Unvaccinated People Are Getting Priority With This One Thing, Officials Say

New guidance is moving unvaccinated individuals to the front of the line.

In recent months, it's been clear there are a number of advantages to getting the COVID shot, beyond just being much more protected against the virus. Vaccinated people have fewer restrictions and are able to travel more freely than unvaccinated people because they're less likely to contract or transmit COVID. Now, however, health officials are urging states to give unvaccinated individuals priority access to one thing: The National Institutes of Health (NIH) recently updated its guidelines to say unvaccinated people should be prioritized over vaccinated people for monoclonal antibody treatment. Tennessee is the first state to embrace this guidance, but it's likely to spread.

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The U.S. Food and Drug Administration (FDA) explains that "monoclonal antibodies are laboratory-made proteins that mimic the immune system's ability to fight off harmful antigens." One kind of monoclonal antibody is sotrovimab, which is specifically directed to work against the spike protein of COVID, "and is designed to block the virus' attachment and entry into human cells," per the FDA. The treatment helps prevent COVID cases from resulting in hospitalization.

On Sept. 3, the NIH adjusted its guidelines to recommend prioritizing the treatment of unvaccinated people and immunocompromised vaccinated people over those who are fully vaccinated. According to NBC News, Tennessee quickly used this shift in guidance to justify advising healthcare providers in the state to treat people most likely to be hospitalized first when supplies are limited, which means favoring the unvaccinated.

The idea has experts split. While some health officials feel it's sensible to treat the most vulnerable population first, others believe the unvaccinated are being rewarded with better treatment, according to The Washington Post. Putting the unvaccinated first can "rub people the wrong way," Karen Bloch, MD, medical director of the antibody infusion clinic at Vanderbilt University Medical Center, told the newspaper. However, she said the reality is that unvaccinated people need the treatment more, as they're more likely to die from COVID.

The Washington Post reports that Lisa Piercey, MD, Tennessee's top health official, acknowledged that although it's the "logical" decision, it's unlikely to be widely popular. "Clinically, it makes sense," Piercey said. "But the doctor in me thinks about all these 'what ifs?' What if there is a super-high-risk older person, but they are not technically considered immunocompromised? Do they not get it, but a 22-year-old unvaccinated person with asthma—they get it?" she posed.

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The current demand for the once little-used antibody treatment has surged as a handful of officials have touted its benefits. The Biden administration just took over the distribution of the treatment in an effort to avoid future shortages. The change in management has drawn objection from states that heavily rely on monoclonal antibody treatment. According to NBC News, in recent months, 70 percent of the country's supply of the treatment has gone to just seven states: Alabama, Florida, Texas, Mississippi, Tennessee, Georgia, and Louisiana.

Per NBC News, the Biden administration ordered more doses, but told states it would start capping the shipments of the drugs to ensure there's enough for the whole country. During a Sept. 16 White House briefing, press secretary Jen Psaki said, "Our supply is not unlimited, and we believe it should be equitable across states across the country."

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