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Monoclonal Antibodies

All About Monoclonal Antibodies in the COVID-19 Fight

In case you haven’t heard, South Florida has set up several monoclonal antibody treatment centers. But what does this mean? Should you get such treatment? Do you need it?

Our primary care doctors at Cohen Medical Associates in Delray Beach have been getting these types of questions and more from our patients, so we want to offer you the information you need to make an informed decision about whether or not they can help you.

What are monoclonal antibodies?

The Centers for Disease Control and Prevention (CDC) defines antibodies as “proteins created by your immune system that help you fight off infections.” Once infected with the coronavirus or received a vaccine, your body makes antibodies to prevent further infection with COVID-19. This process takes anywhere from one to three weeks.

Monoclonal antibodies are a cumbersome description of a useful treatment for COVID-19. They are a type of “biotechnology” (a way to modify living organisms for useful purposes) first developed in the 1970s.

The laboratory-created proteins in monoclonal antibodies work by mimicking the body’s natural immune system. Thus, they can provide immediate protection against invaders instead of waiting for the body to mount its own response. This gives the body time to rally its own defense against the virus. In most cases, they also prevent further infection of more cells, effectively halting the disease process.

Dr. Anthony Fauci, the president’s chief medical advisor, said preliminary research shows the drug cocktail can reduce the risk of hospitalization or death from COVID-19 by 70-85 percent.

Who can get monoclonal antibodies?

The U.S. Food and Drug Administration (FDA) approves their use for “high risk” patients ages 12 and older who had exposure to the coronavirus or who recently tested positive.

The high-risk category includes:

  • anyone age 65 and older
  • those with obesity or who are overweight
  • pregnant women
  • those with chronic kidney or lung disease (including asthma)
  • anyone with cardiovascular disease or hypertension
  • anyone with diabetes
  • those living with neurodevelopmental disorders
  • anyone with sickle cell disease
  • those who are immunocompromised or are taking immunocompromising medication
  • anyone with a “medical-related technological dependence” such as a tracheostomy or gastrostomy

Like the vaccine, treatment with monoclonal antibodies is free. You can get the therapy regardless of whether or not you’ve had a coronavirus vaccine. Any eligible individual can receive it without a prescription as long as it’s administered by an eligible health care provider.

What’s involved?

It’s important to get the treatment within the first 10 days of the onset of symptoms, or as soon as you test positive for the coronavirus. If you wait too long, they’ll be of little use. And once you are in the hospital, it’s too late.

Unlike a quick vaccination, the process of receiving monoclonal antibodies is a comparatively long one. The antibodies are administered intravenously over the course of about an hour. Then you must be monitored for another hour in case of an allergic reaction such as difficulty breathing (which is extremely rare). Alternatively, they can also be given in four shots, two in the arms and two in the stomach.

When they were first authorized for emergency use in the fall of last year, they were in short supply. Several members of the Trump administration received them, including the president himself, but back then they weren’t in widespread use.

Since then, however, the supply has become plentiful, but many people still haven’t heard about the treatment.

Many of those who have received them say they got almost immediate relief from their symptoms.

Palm Beach County restaurant owner Derek McCray was diagnosed with COVID-19 last year, WPTV-TV reports. He told the station that the infusion “kind of brought me back to life.”

Are monoclonal antibodies safe?

As with the technology for the mRNA vaccines, monoclonal antibodies treat other diseases such as Ebola and Crohn’s disease.

But, as with all drugs, there can be some risks.

The National Institutes for Health (NIH) says the therapy may cause several side effects, including:

  • mild pain
  • bleeding, bruising, or soreness of the skin
  • swelling
  • diarrhea
  • fatigue
  • nausea
  • vomiting

More severe reactions can include:

  • thrombotic-type episodes (blood clots)
  • arterial hypertension
  • changes in heart activity
  • slowed bone marrow activity
  • impaired renal function

“Like most medications, you have to target it to the right person at the right time,” Dr. Aileen Marty, Florida International University infectious disease specialist, told CBS Miami. “The side effects are going to depend on the person’s unique immune system and their prior exposure to different types of pathogens,” she said.

A better option

Even though monoclonal antibodies have proven effective at reducing or even stopping symptoms of the virus once you contract it, experts agree it’s far better to avoid needing them in the first place.

This means continuing to practice such safety measures as masking when in public, and—especially—getting vaccinated.

“It’s certainly worse to have to take monoclonal antibodies than having to take a vaccine and never [getting] the disease,” said Marty. “It’s much better to take a vaccine and not have the disease at all.”

All of the sites are open daily from 9 a.m. to 5 p.m. The Florida Department of Health maintains a list of monoclonal antibody treatment sites. Appointments can be scheduled online.

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