HOUSTON — What is a rebound Paxlovid case and why do more people seem to be getting them?
Dr. Peter Hotez, Dean of the National School of Tropical Medicine at Baylor College of Medicine and Co-Director of the Texas Children’s Hospital Center for Vaccine Development, helped explain the drug Paxlovid and the rebound cases.
“Paxlovid it as an antiviral drug,” Hotez said. “It’s a medicine that stops the virus from replicating. And that’s very important because when you get COVID, there are two phases to the illness -- there is the early phase, where the virus is replicating, and then, later on, you get the host inflammatory response.”
Paxlovid can stop severe reactions from occurring as the virus progresses.
When do you take it?
The treatment must be taken early on to work and is taken for five days. Although effective, clinical trials did show a slight chance of getting a Paxlovid rebound case.
“That kind of rebound happened only about 1% to 2% of the time (during clinical trials),” Hotez said. “Now, it seems to be happening more frequently. We don’t have the real number yet but a lot of people have thrown out a 20% number.”
During a rebound case, a person is infectious and must start the isolation process all over. Hotez said it’s not that a person has gotten the virus again, it just wasn’t fully gone and started replicating.
Why does it seem to be happening more?
“Some people believe it’s due to the fact that there’s higher amount of virus with the subvariants, so there’s more virus to treat. The thinking in how you manage this now is either to increase the dose or the number of days of treatment,” Hotez said.
In May, Hotez had a rebound case, too, and took another round of Paxlovid, although he admits there’s debate on whether that’s a good idea. Whether the rebound cases are worse or milder than the first round seems to just depend on the person.
Currently, Paxlovid is being prescribed to both the healthy and those at high risk of developing complications from COVID-19.
Should a fully vaccinated healthy person be taking the anti-viral?
“I think it depends on how much risk you are at, either because you were not vaccinated or because you were vaccinated but you still have other risk factors,” Hotez said. “I think that should not be a deterrent to prescribe it but rather recognize that it’s something we need to look out for.”