May 2022 Update
Effective anticovid medication for over 65 yo
As of 1st May, all general practitioners are now able to issue heavily subsidised PBS prescriptions for one of two effective anti Covid medications for many patients in our age group (over 65 years) who have mildly to moderately symptomatic and medically confirmed Covid infection. To be eligible we must currently also have either ONE (75yo +) or TWO (65-74 yo). comorbidities from a specified list.
Specified Comorbidities include:
- Less than 2 Covid Vaccine doses
- Diabetes requiring medication,
- Heart Failure,
- Lung problems including emphysema or moderate asthma (daily medication)
- Body mass index elevated >30 – To calculate yours Click Here
- Kidney function impaired (eGFR <60)
- Liver cirrhosis
- Lives in residential aged care or residential disability care
- Stroke or Dementia
- Depressed immunity from recent therapies for cancer or severe arthritis
These two medications are Paxlovid (made by Pfizer) (Reported effectivess ~88%, available from 1 May) and Lagevrio (=Molnupiravir) (Reported effectivess ~50%, available from 1 March) , each taken twice daily for 5 days. While the full price (to the PBS scheme) of both of these prescriptions is over $1100 the cost for us as patients is capped at ~$40.00 without and ~$10 with a concession card.
The reason that these prescripions have been made preferentially available for the specified groups is that, even with full vaccination, their risk of progressing to severe illness after developing mild initial symptoms remains sigificantly higher than for other people. These medications are proven to reduce the chance of progressing to severe illness by up to 88%. In order to provide full benefit they need to commence early, preferably within 3 days and always within the five days after symptoms commence. They do not work at all once people are so sick that they need to be in hospital
This development means that from now on if we think that we may have one or more of the specified comorbidities and develop both Covid symptoms and a self-administered positive Covid test, then we should without delay :
- Get a medically confirmed PCR or supervised RAT test – eg at Repatriation Hospital clinic, which often has only a 15 minute wait 9 am to 5 pm 7 days per week.
- Contact our own GP for a telemedicine consultation, in order to discuss whether we qualify for an electronic Paxlovid or Lagevrio prescription delivered by smartphone or email. Paxlovid is contraindicated for a few people and may need avoidance or dose modification of other listed medications on advice from our Dr : (Medications List HERE ) Especially In people with multiple other medications the slightly less effective Lagevrio may be preferable because of its lesser drug interactions. This choice should be discussed with our own GP and or pharmacist in the context of our individual circumstances, preferably at a routine visit in advance of actually catching Covid.
For those seeking further scientific information, an authoritative US review of these medications is available HERE
April 2022 update
Vaccination “Winter Jab (#4) for over 65 yos
All Victorians over 65yo are encouraged to receive a fourth “Winter Booster” any time from 4 months after we received our 3rd dose. This has been recommended because in our age group the substantial protection against severe illness that is provided by vaccines does not last as long as in younger people.
Either Pfizer or Moderna Covid vaccines may be chosen by all of us. They are both very similar in effectiveness (high) and side effects (low)
Flu vaccination with the latest quadrivalent vaccine is also recommended before winter.
Most sites prefer that flu and Covid boosters either are given on the same day (opposite arms) or at least one or two weeks apart. It is worth checking the local policy in advance.