Severely immunocompromised for access to COVID-19 antiviral treatments
Clinicians can use this list to identify if people meet the criteria for "severely immunocompromised" under the COVID-19 antivirals access criteria.
Severly immunocompromised as relates to antiviral access criteria 4.4 for nirmatrelvir with ritonavir and remdesivir.
- heart or lung transplant recipient (any time frame)
- other solid-organ transplant recipient with any of the following:
- transplant received within the last 12 months
- receiving induction immunosuppressant treatment (any timeframe)
- receiving maintenance immunosuppressant treatment that includes mycophenolate mofetil (any timeframe)
- treated for graft rejection within the past 12 months
- allogenic haematopoietic stem cell transplant recipient with any of the following:
- transplant received within last 12 months
- has chronic graft versus host disease
- requires significant ongoing immunosuppression for another reason
- autologous haematopoietic stem cell transplant received within the last 12 months
- multiple myeloma on active and/or maintenance treatment
- combined primary immunodeficiency syndromes (including Severe Combined Immunodeficiency (SCID))
- common variable immunodeficiency (CVID) with additional T-cell defects, past opportunistic infection or requiring immunosuppressive therapy
- diagnosed humoral immunodeficiency with baseline IgG < 3g/L
- HIV with a CD4 T lymphocyte cell count <200 cells/mm3
- person who is receiving:
- potent B-cell or T-cell depleting therapy within the previous 12 months*
- a B-cell inhibitor (e.g. venetoclax or a Bruton tyrosine kinase inhibitor)
- ruxolitinib
- regular 3-4-weekly intravenous or subcutaneous immunoglobulin
- sphingosine 1- phosphate receptor modulator therapy (eg fingolimod) within previous 12 months
- high dose cyclophosphamide (>1g/m2) within previous 6 months.
- high-dose or long-term moderate dose corticosteroids
- is considered otherwise severely immunocompromised and had been given, or would have been given a third dose in their primary course of COVID-19 vaccine
Notes:
* potent B-cell or T-cell depleting therapy such as rituximab, obinutuzumab, ocrelizumab, bendamustine, fludarabine, cladribine, alemtuzumab, anti-thymocyte globulin, CamPath antibody treatment, anti-B-cell bispecific antibody, CAR T-cells or BiTE antibody treatment.