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1. Shard Calculation

Query:

Response:

Calculated Shard: 179 (from laksa122)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa179.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://publichealth.jhu.edu/2024/why-more-people-should-be-prescribed-paxlovid-for-covid\')), getAhrefsUnparsedNoserviceFromURL(\'https://publichealth.jhu.edu/2024/why-more-people-should-be-prescribed-paxlovid-for-covid\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/publichealth.jhu.edu\/2024\/why-more-people-should-be-prescribed-paxlovid-for-covid","crawl_time":1776332417,"first_indexed_time":1706198111,"http_code":200,"src_unparsed":"edu,jhu!publichealth,\/2024\/why-more-people-should-be-prescribed-paxlovid-for-covid s443","src_root_hash":"6599457417117746179","history_drop_reason":null,"meta_title":"Why More People Should Be Prescribed Paxlovid for COVID | Johns Hopkins | Bloomberg School of Public Health","meta_descriptions":["The antiviral Paxlovid is very effective at preventing severe outcomes from COVID infection, but not enough people are taking it."],"attrs_boilerpipe_text":"One of the best tools for preventing severe complications from COVID infection is the prescription antiviral drug Paxlovid. But not nearly as many people who could benefit from it are being prescribed it, says\nAmesh Adalja, MD, FIDSA\n, a senior scholar at the\nJohns Hopkins Center for Health Security\n(link is external)\nwho specializes in infectious diseases and pandemic preparedness. Adalja says that both patients and providers need to be better informed about the benefits of Paxlovid and other antivirals like it.\nPaxlovid is extremely effective when taken within five days of symptom onset. In clinical trials, it reduced the risk of hospitalization and death by almost 90% in unvaccinated people. “It’s a tremendous tool that's completely underutilized,” says Adalja.\nHow does Paxlovid work?\n“Paxlovid is a class of antiviral drug called a protease inhibitor,” explains Adalja. It prevents the SARS-CoV-2 virus, which causes COVID-19 infection, from replicating in the body. At a molecular level, “Paxlovid works by disrupting the protein cutting process of SARS-CoV-2,” he explains. “It blocks an essential step in the virus’s life cycle.”\nWho is Paxlovid recommended for?\nPaxlovid is designed to benefit people at high risk of severe illness who are at least 12 years old and weigh at least 88 pounds. Its purpose is to prevent hospitalization and death, not to decrease symptoms or to help you recover faster, although patients who take it may experience one or both of those benefits.\nWho is considered “high risk” for severe COVID-19 illness, hospitalization, or death?\nAccording to the CDC, people are more likely to experience severe COVID-19 illness if they are over 50 years old, unvaccinated or not up to date on COVID-19 vaccination, immunocompromised, or have\ncertain medical conditions\n(link is external)\n.\n“Any medical condition such as diabetes, hypertension, heart disease, any lung condition like asthma or COPD, would be considered high risk,” says Adalja. Other common risk factors include being overweight, obese, or pregnant. “The majority of Americans probably have some high risk factor,” he says. “A lot of people would benefit from Paxlovid just based on their weight status.”\nIs Paxlovid being prescribed as often as it should be?\n“Antiviral prescribing is underutilized in the United States,” Adalja says. “There are many people with high risk conditions who are not being prescribed Paxlovid [or] an alternative antiviral like molnupiravir.”\nThis may be due to misconceptions, including by physicians, about who should take Paxlovid. “Some might say, ‘we're gonna wait, you don't look that bad,’ which is a complete misunderstanding of how the drug works,” says Adalja. Paxlovid is designed to be given early on to\nprevent\nsymptoms from becoming more severe. The decision to prescribe someone Paxlovid for a COVID infection should be made based on a patient’s risk factors for severe disease, regardless of symptom severity.\nThe same problem exists with antivirals for influenza. “Many high-risk people do not get prescribed an influenza antiviral despite evidence that they benefit,” says Adalja. Doctors may be more comfortable prescribing Tamiflu because they’re more familiar with it, but Tamiflu is also underutilized.\nHow can we improve patient education around Paxlovid?\nOne reason not enough people know about Paxlovid is that it was under emergency use authorization for quite a while, which prohibited Pfizer from advertising the drug. Instead, they relied on doctors to bring it up. Starting in 2023, Pfizer began promoting Paxlovid to consumers through social media ads and commercials. “People complain about direct-to-patient advertising, but it works,” says Adalja. “When patients know a drug by name, they’re more likely to ask their doctor about it.”\nIt’s important that patients feel empowered to ask their health care providers about any and all treatment options, he says. “Patients should be asking their doctors, ‘Would I benefit from Paxlovid?’ ‘Would I benefit from Tamiflu?’ ‘Do I really need this antibiotic?’\nAre there alternatives to Paxlovid?