Paxlovid for healthy 19 year old?

[Anonymous]

I’m 45 and when I asked my doctor for it they said they won’t give it to people who have Covid for the first time. That there are a lot of side effects.

[Anonymous]

DH's (50+) doctor would not prescribe to him with light symptoms. ILs in their 80's, also not prescribed by their doctor. I know one older person who had the rebound/test positive again a few days later.

[Anonymous]

Yikes, no, your gut is correct. Your child definitely should not automatically take Paxlovid.

[Anonymous]

Absolutely have her take it. My DS is 18 and was also offered an Rx. DD has been sick and has Long COVID now, and it is quite serious. There is no data yet on the efficacy of Paxlovid in preventing Long COVID nor on the efficacy of Paxlovid in preventing other serious sequela of COVID like increased cardiac, diabetes and kidney risk, but given the mechanism (prevention of replication of virus) I wanted DS to take it to try and avoid the quite serious Long COVID possibility.

[Anonymous]

If wouldn't take it if I wasn't vulnerable or only had mild symptoms.

[Anonymous]

I don't know but my 21 year-old with chronic health concerns was denied Paxlovid in June so I think it is much worse when young people's risk management needs are dismissed.

It doesn't follow that your kid should take it, but I am very glad to hear it was given as an option.

[Anonymous]

There seems to be a ton of confusion about paxlovid. My DH took it and I felt it really helped - went from terrible cough to almost no cough in 24 hrs, coughs don’t usually do that on their own, and achiness and fever cleared up, only mild GI side effects and no rebound.

But I know people with parents 75 plus being told not to take it.

There’s no longer a shortage of it, and I think people need to be aware of the rebound possibility but there really needs to be a clear statement as to whether the drug is potentially helpful even if just at shortening the duration of illness, and whether any side effect risk overrides the likely benefit. It seems like internists are just operating by their gut feelings as opposed to ant definitive recommendation on prescribing.

[Anonymous]

That is totally bizarre. What I've noticed is that people take Paxlovid, test negative, return to the world, then rebound and discover they've exposed their whole family and many friends afterward. And yes, you can spread covid during your infection rebound, I've seen it happen.

[Anonymous]

No symptoms, definitely would not take it.

[Anonymous]

Anonymous wrote:There seems to be a ton of confusion about paxlovid. My DH took it and I felt it really helped - went from terrible cough to almost no cough in 24 hrs, coughs don’t usually do that on their own, and achiness and fever cleared up, only mild GI side effects and no rebound.

But I know people with parents 75 plus being told not to take it.

There’s no longer a shortage of it, and I think people need to be aware of the rebound possibility but there really needs to be a clear statement as to whether the drug is potentially helpful even if just at shortening the duration of illness, and whether any side effect risk overrides the likely benefit. It seems like internists are just operating by their gut feelings as opposed to ant definitive recommendation on prescribing.

This was exactly my experience (40F) - from moderate symptoms (cough, fever, congestion) to no symptoms after 36 hours. I agree it seems like there is wild variation in who gets it just based on doctors' opinions. That said, a 19-year-old with no symptoms doesn't need it.

[Anonymous]

Slightly off topic- could the rebound we see in Paxlovid be similar to quitting antibiotics early-> infection comes back -> antibiotic resistance & super bugs? Maybe they need to adjust the time one takes Paxlovid?

Never hear anyone discussing this so maybe I'm wrong, but I would avoid taking it unless I'm seriously ill for that reason alone.

[Anonymous]

Anonymous wrote:That is totally bizarre. What I've noticed is that people take Paxlovid, test negative, return to the world, then rebound and discover they've exposed their whole family and many friends afterward. And yes, you can spread covid during your infection rebound, I've seen it happen.

With this variant, people are rebounding even without Paxlovid.

[Anonymous]

No way would I ever take this unless I was an 80yo high-risk patient on their deathbed. The rebound is not worth it.

[Anonymous]

Anonymous wrote:Slightly off topic- could the rebound we see in Paxlovid be similar to quitting antibiotics early-> infection comes back -> antibiotic resistance & super bugs? Maybe they need to adjust the time one takes Paxlovid?

Never hear anyone discussing this so maybe I'm wrong, but I would avoid taking it unless I'm seriously ill for that reason alone.

That is an excellent question, and a lot of scientists are discussing it. We are not seeing resistance to Paxlovid or significant mutations of the viral genome during the rebound phenomenon, so that's good. No super bugs there. It is unclear whether the rebound is due to the natural progression of Covid itself, a course of Paxlovid that is too short, a direct effect of Paxlovid, or a combination. These are all being looked at as possibilities.

It is expected that the virus will eventually be resistant to Paxlovid due to evolutionary pressure, and we will have to develop other therapeutics. Hopefully this won't happen for some time.

One thing that is important to know: Paxlovid is a medication that works when taken EARLY in the course, before serious illness, to prevent that serious illness. If it is given too late it will not work, so it is entirely appropriate to take it in the 1st 5 days of illness if you qualify, even if your symptoms are very mild.

[Anonymous]

It’s given to reduce symptoms, and she has no symptoms. Half of zero, is still zero. This is so bizarre to me.