By Emily Banks Wooten
Dr. Nagakrishnal Nachimuthu, an internal medicine and infectious disease specialist with Baylor St. Luke’s Medical Group, addressed the Livingston Rotary Club recently, presenting updates regarding COVID-19, treatments and vaccines.
“It’s so evolving. By the time I finish, there may be four more updates. In March of 2020 we didn’t expect it to get this bad, but here we are–into the second year of it,” Nachimuthu said.
Regarding some of the outpatient treatment options for COVID-19, she said the FDA has issued emergency use authorization for 2 new oral antiviral agents–Paxlovid and Molnupiravir.
“These oral medications are in limited supply and are recommended for mild to moderate COVID-19 patients who are at high risk of progressing to severe disease,” Nachimuthu said.
“Previously available was the monoclonal antibody infusion which has reduced activity against the omicron variant of COVID-19 so another monoclonal antibody Sotrovimab is recommended and this has emergency use authorization from the FDA for the treatment of non-hospitalized patients at risk of progression to severe disease,” she said, adding, “Remdesivir IV for three days as an outpatient is another treatment which has shown reduction in the risk of hospitalization.
“Evusheld can be used as a pre-exposure prophylaxis in adults and adolescents who do not have the COVID-19 infection but have been exposed to someone with the COVID-19 infection and who are immune-compromised or not fully vaccinated with a COVID-19 vaccine due to severe adverse reactions to a COVID-19 vaccine,” Nachimuthu said.
She addressed the available vaccines and their respective booster schedules.
“The vaccines available in the U.S. are Pfizer, Moderna and Johnson and Johnson. With Pfizer, it’s two shots, 21 days apart and a booster five months after completing the primary series. The primary series is available for children five years and older. Immuno-compromised individuals five years and older should get an additional primary shot 28 days after the second shot. A booster is available for those 12 years and older and the booster can be either the Pfizer or the Moderna vaccine,” Nachimuthu said.
“The Moderna vaccine is two shots 28 days apart with a booster five months after completing the primary series. Immuno-compromised individuals 18 years and older should get an additional shot 28 days after the second shot. The booster is available for those 18 years and older and the booster can be either the Pfizer or the Moderna vaccine,” Nachimuthu said.
“The Johnson and Johnson vaccine is one shot and a booster with either Pfizer or Moderna two months later,” she said.
“There are a lot of conspiracy theories out there but there are no metals, no chips, no latex and no magnets in the vaccines,” she said, adding that the vaccine is safe for pregnant people and does not lead to infertility.
Asked if one should get a COVID vaccine if they’ve already had COVID, she said, “Yes, because we do not know how long and how well the natural immunity protects us. However, we do know that COVID-19 vaccines provide a high level of protection. A study done in Kentucky suggests that people who have recovered from natural immunity are two times more likely to be re-infected if they are not vaccinated compared to being vaccinated after recovery from natural immunity.
“Side effects of the vaccine are most commonly redness, swelling and pain at the site of the injection, but one may also have fatigue, fever, chills and nausea. Rarely myocarditis, which is inflammation of the heart muscle, has been reported with Pfizer and Moderna vaccines. With the Johnson and Johnson vaccine, thrombosis with thrombocytopenia syndrome has been reported where there are blood clots in large blood vessels and low platelets,” Nachimuthu said.
“The other thing is a lot of people keep saying the omicron is mild. Yes, for the vaccinated but the unvaccinated can still end up in the hospital or on a ventilator,” she said.
“New variants are constantly being deployed. Variants will continue to happen. The bottom line is if the community does not have the immunity of the vaccine, this will be ongoing. If the majority of people are vaccinated then the infection can’t progress,” Nachimuthu said.
Asked when COVID will be treated like the flu, Nachimuthu said, “When we have a level of immunity in most of our population. The unvaccinated are two times more likely to get COVID a second time than those who are vaccinated.
“We’re in a better place than we were a year ago. The solution is the majority of our population getting vaccinated,” she said.