\nCurrently there are two other treatments to prevent hospitalization from COVID:\nMolnupiravir\n(link is external)\n, which is another oral antiviral taken at home, and\nremdesivir\n(link is external)\n, which is a three-day daily IV infusion given in a health care facility.\nMolnupiravir is a good alternative for individuals taking medications that may interact with Paxlovid, says Adalja.\nAre there any downsides to taking Paxlovid if you don’t have a risk factor for severe illness?\n“It’s always a risk-benefit ratio,” says Adalja. If you don't have risk factors for severe disease and you take Paxlovid, you may experience the side effects—an altered sense of taste, possible gastrointestinal upset, and possible rebound symptoms—without the benefits the medication is designed to provide.\nCan Paxlovid help prevent long COVID?\nWhile some early studies signaled that Paxlovid might reduce a person’s chance of developing long COVID, more recent research indicates that it does not. This includes a\nstudy\n(link is external)\npublished in January 2024 that found no connection between Paxlovid treatment and long COVID symptoms in vaccinated, non-hospitalized individuals.\nThere are newer antivirals not yet available in the U.S. that have a stronger signal for preventing long COVID, says Adalja.\nDo concerns about COVID rebound* outweigh the benefits of taking Paxlovid?\nNo. “[Rebound] doesn’t happen to everyone—studies show maybe 1 in 5 people who take Paxlovid experience rebound symptoms,” says Adalja. “But even those who do get rebound—with or without taking Paxlovid— don’t do badly.” For people who take Paxlovid and experience rebound, symptoms are generally mild to moderate and they do not require hospitalization.\n“COVID rebound was really made out to be a bigger and more common issue than it is, due to news stories about people like President Biden experiencing it,” he explains. The risk of rebound—whether or not it can be definitively linked to Paxlovid—shouldn't preclude someone who's high risk from taking Paxlovid, and it definitely shouldn’t preclude doctors from prescribing it.\n*COVID rebound is the return of symptoms after someone initially recovers from COVID. The order of events generally looks like this: A person is infected with COVID and feels symptomatic; their symptoms subside over the course of the infection; they may even test negative for COVID on a home antigen test; a few days later, their symptoms return, and they may test positive again on a home antigen test.\nHow much does Paxlovid cost?\nThrough the end of 2023, Paxlovid was free for Americans, with the costs covered by the federal government. An\nagreement between Pfizer and the U.S. Department of Health and Human Services\n(link is external)\nwill ensure Paxlovid remains free through the end of 2024 for patients who are insured through Medicare and Medicaid or uninsured. It will continue to be free through 2028 for individuals who are uninsured and underinsured. Paxlovid is covered by many private insurance plans (costs vary by plan).\nHow can I get a prescription for Paxlovid?\nIf you test positive for COVID, talk to your doctor as soon as possible about any factors that put you at greater risk for severe illness and whether you would benefit from taking Paxlovid.\nIf you don’t have a health care provider, the nationwide\nTest to Treat program\n(link is external)\nhelps people access low- or no-cost treatments quickly. Anyone who tests positive for COVID (or flu) can also access free telehealth care and treatment through the\nHome Test to Treat program\n(link is external)\n.\nAliza Rosen is a digital content strategist in the Office of External Affairs at the Johns Hopkins Bloomberg School of Public Health.\nRelated:\nWhat to Know About JN.1, the Latest Omicron Variant\nMouse Model of COVID-19 in Pregnancy Shows Benefit of Paxlovid Treatment\nWhat to Know About the Updated COVID-19 Vaccine for Fall\/Winter 2023","attrs_markdown":"[Johns Hopkins UniversityEst. 1876 America’s First Research University](https:\/\/150.jhu.edu\/)\n\n[Skip to main content](https:\/\/publichealth.jhu.edu\/2024\/why-more-people-should-be-prescribed-paxlovid-for-covid#main-content)\n\n- [Expand](https:\/\/publichealth.jhu.edu\/2024\/why-more-people-should-be-prescribed-paxlovid-for-covid) [Departments](https:\/\/publichealth.jhu.edu\/departments)\n  - [Biochemistry and Molecular Biology](https:\/\/publichealth.jhu.edu\/departments\/biochemistry-and-molecular-biology)\n  - 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[Biochemistry and Molecular Biology](https:\/\/publichealth.jhu.edu\/departments\/biochemistry-and-molecular-biology)\n  - [Biostatistics](https:\/\/publichealth.jhu.edu\/departments\/biostatistics)\n  - [Environmental Health and Engineering](https:\/\/publichealth.jhu.edu\/departments\/environmental-health-and-engineering)\n  - [Epidemiology](https:\/\/publichealth.jhu.edu\/departments\/epidemiology)\n  - [Health Policy and Management](https:\/\/publichealth.jhu.edu\/departments\/health-policy-and-management)\n  - [Health, Behavior and Society](https:\/\/publichealth.jhu.edu\/departments\/health-behavior-and-society)\n  - [International Health](https:\/\/publichealth.jhu.edu\/departments\/international-health)\n  - [Mental Health](https:\/\/publichealth.jhu.edu\/departments\/mental-health)\n  - [Molecular Microbiology and Immunology](https:\/\/publichealth.jhu.edu\/departments\/molecular-microbiology-and-immunology)\n  - [Population, Family and Reproductive