If the provider waits until the patient is “sick enough,” the next stop is the ER or hospital. By then, the Paxlovid won’t help! So far as we’ve experienced, there are minimal side effects from taking Paxlovid and I wouldn’t hesitate to take it again.
I would not take it again. I still felt exhausted and sick even when testing negative and then rebounded.
My husband took Paxlovid (covered by Medicare) and recovered quickly. I did not take it and was literally on the couch for two weeks. I still feel more winded than I should when walking uphill. So I looked into what the med would cost me through Anthem. $900. So I guess I’ll skip it if I get COVID again.
I’d forgotten this detail but the NP mentioned the analogy to Tamiflu. Looking back, I expect I could’ve pushed her to give me Paxlovid. I’m on Medicare and I had already looked to see if it was covered and my PDP showed a $0 co-pay. But of course it’s too late now. And it feels like I’m on the mend so 
I watch my six month old grandson three days a week and the other grandma watches him two days a week. About a month ago the other grandma felt sick two days after watching grandson and tested positive for Covid. My daughter was a little congested so tested and was positive. No one else (daughter’s husband, baby, 2 year old, me) ever got sick. I had Covid 4 years ago and my most recent shot was in November.
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https://www.nature.com/articles/s41586-024-08511-9
Research found that infection with pre-Omicron variants resulted in durable protection against reinflection by pre-Omicron variants (~80% without waning over a year), but Omicron infection protection against reinflection faded to nothing after a year, although protection against severe or fatal reinfection remained strong and durable.
Perhaps not surprising since the BA.1/2/5 variants of 2022 were replaced by the XBB variants of 2023 which were replaced by the BA.2.86/JN.1 derived variants in 2024. But will protection fade more slowly now since there does not seem to be a new different lineage appearing, versus descendants of JN.1?
I get nervous reading posts that paraphrase a nurse on the phone, or start with “I believe.” If anyone has studies showing that Paxlovid is not as effective as expected, or even that it does not change the outcome, I would love to see them.
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Bottom line : In a large RCT, Paxlovid was not found to alleviate acute COVID-19 symptoms in lower-risk adults — ultimately, about 75% of both Paxlovid and placebo participants had symptom resolution. Notably, the study population was predominantly <65 years old…
“Paxlovid is designed to benefit people at high risk of severe illness who are at least 12 years old and weigh at least 88 pounds. Its purpose is to prevent hospitalization and death, not to decrease symptoms or to help you recover faster, although patients who take it may experience one or both of those benefits.”
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older is 65 and older?
NEJM Article dated 4-3-2024 Nirmatrelvir for Vaccinated or Unvaccinated Adult Outpatients with Covid-19. https://www.nejm.org/doi/full/10.1056/NEJMoa2309003
“In adult participants with Covid-19 who were at standard or high risk for severe Covid-19, there was no significant difference in the time to symptom alleviation between the nirmatrelvir–ritonavir group and the placebo group.”
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I wonder if the question of Paxlovid usefulness has been resolved further in the last year. The Johns Hopkins and NEJM links above would seem to differ in their message last year.
From the Johns Hopkins article: 1/25/24
Who is Paxlovid recommended for?
Paxlovid is designed to benefit people at high risk of severe illness who are at least 12 years old and weigh at least 88 pounds. Its purpose is to prevent hospitalization and death, not to decrease symptoms or to help you recover faster, although patients who take it may experience one or both of those benefits.
Who is considered “high risk” for severe COVID-19 illness, hospitalization, or death?
According to the CDC, people are more likely to experience severe COVID-19 illness if they are over 50 years old, unvaccinated or not up to date on COVID-19 vaccination, immunocompromised, or have certain medical conditions.
“Any medical condition such as diabetes, hypertension, heart disease, any lung condition like asthma or COPD, would be considered high risk,” says Adalja. Other common risk factors include being overweight, obese, or pregnant. “The majority of Americans probably have some high risk factor,” he says. “A lot of people would benefit from Paxlovid just based on their weight status.”
and
Is Paxlovid being prescribed as often as it should be?
“Antiviral prescribing is underutilized in the United States,” Adalja says. “There are many people with high risk conditions who are not being prescribed Paxlovid [or] an alternative antiviral like molnupiravir.”
This may be due to misconceptions, including by physicians, about who should take Paxlovid. “Some might say, ‘we’re gonna wait, you don’t look that bad,’ which is a complete misunderstanding of how the drug works,” says Adalja. Paxlovid is designed to be given early on to prevent symptoms from becoming more severe. The decision to prescribe someone Paxlovid for a COVID infection should be made based on a patient’s risk factors for severe disease, regardless of symptom severity.
However the NEJM study 4/24 showed that those who took Paxlovid recovered one day sooner than those who took placebo (12 days vs 13) , which they said was not “statistically signficant.” Also not statistically signifiant (low percentage of participants) 5 patients on Paxlovid vs 10 on placebo were hospitalized or died within 28 days from any cause.
My lay person takeaway of the NEJM article is: now that the general population has some degree of immunity due to vaccination and/or prior infection, Paxlovid is not making that much of a difference in outcomes, and that has changed the cost/benefit calculus. So for someone like me, whose only risk factor is being age 66, there is no longer a clear case for taking Paxlovid.
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Everyone in my family has asthma, so we are all high risk and likely to keep being prescribed and taking Paxlovid if/when we get covid. We have all had it once (duly each taken our Paxlovid) and hope to avoid any repeats.
Right. For those at higher risk like your family Paxlovid should be considered
The Johns Hopkins has a list of factors that constitute risk, including overweight, various medical conditions, longer time from vaccination, over 50 and concludes
"The majority of Americans probably have some high risk factor,” he says. “A lot of people would benefit from Paxlovid just based on their weight status.”
I personally don’t care: I was hospitalized with COVID: it affected my heart. I am still not sure if Paxlovid contributed to my arrythmias, but I stopped it after three days. Paxlovid totally stopped my symptoms otherwise.
I just wanted to present two perspectives for balance. I have no idea what is the right one, and it sounds like there is still some difference of opinion in the medical field. For high risk folks, accurate information that is up to date is important.
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There might also be the problem that someone who has COVID-19 does not realize that they have COVID-19 until it is too late for Paxlovid to be used, since it is supposed to be given early to have the intended effects.
Last week it was my mother with Covid, her 2nd time, the first was 2 years ago, now it’s my 100 year old MIL. MIL is out and about all the time, and this is her 1st time with Covid. She wasn’t feeling well for a couple of days, so asked my BIL to take her to UC. When she couldn’t get up out of the chair by herself due to weakness, he decided to take her to the ER instead.
MIL did not know she had Covid until the ER, as she didn’t test. They also said she had a “slight UTI.” I asked if that was like being a little bit pregnant! My son, who is a physician, said the ER usually says everyone has a UTI! While they said she could go home, it was suggested she stay and get fluids and antibiotics. They put her on oxygen today as her pulse ox was in the upper 80s and heparin. She doesn’t feel great, but is totally with it and in good spirits.
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I’m really not seeing the difference of opinion. paxlovid has always been recommended for high risk patients, i.e., those who are older and/or with co-morbidities, and obesity is a co-morbidity.
Some nasal spray vaccine news:
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