finished may not cause you any serious health problems, but should be taken up with your doctor. However, if you are taking drugs such as transplant rejection drugs or antiarrhythmic drugs that regulate your heartbeat, “these could cause catastrophic complications” if taken with Paxlovid, says Dr. Scott Roberts, assistant professor of infectious diseases at Yale School of Medicine.
Paxlovid is not recommended for people who are unlikely to get seriously ill from COVID. In June, the drug’s manufacturer, Pfizer, announced it was discontinuing a clinical trial for standard-risk people because Paxlovid didn’t significantly reduce hospitalization and death in that group. The trial included both vaccinated and unvaccinated people.
Perhaps those results aren’t surprising, since “for people who are low-risk, their risk of getting hospitalized is so low that taking Paxlovid isn’t adding any advantage,” says Dr. Daniel Kuritzkes, chief of the division of infectious diseases at Brigham and Women’s Hospital in Boston.
Also in June, Pfizer announced it had applied to the FDA for full approval for Paxlovid.
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Q: What are the options for someone who can’t take Paxlovid?
A couple of other antiviral medications (Veklury and Lagevrio) and a monoclonal antibody drug (Bebtelovimab) also reduce people’s risk of hospitalization and death from COVID. But they are less convenient than Paxlovid, requiring injections or infusions, or not as effective. Still, they are possibilities if you are unable to take Paxlovid.
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Q: How often do people experience rebound infections after taking Paxlovid?
A small percentage of people get COVID symptoms and test positive for the coronavirus again after completing a five-day course of Paxlovid. But how many patients are affected and why rebounds occur are much debated.
In the Pfizer clinical trial, 1% to 2% of participants tested positive for COVID again after completing a course of Paxlovid. Because the rebound occurred in people who got the drug and those who got a placebo, the FDA concluded that “it is unclear at this point that this is related to drug treatment.”
A study published in June by researchers at the Mayo Clinic found that fewer than 1% of 483 high-risk patients who had received Paxlovid experienced rebound symptoms.
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Anecdotal reports suggest that the rebound figure is higher, though. Several prominent people in the medical community have reported experiencing rebound infections and symptoms, though they are typically mild. In addition to Biden and Fauci, director of the National Institute of Allergy and Infectious Diseases, the group includes Dr. David Ho, director of the Aaron Diamond AIDS Research Center at Columbia University, and Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine.
“I’m still confused about it, and most of the people I speak to about it are still confused because we don’t know why exactly it’s happening,” says Dr. Robert Wachter, a professor and the chair of the Department of Medicine at the University of California-San Francisco. In May, Wachter tweeted about the rebound experience of his wife, writer Katie Hafner. “The public data on frequency doesn’t sync up with everybody’s experience.”
There are several theories for why rebounds occur. Some experts suspect the drug doesn’t totally eliminate the virus in some people who have a high viral burden, leading to a resurgence after the five-day course. Others suggest that because the treatment is started immediately after COVID symptoms emerge, the body’s immune system doesn’t get a chance to
