For the first two years of the pandemic, Jennifer Pate asked herself one question before she did anything: “Is it worth dying about?”
She has two immune deficiencies that make her body unable to produce antibodies and fight off viruses like COVID-19 after infection. Even the smallest daily tasks were a matter of life or death.
“‘Hey, do you think I could just run to HEB?'” Pate asked her brother, a former manager of a large hospital.
“David will say, ‘Is it worth dying for?’ And I’m gonna say no. Well, “What if I just hit Target.” “Is it worth dying about?” ‘No.'”
Because of her condition, when the outbreak first reached Houston, Pate’s doctors told her the pandemic was likely a death sentence. She turned her life upside down to protect herself as much as possible: she started working from home. She relied on Amazon, Instacart, and Doordash to avoid going to the grocery store. She would only go out in public for the absolute bare minimum—picking up medication and taking her pets to the vet.
But news of a breakthrough COVID-19 drug finally helped Pate take the first steps on her doorstep.
Evusheld, a preventative therapeutic launched in December, is a combination of monoclonal antibodies intended for immunocompromised people who don’t mount an adequate immune response to vaccines — such as cancer patients receiving chemotherapy or people with autoimmune diseases. Doctors can decide whether patients with chronic conditions such as diabetes or liver disease could also benefit.
When Jennifer Pate found out about it, she told her doctor.
“I get it in the nanosecond it comes out.” said godfather at the time.
She was the first patient at Houston Methodist Hospital to receive Evusheld in January. She is still very cautious but has opened up her life in small ways. She is comfortable letting the plumber in to fix the toilet and she accompanied her mother to the emergency room after breaking her arm. Your willingness to take risks has increased slightly.
“I’m not exaggerating, it was the best day of my life,” said Pate.
The injections, now approved by the FDA for emergency use, are meant to be taken before infection occurs. And the drug has been shown to be safe, said Dr. William Musick, pharmacist at Houston Methodist Hospital.
“Out of 20,000 patients, there were a few infusion reactions that required additional monitoring and maybe some Benadryl and Tylenol, but otherwise it’s extremely well tolerated,” Musick said.
But this lifeline, which has calmed the fears of some immune-compromised, goes largely unnoticed.
In the past six months, few Texans have taken advantage. The Department of State Health Services allocated 30,000 cures across the state from December through early May, according to an email from a spokesman. Much of this product is still on the shelf.
Although Texas has received 100,000 therapies from the federal government, low demand has kept the state from contracting them out to providers.
Sheri Innerarity, chair of the Texas Nurse Practitioners Education Committee and a professor at UT Austin, says most people have never heard of Evusheld — including medical professionals. She only found out about it at the end of March.
“There are no commercials on TV,” Innerarity said. “So if I didn’t know and I am where I am and I teach what I teach, I was pretty appalled at how many people really wouldn’t know.”
“I had a patient who I really believed would have survived if they had known about this drug before they got COVID,” Innerarity said.
A major reason people don’t know is that drugmaker AstraZenca doesn’t market Evusheld. That’s because it doesn’t have full formal FDA approval, according to Mark Esser, AstraZeneca’s vice president of early vaccines and early therapies.
“It’s one of the emergency permit agreements,” Esser said. “I’m sure you’ve seen commercials from drug companies on TV. We can raise awareness, but we don’t go directly to the consumer. Maybe that’s one reason people aren’t that familiar with it.”
The state health department has made efforts to inform providers, but not the general public. The local health departments in Houston and Harris County have also not sponsored Evusheld.
Innerarity said there are access issues for those who are aware of the therapy. There are only 10 locations in Harris County, mostly concentrated on the west side. In rural areas, particularly parts of West Texas, the nearest provider can be hundreds of miles away.
“It’s absolutely an equity issue,” Innerarity said. “If you don’t have initial access and a provider who is aware of it, it’s not going to happen.”
Stephanie Duke, an attorney at Disability Rights Texas, isn’t surprised that Evusheld remains relatively unknown. From testing to vaccines, there’s often no planning that includes the disability community, she said.
“Unfortunately, I can’t say I’m shocked that nobody knows,” Duke said. “But that’s just a general topic, right? Because with every disaster, people are not aware of it.”
The treatment itself is free for the time being, but administration fees may be incurred by the provider. Duke wonders how long that will last as pandemic fatigue deepens and the federal government divests funding from COVID-19.
Going forward, she hopes all levels of government devote more resources to spreading the word.
“There should be a targeted, coordinated response, somehow backed up with government agencies, whoever, to get that word out,” Duke said.
Subscribe to something Houston today
Fill out the form below to subscribe to our new daily editorial newsletter from the HPM Newsroom.