Health](https:\/\/publichealth.jhu.edu\/departments\/population-family-and-reproductive-health)\n- [Faculty](https:\/\/publichealth.jhu.edu\/faculty\/directory\/list)\n- [Topics](https:\/\/publichealth.jhu.edu\/topics)\n\nSearch\n\nBloomberg School\n\n# More Americans Could Benefit from Paxlovid for COVID Infection\nPaxlovid is “a tremendous tool that's completely underutilized”\n\nPublished\n\nJanuary 25, 2024\n\nBy\n\nAliza Rosen\n\n[COVID-19](https:\/\/publichealth.jhu.edu\/topics\/covid-19-and-public-health)\n\n[Infectious Diseases](https:\/\/publichealth.jhu.edu\/topics\/infectious-diseases-and-public-health)\n\n[Medicine](https:\/\/publichealth.jhu.edu\/topics\/medicine-and-public-health)\n\n![Person sick on their couch looks at home COVID test results during a telehealth appointment](https:\/\/publichealth.jhu.edu\/sites\/default\/files\/styles\/article_feature\/public\/2024-01\/more-people-should-take-paxlovid.jpg?h=6e972868&itok=V3oQSF6s)\n\nOne of the best tools for preventing severe complications from COVID infection is the prescription antiviral drug Paxlovid. But not nearly as many people who could benefit from it are being prescribed it, says [Amesh Adalja, MD, FIDSA](https:\/\/publichealth.jhu.edu\/faculty\/3528\/amesh-adalja), a senior scholar at the [Johns Hopkins Center for Health Security](https:\/\/www.centerforhealthsecurity.org\/ \"(opens in a new window)\") who specializes in infectious diseases and pandemic preparedness. Adalja says that both patients and providers need to be better informed about the benefits of Paxlovid and other antivirals like it.\n\nPaxlovid is extremely effective when taken within five days of symptom onset. In clinical trials, it reduced the risk of hospitalization and death by almost 90% in unvaccinated people. “It’s a tremendous tool that's completely underutilized,” says Adalja.\n\n**How does Paxlovid work?**\n\n“Paxlovid is a class of antiviral drug called a protease inhibitor,” explains Adalja. It prevents the SARS-CoV-2 virus, which causes COVID-19 infection, from replicating in the body. At a molecular level, “Paxlovid works by disrupting the protein cutting process of SARS-CoV-2,” he explains. “It blocks an essential step in the virus’s life cycle.”\n\n**Who is Paxlovid recommended for?**\n\nPaxlovid is designed to benefit people at high risk of severe illness who are at least 12 years old and weigh at least 88 pounds. Its purpose is to prevent hospitalization and death, not to decrease symptoms or to help you recover faster, although patients who take it may experience one or both of those benefits.\n\n**Who is considered “high risk” for severe COVID-19 illness, hospitalization, or death?**\n\nAccording to the CDC, people are more likely to experience severe COVID-19 illness if they are over 50 years old, unvaccinated or not up to date on COVID-19 vaccination, immunocompromised, or have [certain medical conditions](https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/need-extra-precautions\/people-with-medical-conditions.html \"(opens in a new window)\").\n\n“Any medical condition such as diabetes, hypertension, heart disease, any lung condition like asthma or COPD, would be considered high risk,” says Adalja. Other common risk factors include being overweight, obese, or pregnant. “The majority of Americans probably have some high risk factor,” he says. “A lot of people would benefit from Paxlovid just based on their weight status.”\n\n> [View this post on Instagram](https:\/\/www.instagram.com\/p\/C3A4MMXP8Mw\/?utm_source=ig_embed&utm_campaign=loading \"(opens in a new window)\")\n> \n> [A post shared by Johns Hopkins Public Health (@johnshopkinssph)](https:\/\/www.instagram.com\/p\/C3A4MMXP8Mw\/?utm_source=ig_embed&utm_campaign=loading \"(opens in a new window)\")\n\n**Is Paxlovid being prescribed as often as it should be?**\n\n“Antiviral prescribing is underutilized in the United States,” Adalja says. “There are many people with high risk conditions who are not being prescribed Paxlovid \\[or\\] an alternative antiviral like molnupiravir.”\n\nThis may be due to misconceptions, including by physicians, about who should take Paxlovid. “Some might say, ‘we're gonna wait, you don't look that bad,’ which is a complete misunderstanding of how the drug works,” says Adalja. Paxlovid is designed to be given early on to *prevent* symptoms from becoming more severe. The decision to prescribe someone Paxlovid for a COVID infection should be made based on a patient’s risk factors for severe disease, regardless of symptom severity.\n\nThe same problem exists with antivirals for influenza. “Many high-risk people do not get prescribed an influenza antiviral despite evidence that they benefit,” says Adalja. Doctors may be more comfortable prescribing Tamiflu because they’re more familiar with it, but Tamiflu is also underutilized.\n\n**How can we improve patient education around Paxlovid?**\n\nOne reason not enough people know about Paxlovid is that it was under emergency use authorization for quite a while, which prohibited Pfizer from advertising the drug. Instead, they relied on doctors to bring it up. Starting in 2023, Pfizer began promoting Paxlovid to consumers through social media ads and commercials. “People complain about direct-to-patient advertising, but it works,” says Adalja. “When patients know a drug by name, they’re more likely to ask their doctor about it.”