What You Need to Know About Monoclonal Antibody Therapeutic Treatment

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UPDATE: As of September 21, 2021, local supply of Monoclonal antibodies is extremely low, and is expected to remain so for two or more weeks. If you are seeking treatment, you will need to go through your health care provider for a referral. Please do not call local treatment providers or go to the emergency department for monoclonal antibody treatment.

Getting vaccinated is the best way to protect yourself and others against COVID-19. We know that people who are fully vaccinated are much less likely to get COVID-19, and that the vaccines continue to prove effective in keeping people from getting seriously sick or dying if they catch the virus.

We also know that COVID-19—and especially the delta variant—are still circulating widely in our community. Local case and hospitalization rates are at the highest that they’ve ever been, with unvaccinated people representing the vast majority of these cases. Breakthrough cases (when someone who is fully vaccinated and contracts COVID-19) are also a reality, and in rare circumstances, fully vaccinated folks are still becoming critically ill with the virus.

Thankfully, for certain high risk individuals who do get COVID-19—regardless of vaccination status—there is some good news available.

What are monoclonal antibodies?

Monoclonal antibodies are laboratory-made proteins that help jumpstart your immune system so you can fight off a COVID-19 infection. They can be given by a shot or an IV infusion. Studies show that the treatments successfully fight the virus and prevent serious illness.

Is Monoclonal Antibody Therapeutic Treatment safe?

To date, the Food and Drug Administration (FDA) has issued Emergency Use Authorization for several monoclonal antibody treatments. The FDA currently recommends the REGEN-COV™ and Sotrovimab monoclonal antibodies for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients who are at high risk for progression to severe COVID-19, including hospitalization or death.

Just like with any medication, the safety and effectiveness of this investigational therapy continues to be evaluated by the FDA for treatment of COVID-19.

Potential side effects of REGEN-COV™ and Sotrovimab include allergic reactions, including anaphylaxis, as well as infusion-related reactions, including pain, bruising of the skin, soreness, swelling, and possible infection at the injection site.

Who should get this treatment and when?

Monoclonal antibody therapies can treat mild to moderate COVID-19 in adults and children 12 and older (must weigh at least 88 lbs.), who are at high risk for developing severe illness. Some fully vaccinated people may even qualify for antibody treatment if they are in a high-risk category.

Regardless of vaccination status, timing is important. Monoclonal antibodies must be given within 10 days of getting symptoms to work best. Once someone is hospitalized or needs oxygen therapy due to COVID-19, they are no longer eligible to receive monoclonal antibody treatments. Check with your doctor right away to decide if this treatment is right for you.

If you were treated for COVID-19 with monoclonal antibodies, you should wait 90 days before getting a COVID-19 vaccine. Talk to your healthcare professional if you are unsure what treatments you received or if you have more questions about getting a COVID-19 vaccine.

Do I still need to get vaccinated if this treatment is available?

Monoclonal antibody therapies are not authorized for pre-exposure prevention of COVID-19. These therapies do not replace vaccination against COVID-19. Getting vaccinated is the best way to prevent against contracting COVID-19 and is recommended by the CDC for everyone 12 years and older.   

How are vaccines and monoclonal therapies different?

A vaccine helps stimulate and prepare your immune system to respond if or when you are exposed to COVID-19. Two weeks following your final dose, your immune system is prepped and ready to create antibodies, even before they are needed.

Monoclonal antibodies boost the immune system after you are already sick with COVID-19. The treatment speeds up your immune response to prevent a person’s symptoms from getting worse. Monoclonal antibodies act as guided missiles that target the virus, but protection doesn’t stick around. While monoclonal antibodies are effective for a short period, COVID-19 vaccines have been proven to still offer significant protection months down the road.

While Monoclonal Antibody Therapeutic Treatment is a great option for people who are already sick with the virus and at an increased risk for complications, vaccination is the easiest and most effective option for keeping people safe.

Is this treatment free?

The federal government provides some monoclonal antibody treatments for free. Depending on insurance coverage, some may need to pay an administration fee. This is to cover the costs of giving the treatment, not for the antibodies. As always, check with your insurance provider to learn more about treatment costs for your specific plan, first. For people with Medicare and Medicaid, the cost of administering the treatment should be covered.

Where can I get Monoclonal Antibody Therapeutic Treatment?

Monoclonal antibody (mAb) therapy is available in Washington state with a provider’s recommendation for certain high risk individuals. People can be at high risk because of many reasons including their age, having an underlying medical condition, and other things. Some of the most common reasons include:

  • Age ≥ 65 years
  • Obesity or being overweight based on Centers for Disease Control and Prevention clinical growth charts
  • Pregnancy
  • Chronic kidney disease
  • Diabetes
  • Immunosuppressive disease or immunosuppressive treatment
  • Heart or circulatory conditions such as heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension)
  • Chronic lung diseases including COPD (chronic obstructive pulmonary disease), asthma (moderate to severe), interstitial lung disease, cystic fibrosis, and pulmonary hypertension
  • Sickle cell disease
  • Neurodevelopmental disorders such as cerebral palsy
  • Having a medical device (for example, tracheostomy, gastrostomy, or positive pressure ventilation [not related to COVID-19])

If you think you might qualify for this treatment, please speak to your healthcare provider first and get a referral before contacting these sites to arrange an appointment. There is limited capacity at certain sites, and it is preferred that individuals contact these facilities over the phone to arrange an appointment time, in order to limit exposure for staff and other patients.

To find a Monoclonal Antibody Therapeutic Treatment location near you, go to: https://bit.ly/3hVhagX.

Taking the Guesswork out of Getting Tested

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Skagit County Public Health has been receiving a lot of calls in recent days from people asking about local COVID-19 testing options. In the past week alone, about 30% of all our incoming calls have been about testing.

