest that the drugs may “hinder the effort to vaccinate people,” said Scott Ratzan, an expert in health communication at the institution, who led the survey.

Ratzan said one in eight respondents said they would rather be treated with a pill than vaccinated. “It’s a high number,” he said.

The concern follows news released on Friday by Pfizer, maker of one of the leading Covid-19 vaccines, that its experimental antiviral pill Paxlovid reduces by 89% the risk of hospitalization and death from the disease in adults of high risk.

Pfizer’s results followed news from MSD and its partner Ridgeback Biotherapeutics on Oct. 1 that its antiviral drug has cut hospital admissions and deaths in half. This drug, called molnupiravir, received conditional approval in the UK on Thursday (4). Both need authorization from US health agencies to be marketed from December.

“Counting on an antiviral drug exclusively is a bit of a game of dice in terms of how you’re going to fare. Clearly, it’s better than nothing, but it’s a pretty high stake,” said Dr. Peter Hotez, vaccine expert and professor of molecular virology and microbiology at Baylor College of Medicine.

Six infectious disease experts interviewed by Reuters were equally enthusiastic about the prospect of effective new treatments for Covid-19 and agreed that there are no substitutes for vaccines.

Even in the face of the highly transmissible delta variant of the virus, Pfizer-BioNTech vaccines remain effective, cutting the risk of hospitalization by 86.8% combined, according to a study done by the US government.

They said some unvaccinated people have already used monoclonal antibodies — drugs that need to be given intravenously — as a barrier if they become infected.

“I think the news from Pfizer is wonderful. It goes hand in hand with vaccination. It doesn’t replace it,” said Dr. Leana Wen, emergency physician and professor of public health at George Washington University and former health commissioner for Baltimore .

Deciding not to get vaccinated “would be a tragic mistake,” said Albert Bourla, chief executive of Pfizer. “These are treatments … for the unfortunate who get sick,” Bourla told Reuters in an interview on Friday. “There should be no reason not to protect yourself and put yourself, your family and society at risk.”

antiviral challenges

One of the main reasons for not trusting the new pills, experts say, is that antiviral medications, which prevent the virus from replicating in the human body, must be given early in the disease because Covid-19 has different phases.

In the first stage, the virus quickly replicates in the body. Many of Covid-19’s worst effects, however, occur in the second phase, arising from a deficient immune reaction that is triggered by the replicating virus, said Dr. Celine Gounder, an infectious disease specialist and founder of Just Human Productions, a non-profit multimedia organization profitable.

“When you have shortness of breath or other symptoms that would cause you to be hospitalized, you’re in that dysfunctional immune phase where antivirals aren’t really going to help much,” she said.

Hotez agreed. He said getting treated early can be difficult because the window for the transition of the virus from the replication phase to the inflammatory phase is fluid.

“For some people, it happens sooner; for others, it happens later,” said Hotez.

He said many people in the early stages of the disease feel surprisingly well and may not notice that their oxygen levels are dropping, one of the first signs that the inflammatory phase of the disease has started.

“Often you won’t realize you’re getting sick until it’s too late,” he said.

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