\n\nIt’s important that patients feel empowered to ask their health care providers about any and all treatment options, he says. “Patients should be asking their doctors, ‘Would I benefit from Paxlovid?’ ‘Would I benefit from Tamiflu?’ ‘Do I really need this antibiotic?’\n\n**Are there alternatives to Paxlovid?**\n\nCurrently there are two other treatments to prevent hospitalization from COVID: [Molnupiravir](https:\/\/www.covid19treatmentguidelines.nih.gov\/therapies\/antivirals-including-antibody-products\/molnupiravir\/ \"(opens in a new window)\"), which is another oral antiviral taken at home, and [remdesivir](https:\/\/www.covid19treatmentguidelines.nih.gov\/therapies\/antivirals-including-antibody-products\/remdesivir\/ \"(opens in a new window)\"), which is a three-day daily IV infusion given in a health care facility.\n\nMolnupiravir is a good alternative for individuals taking medications that may interact with Paxlovid, says Adalja.\n\n**Are there any downsides to taking Paxlovid if you don’t have a risk factor for severe illness?**\n\n“It’s always a risk-benefit ratio,” says Adalja. If you don't have risk factors for severe disease and you take Paxlovid, you may experience the side effects—an altered sense of taste, possible gastrointestinal upset, and possible rebound symptoms—without the benefits the medication is designed to provide.\n\n**Can Paxlovid help prevent long COVID?**\n\nWhile some early studies signaled that Paxlovid might reduce a person’s chance of developing long COVID, more recent research indicates that it does not. This includes a [study](https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.29333 \"(opens in a new window)\") published in January 2024 that found no connection between Paxlovid treatment and long COVID symptoms in vaccinated, non-hospitalized individuals.\n\nThere are newer antivirals not yet available in the U.S. that have a stronger signal for preventing long COVID, says Adalja.\n\n**Do concerns about COVID rebound\\* outweigh the benefits of taking Paxlovid?**\n\nNo. “\\[Rebound\\] doesn’t happen to everyone—studies show maybe 1 in 5 people who take Paxlovid experience rebound symptoms,” says Adalja. “But even those who do get rebound—with or without taking Paxlovid— don’t do badly.” For people who take Paxlovid and experience rebound, symptoms are generally mild to moderate and they do not require hospitalization.\n\n“COVID rebound was really made out to be a bigger and more common issue than it is, due to news stories about people like President Biden experiencing it,” he explains. The risk of rebound—whether or not it can be definitively linked to Paxlovid—shouldn't preclude someone who's high risk from taking Paxlovid, and it definitely shouldn’t preclude doctors from prescribing it.\n\n*\\*COVID rebound is the return of symptoms after someone initially recovers from COVID. The order of events generally looks like this: A person is infected with COVID and feels symptomatic; their symptoms subside over the course of the infection; they may even test negative for COVID on a home antigen test; a few days later, their symptoms return, and they may test positive again on a home antigen test.*\n\n**How much does Paxlovid cost?**\n\nThrough the end of 2023, Paxlovid was free for Americans, with the costs covered by the federal government. An [agreement between Pfizer and the U.S. Department of Health and Human Services](https:\/\/www.hhs.gov\/about\/news\/2023\/10\/13\/hhs-and-pfizer-reach-agreement-to-increase-patient-access-to-paxlovid.html \"(opens in a new window)\") will ensure Paxlovid remains free through the end of 2024 for patients who are insured through Medicare and Medicaid or uninsured. It will continue to be free through 2028 for individuals who are uninsured and underinsured. Paxlovid is covered by many private insurance plans (costs vary by plan).\n\n**How can I get a prescription for Paxlovid?**\n\nIf you test positive for COVID, talk to your doctor as soon as possible about any factors that put you at greater risk for severe illness and whether you would benefit from taking Paxlovid.\n\nIf you don’t have a health care provider, the nationwide [Test to Treat program](https:\/\/aspr.hhs.gov\/TestToTreat\/Pages\/default.aspx \"(opens in a new window)\") helps people access low- or no-cost treatments quickly. Anyone who tests positive for COVID (or flu) can also access free telehealth care and treatment through the [Home Test to Treat program](https:\/\/www.test2treat.org\/ \"(opens in a new window)\").\n\n*Aliza Rosen is a digital content strategist in the Office of External Affairs at the Johns Hopkins Bloomberg School of Public Health.