After the approval of two different vaccines against the Sars-Cov-2 (COVID-19), the US under the Biden administration is racing to get vaccines in peoples’ arms as more contagious strains of the virus emerge.
The vaccines appear to be highly efficacious in clinical trials in preventing the infection. However, both vaccines currently available, and some others in the pipeline, require two doses separated by several weeks to achieve maximal effectiveness.
Another approach that is being studied for the treatment of active COVID-19 cases seems to be also effective in preventing infections, just like a vaccine would do. Bamlanivimab is a monoclonal antibody developed by Eli Lilly Company that has shown some benefit in treating people infected with mild disease (see my article posted on September 29, 2020, “Hope Against the Virus: Ly-Cov555 may boost Immunity!” under the COVID-19 section).
As a brief refresher, these monoclonal antibodies come from actual patients infected with the coronavirus. They are produced by a unique lineage of the B- lymphocytes, the specialized cells of the immune system that make antibodies.
The antibodies bind and remove viruses from circulation and can destroy cells already infected by the virus to prevent them from spreading the infection.
Monoclonal antibodies are selected because they are very potent at clearing the virus. What’s really cool is that they can be given to treat COVID-19, but because they circulate in the blood for a long time (weeks), they could also prevent a person from getting infected if there is enough in the blood.
This particular study focused on both workers and residents in nursing homes. This is really important because nursing home residents are elderly and many have underlying medical conditions.
They are also living in a group setting. Early in the pandemic, as many as one-third of all COVID-19 cases originated in nursing homes. The mortality rate was very high. In this study, receiving Bamlanivimab reduced the chances of getting infected with coronavirus by 57% overall.
But among nursing home residents, the product reduced the chances of getting infected by 80%! These are extremely promising initial results in one of the highest risk groups.
So you may be wondering, what are the advantages of using a monoclonal antibody like Bamlanivimab over a vaccine for preventing COVID-19?
The two vaccines currently in use had higher rates of protection (94-95%), although it’s likely that some groups may not experience such high rates of protection.
One important difference is that the vaccines require several weeks to reach maximum levels of protection and that requires both doses. The monoclonal antibody can provide protection very quickly after it is dosed, depending on how it is administered.
This might be particularly helpful in the event a household member becomes infected and the other household members could be exposed to that person. It could be used to protect them.
What about combining monoclonal antibodies with vaccines for extra protection against COVID- 19? There is concern that these two guys may not play nicely together in the sandbox. It seems possible that monoclonal antibodies could diminish the response to the vaccine.
It’s possible that they may work together if the dosing is spaced adequately apart. For example, a person who is fully vaccinated is put in a situation where they are at higher risk (e.g. a work assignment or positive COVID-19 case in their home). But we need more research to answer this question. Stay tuned; this could be a game changer!
BTW, I had my first dose of the Moderna vaccine on January 21st. Have you had or scheduled yours yet?