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No, Tennessee Isn't Hoarding Monoclonal Antibody Treatment for the Unvaccinated

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Reason Roundup

Elizabeth Nolan Brown | 9.22.2021 9:30 AM

A widely reported rumor suggests that Tennessee will only offer promising monoclonal antibody treatments to COVID-19 patients who are unvaccinated. The idea is spawning outrage, since it implies that people who took personal precautions (and public health officials' advice) are being deliberately disadvantaged if sick, while those who chose not to receive a life-saving vaccine are getting special privileges. There's just one problem: It's not true.

That hasn't stopped the "news" of Tennessee's unvaccinated-only treatment-rationing from being touted in a number of national headlines. For instance: "Tennessee will now DENY vaccinated COVID-19 patients access to monoclonal antibody treatments as federal government begins limiting shipments of the drugs," the Daily Mail says.

OK, but that's the notoriously tabloidy Daily Mail. Let's check in with a mainstream news publication like USA Today or NBC News or Insider and…. oh. "Tennessee limiting monoclonal antibody treatment to unvaccinated residents," reads an NBC News headline. "Tennessee Recommends Vaccinated Residents Lose Access to Monoclonal Antibody Treatment," claims USA Today. "Tennessee to reserve monoclonal antibody treatment for unvaccinated," touts an Insider headline.

What's really going on?

The state simply issued guidelines about monoclonal antibody treatment prioritization should a shortage arise. This guidance recommends prioritizing people most likely to suffer severe COVID-19 cases leading to hospitalization.

This is a group that could include people with compromised immune systems, those over 65 years old, pregnant women, people who are vulnerable due to underlying health conditions—and, yes, the unvaccinated. But it's in no way limited to the unvaccinated, nor is anyone suggesting they should automatically get priority.

Here's what the Tennessee Department of Health actually said:

Our recommendation to monoclonal antibody providers or individual facilities across the state is if they need to prioritize distribution of the treatment, the NIH (National Institutes of Health) guidelines are the recommended approach for that prioritization, including prioritizing those who are most likely to be hospitalized. Ultimately, this comes down to providers' clinical judgment to ensure those most at risk are receiving this treatment.

NIH guidelines on monoclonal antibody treatment, issued September 3, recommended monoclonal antibodies "for the treatment of mild to moderate COVID-19 and for post-exposure prophylaxis (PEP) of SARS-CoV-2 infection in individuals who are at high risk for progression to severe COVID-19."

At the moment, there is no shortage of monoclonal antibody treatment—in Tennessee, or nationally, according to the NIH website—although the agency does warn that "logistical constraints (e.g., limited space, not enough staff who can administer therapy) can make it difficult to administer these agents to all eligible patients."

Should it become necessary "to triage eligible patients," the agency suggests prioritizing people who already have the disease, "unvaccinated or incompletely vaccinated individuals who are at high risk of progressing to severe COVID-19," and "vaccinated individuals who are not expected to mount an adequate immune response (e.g., immunocompromised individuals)."

NIH also notes that "providers should use their clinical judgment when prioritizing treatment" and stresses that "when there are no logistical constraints for administering therapy, these considerations should not limit the provision of anti-SARS-CoV-2 monoclonal antibodies." (Emphasis theirs.)

The prospect of treatment rationing comes in the wake of the Biden administration changing how states may get their hands on monoclonal antibodies. The Department of Health and Human Services (HHS) will now allocate monoclonal antibody supplies to state health departments based on state need and "on COVID-19 case burden," rather than letting states order directly from its supplier, it said.

The move is "an effort to more evenly distribute the 150,000 doses that the government makes available each week," reports Politico. "Demand from a handful of southern states has exploded since [August], state and federal officials said, raising concerns they were consuming a disproportionate amount of the national supply. Seven states — Texas, Florida, Mississippi, Tennessee, Georgia, Louisiana, and Alabama—accounted for 70 percent of all orders in early September."

Internet freedom continues........

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