*\n\n## Related:\n- [What to Know About JN.1, the Latest Omicron Variant](https:\/\/publichealth.jhu.edu\/2024\/jn1-the-dominant-variant-in-the-covid-surge)\n- [Mouse Model of COVID-19 in Pregnancy Shows Benefit of Paxlovid Treatment](https:\/\/publichealth.jhu.edu\/2023\/mouse-model-of-covid-19-in-pregnancy-shows-benefit-of-paxlovid-treatment)\n- [What to Know About the Updated COVID-19 Vaccine for Fall\/Winter 2023](https:\/\/publichealth.jhu.edu\/2023\/what-to-know-about-the-updated-covid-19-vaccine-for-fall\/winter-2023)\n\n## More from the Bloomberg School\n- [See latest headlines](https:\/\/publichealth.jhu.edu\/headlines)\n- [Learn more about the Department of Environmental Health and Engineering](https:\/\/publichealth.jhu.edu\/departments\/environmental-health-and-engineering)\n\n## Related Content\n[![A patient fills out a form while her blood and saliva are screened for Hepatitis C and HIV in Spencer, West Virginia, on September 28, 2017.](https:\/\/publichealth.jhu.edu\/sites\/default\/files\/styles\/related_content\/public\/2026-04\/hep-c.jpg?h=4f4378cb&itok=zR0m9KTH)](https:\/\/publichealth.jhu.edu\/2026\/what-to-know-about-hepatitis-c)\n\n### [What to Know About Hepatitis C](https:\/\/publichealth.jhu.edu\/2026\/what-to-know-about-hepatitis-c)\nApril 10, 2026\n\n### [Why Review of the U.S.’s Measles Elimination Status Has Been Delayed](https:\/\/publichealth.jhu.edu\/2026\/why-review-of-the-uss-measles-elimination-status-has-been-delayed)\nApril 09, 2026\n\n[![Veterinarian seated in front of client with small dog on her lap lets dog sniff his hand while he speaks to the client.](https:\/\/publichealth.jhu.edu\/sites\/default\/files\/styles\/related_content\/public\/2026-02\/pet-vaccines-veterinarian.jpg?h=f321a05b&itok=pykOpVbz)](https:\/\/publichealth.jhu.edu\/2026\/vaccinating-your-dog-or-cat-can-also-protect-you)\n\n### [Why We Vaccinate Our Dogs and Cats](https:\/\/publichealth.jhu.edu\/2026\/vaccinating-your-dog-or-cat-can-also-protect-you)\nFebruary 27, 2026\n\n[![A fact sheet for measles sits on a table at a mobile clinic offering free vaccinations on February 6, 2026, in Spartanburg, South Carolina](https:\/\/publichealth.jhu.edu\/sites\/default\/files\/styles\/related_content\/public\/2026-02\/measles-alert.jpg?h=f321a05b&itok=ZGLwxGrm)](https:\/\/publichealth.jhu.edu\/2026\/what-is-a-measles-exposure-alert)\n\n### [There's a Measles Alert in My Area. Now What?](https:\/\/publichealth.jhu.edu\/2026\/what-is-a-measles-exposure-alert)\nFebruary 24, 2026\n\n[![Screenshots from two videos assigned to participants in the study. Top left corner: a Brazilian man in a suit poses as an executive of a fictitious tobacco company. Top right: The same man holds 12 cigarettes in his hands. Bottom right: a woman in a white lab coat holding a vial, posing as an employee of a fictitious tobacco company's lab. Bottom left: the same woman reads data displayed on a desktop computer screen. ](https:\/\/publichealth.jhu.edu\/sites\/default\/files\/styles\/related_content\/public\/2026-01\/2240x1260px-News-Item-2026.02-CSR-Brazil.jpg?h=5eaa5dc3&itok=VbdQTyA6)](https:\/\/publichealth.jhu.edu\/221\/2026\/cigarettes-lies-and-videotape-study-links-consumer-perceptions-with-tobacco-industry-deceptions)\n\n### [Cigarettes, Lies, and Videotape: Study Links Consumer Perceptions with Tobacco Industry Deceptions](https:\/\/publichealth.jhu.edu\/221\/2026\/cigarettes-lies-and-videotape-study-links-consumer-perceptions-with-tobacco-industry-deceptions)\nFebruary 04, 2026\n\n**Johns Hopkins Bloomberg School of Public Health**  \n [615 N. Wolfe Street, Baltimore, MD 21205](https:\/\/goo.gl\/maps\/p6Eowe2n6W2FuJ3k7 \"(opens in a new window)\")\n\n## Footer social\n- [LinkedIn](https:\/\/www.linkedin.com\/school\/johns-hopkins-bloomberg-school-of-public-health\/ \"(opens in a new window)\")\n- [Facebook](https:\/\/www.facebook.com\/JohnsHopkinsSPH \"(opens in a new window)\")\n- [Instagram](https:\/\/www.instagram.com\/johnshopkinssph\/ \"(opens in a new window)\")\n- [BlueSky](https:\/\/bsky.app\/profile\/johnshopkinssph.bsky.social \"(opens in a new window)\")\n- [X (Formerly Twitter)](https:\/\/twitter.com\/JohnsHopkinsSPH \"(opens in a new window)\")\n- [Youtube](https:\/\/www.youtube.com\/user\/JohnsHopkinsSPH \"(opens in a new window)\")\n\n## Footer menu primary\n- [Offices & Services](https:\/\/publichealth.jhu.edu\/offices-and-services)\n- [Alumni](https:\/\/publichealth.jhu.edu\/alumni)\n- [Giving](https:\/\/publichealth.jhu.edu\/giving)\n- [Calendars](https:\/\/publichealth.jhu.edu\/calendars-at-the-bloomberg-school)\n- [Careers](https:\/\/publichealth.jhu.edu\/careers \"Job Opportunities and Career Resources\")\n- [Contact Us](https:\/\/publichealth.jhu.edu\/contact-us)\n\n## Footer menu secondary\n- [Centers & Institutes Directory](https:\/\/publichealth.jhu.edu\/centers-and-institutes-directory)\n- [My.PublicHealth](https:\/\/my.publichealth.jhu.edu\/)\n- [My.JH](https:\/\/my.jh.edu\/myJH\/ \"(opens in a new window)\")\n- [CoursePlus](https:\/\/courseplus.jhu.edu\/)\n- [Student Information System](https:\/\/sis.jhu.edu\/)\n\n[Johns Hopkins University](https:\/\/www.jhu.edu\/)\n\n## Footer menu extra\n- [Web Policies](https:\/\/publichealth.jhu.edu\/web-policies)\n- [Accessibility](https:\/\/accessibility.jhu.edu\/)\n- [Website Help](https:\/\/webhelp.publichealth.jhu.edu\/support\/tickets\/new)\n\n## We use cookies on this site to enhance your user experience.\nBy clicking the Accept button, you agree to us doing so.\n\nLearn more\n\nAccept\n\nNo, thanks","attrs_readable_markdown":"One of the best tools for preventing severe complications from COVID infection is the prescription antiviral drug Paxlovid. But not nearly as many people who could benefit from it are being prescribed it, says [Amesh Adalja, MD, FIDSA](https:\/\/publichealth.jhu.edu\/faculty\/3528\/amesh-adalja), a senior scholar at the [Johns Hopkins Center for Health Security](https:\/\/www.centerforhealthsecurity.org\/ \"(opens in a new window)\") who specializes in infectious diseases and pandemic preparedness. Adalja says that both patients and providers need to be better informed about the benefits of Paxlovid and other antivirals like it.