Medications that prevent COVID-19 infections

COVID-19 (coronavirus disease 19) is a viral respiratory infection that first emerged in late 2019 and became a global pandemic in early 2020. While it was downgraded from a global health emergency in 2023, infections continue to spread and new variants continue to emerge. Similar to the flu and other respiratory illnesses, COVID-19 infections tend to see a surge during the fall and winter months.

While most cases of COVID-19 cause mild to moderate symptoms, there remains a significant number of people who are at increased risk for severe outcomes. Severe COVID-19 infections can result in respiratory distress, hospitalization, intubation and ventilation, and death.

Who is at increased risk for severe COVID-19?

Although COVID-19 is no longer a public health emergency, severe infections remain a significant risk to the health of many individuals. Being 65 years or older, being under 6 months of age, being immunocompromised, and living in an assisted care facility are associated with an elevated risk of severe infections and outcomes. There are also more than 20 underlying health conditions associated with increased risk of severe COVID-19.

Anyone with one of these risk factors should meet with their healthcare provider to discuss steps to protect themselves against severe COVID-19 and what to do if they become infected.

In addition to basic precautions like masks, handwashing, and avoiding crowds, there are several drugs and medicines that can help prevent COVID-19 infections.

Vaccines

Vaccines are one of the most reliable methods available for preventing COVID-19 infections.

In very simple terms, vaccines work by training the immune system to fight a specific infection. When an infectious agent enters the body, the immune system produces antibodies, which are proteins that can attach to that agent and label it as something that needs to be neutralized and destroyed by immune cells.

Vaccines stimulate a similar response, causing the immune system to activate and start producing antibodies. This is why vaccines often cause cold-like symptoms or other mild side effects. These are not symptoms of infection, but symptoms of the immune system going to work.

If a vaccinated person is exposed to COVID-19, the immune system has a massive head start on getting rid of the virus.

Vaccines are regularly updated to respond to new strains of COVID-19, and it’s recommended to stay up to date on vaccines to maintain immunity.

It’s also important to note that people who are moderately-to-severely immunocompromised may need an additional dose of a vaccine to build immunity. The additional dose helps counteract the lower immune response that occurs when a condition compromises immune system function.

Pre-exposure prophylaxis (PrEP)

People who are moderately-to-severely immunocompromised are some of the most vulnerable to severe COVID-19 infections and outcomes.

Immunocompromised means that the immune system is not completely functioning and is less capable of fighting infections. Common causes of a compromised immune system include cancer, chemotherapy, chronic infections (HIV, viral hepatitis), liver cirrhosis, sickle cell disease, autoimmune diseases, receiving an organ or stem cell transplant, and diabetes.

In addition to vaccines, people who are moderately-to-severely immunocompromised may receive pre-exposure prophylaxis (PrEP), an infusion of laboratory-produced antibodies that provide protection against the virus that causes COVID-19 before exposure.

If you or a loved one is immunocompromised, this is a topic to discuss with your healthcare provider.

Post-exposure prophylaxis (PEP)

This is a new and emerging approach to preventing the spread of COVID-19. Post-exposure prophylaxis (PEP) refers to medications that are taken after a high-risk exposure, such as a household member who has COVID-19. Taken after exposure—but before testing positive—these medications help prevent an infection from starting.

Antiviral therapy for COVID-19

While not a preventive therapy, antiviral therapies are getting a mention because they help prevent severe COVID-19. These are drugs that are prescribed when a person has COVID-19, and work by stopping the virus from replicating. This can shorten the severity and duration of an infection and prevent severe outcomes.

Important safety considerations for any medication

Billions of doses of COVID-19 vaccines have been administered and confirmed reports of significant side effects are extremely rare. Before getting a vaccine, tell the healthcare provider or pharmacist administering the vaccine about:

• History of allergic reactions
• History of heart inflammation or multisystem inflammatory syndrome
• Current or recent COVID-19 infection or symptoms
• Any medications you take or have taken recently
• Underlying health conditions, including immune disorders and cancer

Always discuss the potential for adverse effects before starting any medication, such as a PEP medication or antiviral medication. Questions to ask include:

• What side effects can this medication cause?
• Can this medication interact with other drugs? Provide a list of all medications you are taking, including prescriptions, over-the-counter medicines, and supplements, including herbal supplements.
• Can this medication interfere with contraceptives?
• Is this medication safe to take while pregnant, planning to become pregnant, or breastfeeding?

Remember, a healthcare provider will always be your best source of information.