What is your approach to the use of Paxlovid for patients with risk factors for severe Covid-19 infection but who have received SARS-CoV-2 vaccines in light of the EPIC-SR trial findings?

Although EPIC-SR Trial may not have shown a significant benefit of paxlovid in standard-risk patients regardless of vaccination status, EPIC HR and real-world evidence have shown benefits in high-risk populations. Shared decision-making with the patient is always the best policy.

Disclosure: I have received personal consulting honoraria and institutional research funding from Pfizer.

Hopefully, the question is moot. Two days ago, I asked my team when the last time we had a patient who even tested COVID+. I couldn't remember any. We may have had 1 patient, who tested COVID+ in the last 3 months. We haven't had a patient, who was ill from COVID, in a year or so. An interesting development is that more recent Covid patients have sore throats and nasal congestion, like the "common cold". In 2020, very few had sore throat and none had nasal congestion. Although I admittedly have a limited understanding of viral evolution and immunology, this development, to me, suggests that mucosal immunity in the upper respiratory tract is different than that in the lower respiratory tract.

SMS

Due to my first-hand experience of taking Paxlovid as well as my immediate friends and family, I prefer to take it rather than just wait for natural immunity to work. COVID-19 has caused so many long-term side effects, so do not want those clots or fibrosis to happen. I was able to bounce back to my normal physical health within 2 days of taking Paxlovid.

I had such a severe sore throat, the worst among the 3 times I contracted COVID-19, generalized malaise, and fatigue. Taking Paxlovid did make a huge difference. The same thing with my daughter, who is in her early 20s, and had fevers and was very weak. We both are not high-risk cases, but I’m glad we took it.