\n\nPaxlovid is extremely effective when taken within five days of symptom onset. In clinical trials, it reduced the risk of hospitalization and death by almost 90% in unvaccinated people. “It’s a tremendous tool that's completely underutilized,” says Adalja.\n\n**How does Paxlovid work?**\n\n“Paxlovid is a class of antiviral drug called a protease inhibitor,” explains Adalja. It prevents the SARS-CoV-2 virus, which causes COVID-19 infection, from replicating in the body. At a molecular level, “Paxlovid works by disrupting the protein cutting process of SARS-CoV-2,” he explains. “It blocks an essential step in the virus’s life cycle.”\n\n**Who is Paxlovid recommended for?**\n\nPaxlovid is designed to benefit people at high risk of severe illness who are at least 12 years old and weigh at least 88 pounds. Its purpose is to prevent hospitalization and death, not to decrease symptoms or to help you recover faster, although patients who take it may experience one or both of those benefits.\n\n**Who is considered “high risk” for severe COVID-19 illness, hospitalization, or death?**\n\nAccording to the CDC, people are more likely to experience severe COVID-19 illness if they are over 50 years old, unvaccinated or not up to date on COVID-19 vaccination, immunocompromised, or have [certain medical conditions](https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/need-extra-precautions\/people-with-medical-conditions.html \"(opens in a new window)\").\n\n“Any medical condition such as diabetes, hypertension, heart disease, any lung condition like asthma or COPD, would be considered high risk,” says Adalja. Other common risk factors include being overweight, obese, or pregnant. “The majority of Americans probably have some high risk factor,” he says. “A lot of people would benefit from Paxlovid just based on their weight status.”\n\n**Is Paxlovid being prescribed as often as it should be?**\n\n“Antiviral prescribing is underutilized in the United States,” Adalja says. “There are many people with high risk conditions who are not being prescribed Paxlovid \\[or\\] an alternative antiviral like molnupiravir.”\n\nThis may be due to misconceptions, including by physicians, about who should take Paxlovid. “Some might say, ‘we're gonna wait, you don't look that bad,’ which is a complete misunderstanding of how the drug works,” says Adalja. Paxlovid is designed to be given early on to *prevent* symptoms from becoming more severe. The decision to prescribe someone Paxlovid for a COVID infection should be made based on a patient’s risk factors for severe disease, regardless of symptom severity.\n\nThe same problem exists with antivirals for influenza. “Many high-risk people do not get prescribed an influenza antiviral despite evidence that they benefit,” says Adalja. Doctors may be more comfortable prescribing Tamiflu because they’re more familiar with it, but Tamiflu is also underutilized.\n\n**How can we improve patient education around Paxlovid?**\n\nOne reason not enough people know about Paxlovid is that it was under emergency use authorization for quite a while, which prohibited Pfizer from advertising the drug. Instead, they relied on doctors to bring it up. Starting in 2023, Pfizer began promoting Paxlovid to consumers through social media ads and commercials. “People complain about direct-to-patient advertising, but it works,” says Adalja. “When patients know a drug by name, they’re more likely to ask their doctor about it.”\n\nIt’s important that patients feel empowered to ask their health care providers about any and all treatment options, he says. “Patients should be asking their doctors, ‘Would I benefit from Paxlovid?’ ‘Would I benefit from Tamiflu?’ ‘Do I really need this antibiotic?’\n\n**Are there alternatives to Paxlovid?**\n\nCurrently there are two other treatments to prevent hospitalization from COVID: [Molnupiravir](https:\/\/www.covid19treatmentguidelines.nih.gov\/therapies\/antivirals-including-antibody-products\/molnupiravir\/ \"(opens in a new window)\"), which is another oral antiviral taken at home, and [remdesivir](https:\/\/www.covid19treatmentguidelines.nih.gov\/therapies\/antivirals-including-antibody-products\/remdesivir\/ \"(opens in a new window)\"), which is a three-day daily IV infusion given in a health care facility.\n\nMolnupiravir is a good alternative for individuals taking medications that may interact with Paxlovid, says Adalja.\n\n**Are there any downsides to taking Paxlovid if you don’t have a risk factor for severe illness?**\n\n“It’s always a risk-benefit ratio,” says Adalja. If you don't have risk factors for severe disease and you take Paxlovid, you may experience the side effects—an altered sense of taste, possible gastrointestinal upset, and possible rebound symptoms—without the benefits the medication is designed to provide.\n\n**Can Paxlovid help prevent long COVID?**\n\nWhile some early studies signaled that Paxlovid might reduce a person’s chance of developing long COVID, more recent research indicates that it does not. This includes a [study](https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.29333 \"(opens in a new window)\") published in January 2024 that found no connection between Paxlovid treatment and long COVID symptoms in vaccinated, non-hospitalized individuals.