There is a recently available pre-exposure treatment for COVID-19 that could help San Diegans whose immune systems are not able fight the virus, but for some, access is an issue.
KPBS spoke with a San Diego woman who lives with a compromised immune system. She did not want to use her name, but said her condition has been with her since childhood.
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“I had two surgeries before I was 18 for sinus infections that had gotten so bad they couldn't treat them with antibiotics," the woman said. "I think most of high school I was on preventative antibiotics cause I was sick so often.”
She had a primary immune deficiency known as hypogammaglobulinemia.
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Something as simple as a cold can send her to the hospital. Like others who are immunocompromised, she does not respond well or at all to vaccines.
That is why she is so hopeful about a new treatment called Evusheld, a preventative antibody therapy shown to give the same protection that healthy people get from COVID-19 vaccines.
Right now she counters the risk of COVID-19 infection by getting monthly antibody infusions, known as intravenous immunoglobulins, to beef up her immune system.
"That’s usually how I get my protection to be able to live a pretty normal life," she said.
When the pandemic hit, the San Diego resident did not know what to think.
“I was terrified, honestly I was like, ‘Oh gosh,’ because remember H1N1 was the last pandemic and I ended up in the hospital during the pandemic, seriously ill, and I was like, ‘Well I guess I'm going to die,’” she said.
More than 80% of San Diegans are fully vaccinated and the majority of people are back to a pre-pandemic lifestyle, but not this resident.
“If something like a cold can send me to the ER, if you see how sick COVID is making people and when you don't have that level of protection that other people have like the question is what does it, like you don't feel confident that you could probably weather it (COVID-19) at all and you really don't want to take the chance because the chance is a life or death chance,” she said.
Evusheld could be a game-changer for the woman giving her hope of a more normal life.
“It was given the emergency use authorization — I was so excited. I thought finally I can — I have nieces and nephews that live across the country and maybe I can go visit them and my parents are older and I haven’t seen my dad since the pandemic began," she said trying to hold back tears. "And I’d really love to go visit him. Sorry, that one is actually hard, I really love to visit my dad and I would love to do it and feel safe and feel not scared or feel like if I did get it there’s a very good chance I wouldn’t get very sick and I don’t have — I just don’t have that assurance right now. It’s hard.”
The San Diego resident has been medically eligible for Evusheld for months and even though she needs it, she has not been able to get it. Her doctor is in Los Angeles and does not have access yet. She was excited to hear San Diego County Medical Director Dr. Seema Shah recently putting out the call for treatment requests.
“There’s definitely increasing demand but not at the rate at which we would like to see it," Shah said on March 14. "And that’s really why getting that message out that if you’re immune compromised talk to your doctor get referred, get your Evusheld.”
“Wait, it’s available?” the San Diego resident thought after seeing that.
She tried to get Evusheld locally at UC San Diego Health, but was disappointed to find out that they and other hospitals are reserving doses for their patients.
She could become a UCSD patient, but that would mean starting a new care plan with a new doctor.
San Diego County officials control the local distribution for Evusheld and the county said supply is not an issue. However, the bulk of doses go to major hospital systems, like UCSD Health, Kaiser and Scripps. Other health care systems have limited supplies.
“Health care in San Diego is a little bit siloed and there are four or five large systems, but also a lot of people that have private physicians and they are kind of lost here and so we’re happy to serve that role," said Dr. Christian Ramers, Chief of Population Health at Family Health Centers of San Diego.
Family Health Centers of San Diego is one place that takes outside referrals for Evusheld.
“We’ve had people come down from large transplant centers in Los Angeles who for whatever reason cannot get it from their own system and we’ve had inquiries from out of state," Ramers said. He also added they are seeing San Diego residents coming to them who cannot get it through their own system.
The county is working to expand awareness about Evusheld, but the current system does not work for everyone.
“I actually found a infusion center in Oakland," the San Diego woman said.
She is not waiting around and is jumping on an opportunity to get Evusheld in Northern California. It’s not her preferred option, but she sees it as the only way to get the same protection that vaccinated people have.
"You know the shot was free for everybody, I feel like then we should also make this really easily accessible for everyone who is immune deficient and needs it so that way they are protected and have the same equal protection as a vaccinated person beside them," she said.
Evusheld can also provide protection for those who are allergic to COVID-19 vaccines.
Federal data shows UC San Diego health has access to the most doses of Evusheld, however the treatment is not available to everyone who is immunocompromised.
UCSD Health officials said they are working with the county to develop an open referral process, but that system is not in place yet.
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There’s a recently available drug for San Diegans whose immune systems are not able fight COVID-19, but for some, access is an issue. -
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