Most callers are asking about access and want to know where they can go locally to get tested. In response, we have made sure that our testing options webpage is up-to-date and matches the Washington Department of Health’s list as well.

For a list of local testing options, go to: https://www.skagitcounty.net/Departments/HealthDiseases/coronavirusTESTsites.htm.

For a full list of regional testing locations, go to: https://www.doh.wa.gov/Emergencies/COVID19/TestingforCOVID19/TestingLocations

Many callers are also wondering about the differences between testing locations and the types of tests that they offer. While some locations offer both PCR and Antigen testing, many times a location will provide one or the other. With the recent opening of the Canadian border to fully vaccinated Americans, it is not surprising that so many people are wondering about which type of COVID test they should get.

So, here are some answers that may be helpful as you choose between testing options:

When should I get tested?

If you have had close contact exposure to a COVID-19 case or if you are concerned that you may have been exposed and are not experiencing symptoms, it is recommended that you wait 3 to 5 days after that initial exposure to get a diagnostic test. This wait time is due to the incubation period of the virus, the amount of the virus in your body, and the characteristics of diagnostic tests.

Those experiencing COVID-19 symptoms should get tested as soon as possible. Symptoms may include the following:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

What types of tests are available?

There are essentially two broad categories of testing:

  1. Antigen test (frequently referred to as a rapid test). This test detects protein fragments specific to the Coronavirus. It can be done in at a pharmacy, clinic, doctor’s office, or hospital. Turnaround time for results is usually very quick, and in some cases, results can be reported within 15 minutes.
  1. PCR test (may be referred to as a viral or molecular test). PCR testing is considered the “gold standard” in SARS-CoV-2 detection. This test actually detects RNA (or genetic material) that is specific to the virus and can detect the virus within days of infection, even those who have no symptoms. The test can also be done at a pharmacy, clinic, doctor’s office, or hospital. Turnaround time for results can be longer (generally in the 2-3 day range) since PCR samples are tested in a lab.

What kind of test should I get?

It is always best to talk with your health care provider about which test is best for you.

If you have symptoms, get the quick antigen test if it is available. If it is positive, you can start isolating right away to protect those around you from the spread of the virus. If the antigen test is negative, you should get retested using a PCR test and be sure to isolate yourself until you receive the result.

For most people who do not have symptoms but want to be tested because they may have been exposed or are traveling soon, the PCR test is the better choice. It can find small amounts of the virus that might be seen before symptoms start.

How accurate are these tests?

PCR tests work by detecting genetic material from SARS-CoV-2, the virus that causes COVID-19. The genetic material from SARS-CoV-2 cannot be confused with the genetic material from other viruses, so this kind of test is highly specific. This means it rarely gives a false positive. If you are tested and the test comes back positive, you can be very sure that you are infected with this virus. Antigen tests are also very specific and rarely give a false positive.

Unfortunately, neither test is equally sensitive. If the specimen collection is not done perfectly, or if you are in an early stage of infection or already partially recovered, a sample might not contain enough viral material to come back positive. This is why timing is key for getting a positive test result. If you have been potentially exposed to COVID-19 but are not sick, it is best to get tested at least 5 days after the last potential exposure.

Because false negative results on diagnostic tests can happen, a negative result should not give you a sense of false security. If you have any symptoms of COVID-19, it is safest to assume you are infected and self-quarantine.

What test do I need to travel?

While the most universally accepted COVID-19 test is a molecular PCR test, some destinations may accept antigen tests as well. It is best to check with your destination, airline (etc.) when planning your trip.

If you are not fully vaccinated and must travel domestically or internationally, you will be required to get tested 1-3 days before your trip. Those who are fully vaccinated do not require testing before domestic travel, however most international destinations will still require pre-travel testing.

For those traveling, the best local PCR testing option is:

I’m looking for a low barrier testing option in Skagit County. Where should I go?

Skagit County Public Health is now offering free antigen testing at our Wednesday evening vaccine clinics at the Skagit County Administrative Building (700 S 2nd Street Mount Vernon, WA 98273) from 6-9pm.

We accept anyone 5 years and older; no appointment or insurance required. Test results are available in 15 minutes.

Note: This is NOT intended as a pre-travel test.

Can I use an At-Home Test Kit?

If you need to be tested for COVID-19 and can’t get tested by a healthcare provider or another testing location, you can consider using either a self-collection kit or a self-test that can be performed at home or anywhere else. Sometimes a self-test is also called a “home test” or an “at-home test.”

The following At-Home Tests are recommended by the Washington Department of Health (DOH):

When using an At-Home Test, please keep the following in mind:

  • All instructions for performing the test must be followed.
  • Self-tests can be used by anyone who is symptomatic regardless of their vaccination status.
  • Unvaccinated persons with no COVID-19 symptoms can also use self-tests, especially if they were potentially exposed to someone with COVID-19.
  • If an individual tests positive, they should isolate and inform any close contacts.

Those who test positive are asked to call the WA State COVID-19 Hotline at 1-800-525-0127 as soon as possible. The hotline is open from 6 AM to 10 PM Monday, and 6 AM to 6 PM Tuesday – Friday (and observed state holidays). Language assistance is available.

What is an Antibody test?

An antibody test looks for the body’s response to SARS-CoV-2, the virus that causes COVID-19. It is a blood test that is good at determining if you had the disease, but not good for determining if you have the disease. As such, antibody tests should not be used to diagnose the virus.

While there is evidence that antibodies may provide protection from infection, that has not yet been proven and therefore results of an antibody test should not be used to determine immunity.

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For more information about testing and for frequently asked questions, go to the WA DOH COVID-19 Testing webpage: https://www.doh.wa.gov/Emergencies/COVID19/TestingforCOVID19.