\n\nThere are newer antivirals not yet available in the U.S. that have a stronger signal for preventing long COVID, says Adalja.\n\n**Do concerns about COVID rebound\\* outweigh the benefits of taking Paxlovid?**\n\nNo. “\\[Rebound\\] doesn’t happen to everyone—studies show maybe 1 in 5 people who take Paxlovid experience rebound symptoms,” says Adalja. “But even those who do get rebound—with or without taking Paxlovid— don’t do badly.” For people who take Paxlovid and experience rebound, symptoms are generally mild to moderate and they do not require hospitalization.\n\n“COVID rebound was really made out to be a bigger and more common issue than it is, due to news stories about people like President Biden experiencing it,” he explains. The risk of rebound—whether or not it can be definitively linked to Paxlovid—shouldn't preclude someone who's high risk from taking Paxlovid, and it definitely shouldn’t preclude doctors from prescribing it.\n\n*\\*COVID rebound is the return of symptoms after someone initially recovers from COVID. The order of events generally looks like this: A person is infected with COVID and feels symptomatic; their symptoms subside over the course of the infection; they may even test negative for COVID on a home antigen test; a few days later, their symptoms return, and they may test positive again on a home antigen test.*\n\n**How much does Paxlovid cost?**\n\nThrough the end of 2023, Paxlovid was free for Americans, with the costs covered by the federal government. An [agreement between Pfizer and the U.S. Department of Health and Human Services](https:\/\/www.hhs.gov\/about\/news\/2023\/10\/13\/hhs-and-pfizer-reach-agreement-to-increase-patient-access-to-paxlovid.html \"(opens in a new window)\") will ensure Paxlovid remains free through the end of 2024 for patients who are insured through Medicare and Medicaid or uninsured. It will continue to be free through 2028 for individuals who are uninsured and underinsured. Paxlovid is covered by many private insurance plans (costs vary by plan).\n\n**How can I get a prescription for Paxlovid?**\n\nIf you test positive for COVID, talk to your doctor as soon as possible about any factors that put you at greater risk for severe illness and whether you would benefit from taking Paxlovid.\n\nIf you don’t have a health care provider, the nationwide [Test to Treat program](https:\/\/aspr.hhs.gov\/TestToTreat\/Pages\/default.aspx \"(opens in a new window)\") helps people access low- or no-cost treatments quickly. Anyone who tests positive for COVID (or flu) can also access free telehealth care and treatment through the [Home Test to Treat program](https:\/\/www.test2treat.org\/ \"(opens in a new window)\").\n\n*Aliza Rosen is a digital content strategist in the Office of External Affairs at the Johns Hopkins Bloomberg School of Public Health.*\n\n## Related:\n- [What to Know About JN.1, the Latest Omicron Variant](https:\/\/publichealth.jhu.edu\/2024\/jn1-the-dominant-variant-in-the-covid-surge)\n- [Mouse Model of COVID-19 in Pregnancy Shows Benefit of Paxlovid Treatment](https:\/\/publichealth.jhu.edu\/2023\/mouse-model-of-covid-19-in-pregnancy-shows-benefit-of-paxlovid-treatment)\n- [What to Know About the Updated COVID-19 Vaccine for Fall\/Winter 2023](https:\/\/publichealth.jhu.edu\/2023\/what-to-know-about-the-updated-covid-19-vaccine-for-fall\/winter-2023)","meta_canonical":null}

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Boilerpipe Text	One of the best tools for preventing severe complications from COVID infection is the prescription antiviral drug Paxlovid. But not nearly as many people who could benefit from it are being prescribed it, says Amesh Adalja, MD, FIDSA , a senior scholar at the Johns Hopkins Center for Health Security (link is external) who specializes in infectious diseases and pandemic preparedness. Adalja says that both patients and providers need to be better informed about the benefits of Paxlovid and other antivirals like it. Paxlovid is extremely effective when taken within five days of symptom onset. In clinical trials, it reduced the risk of hospitalization and death by almost 90% in unvaccinated people. “It’s a tremendous tool that's completely underutilized,” says Adalja. How does Paxlovid work? “Paxlovid is a class of antiviral drug called a protease inhibitor,” explains Adalja. It prevents the SARS-CoV-2 virus, which causes COVID-19 infection, from replicating in the body. At a molecular level, “Paxlovid works by disrupting the protein cutting process of SARS-CoV-2,” he explains. “It blocks an essential step in the virus’s life cycle.” Who is Paxlovid recommended for? Paxlovid is designed to benefit people at high risk of severe illness who are at least 12 years old and weigh at least 88 pounds. Its purpose is to prevent hospitalization and death, not to decrease symptoms or to help you recover faster, although patients who take it may experience one or both of those benefits. Who is considered “high risk” for severe COVID-19 illness, hospitalization, or death? According to the CDC, people are more likely to experience severe COVID-19 illness if they are over 50 years old, unvaccinated or not up to date on COVID-19 vaccination, immunocompromised, or have certain medical conditions (link is external) . “Any medical condition such as diabetes, hypertension, heart disease, any lung condition like asthma or COPD, would be considered high risk,” says Adalja. Other common risk factors include being overweight, obese, or pregnant. “The majority of Americans probably have some high risk factor,” he says. “A lot of people would benefit from Paxlovid just based on their weight status.” Is Paxlovid being prescribed as often as it should be? “Antiviral prescribing is underutilized in the United States,” Adalja says. “There are many people with high risk conditions who are not being prescribed Paxlovid [or] an alternative antiviral like molnupiravir.” This may be due to misconceptions, including by physicians, about who should take Paxlovid. “Some might say, ‘we're gonna wait, you don't look that bad,’ which is a complete misunderstanding of how the drug works,” says Adalja. Paxlovid is designed to be given early on to prevent symptoms from becoming more severe. The decision to prescribe someone Paxlovid for a COVID infection should be made based on a patient’s risk factors for severe disease, regardless of symptom severity. The same problem exists with antivirals for influenza. “Many high-risk people do not get prescribed an influenza antiviral despite evidence that they benefit,” says Adalja. Doctors may be more comfortable prescribing Tamiflu because they’re more familiar with it, but Tamiflu is also underutilized. How can we improve patient education around Paxlovid? One reason not enough people know about Paxlovid is that it was under emergency use authorization for quite a while, which prohibited Pfizer from advertising the drug. Instead, they relied on doctors to bring it up. Starting in 2023, Pfizer began promoting Paxlovid to consumers through social media ads and commercials. “People complain about direct-to-patient advertising, but it works,” says Adalja. “When patients know a drug by name, they’re more likely to ask their doctor about it.” It’s important that patients feel empowered to ask their health care providers about any and all treatment options, he says. “Patients should be asking their doctors, ‘Would I benefit from Paxlovid?’ ‘Would I benefit from Tamiflu?’ ‘Do I really need this antibiotic?’ Are there alternatives to Paxlovid? Currently there are two other treatments to prevent hospitalization from COVID: Molnupiravir (link is external) , which is another oral antiviral taken at home, and remdesivir (link is external) , which is a three-day daily IV infusion given in a health care facility. Molnupiravir is a good alternative for individuals taking medications that may interact with Paxlovid, says Adalja. Are there any downsides to taking Paxlovid if you don’t have a risk factor for severe illness? “It’s always a risk-benefit ratio,” says Adalja. If you don't have risk factors for severe disease and you take Paxlovid, you may experience the side effects—an altered sense of taste, possible gastrointestinal upset, and possible rebound symptoms—without the benefits the medication is designed to provide. Can Paxlovid help prevent long COVID? While some early studies signaled that Paxlovid might reduce a person’s chance of developing long COVID, more recent research indicates that it does not. This includes a study (link is external) published in January 2024 that found no connection between Paxlovid treatment and long COVID symptoms in vaccinated, non-hospitalized individuals. There are newer antivirals not yet available in the U.S. that have a stronger signal for preventing long COVID, says Adalja. Do concerns about COVID rebound* outweigh the benefits of taking Paxlovid? No. “[Rebound] doesn’t happen to everyone—studies show maybe 1 in 5 people who take Paxlovid experience rebound symptoms,” says Adalja. “But even those who do get rebound—with or without taking Paxlovid— don’t do badly.” For people who take Paxlovid and experience rebound, symptoms are generally mild to moderate and they do not require hospitalization. “COVID rebound was really made out to be a bigger and more common issue than it is, due to news stories about people like President Biden experiencing it,” he explains. The risk of rebound—whether or not it can be definitively linked to Paxlovid—shouldn't preclude someone who's high risk from taking Paxlovid, and it definitely shouldn’t preclude doctors from prescribing it. *COVID rebound is the return of symptoms after someone initially recovers from COVID. The order of events generally looks like this: A person is infected with COVID and feels symptomatic; their symptoms subside over the course of the infection; they may even test negative for COVID on a home antigen test; a few days later, their symptoms return, and they may test positive again on a home antigen test. How much does Paxlovid cost? Through the end of 2023, Paxlovid was free for Americans, with the costs covered by the federal government. An agreement between Pfizer and the U.S. Department of Health and Human Services (link is external) will ensure Paxlovid remains free through the end of 2024 for patients who are insured through Medicare and Medicaid or uninsured. It will continue to be free through 2028 for individuals who are uninsured and underinsured. Paxlovid is covered by many private insurance plans (costs vary by plan). How can I get a prescription for Paxlovid? If you test positive for COVID, talk to your doctor as soon as possible about any factors that put you at greater risk for severe illness and whether you would benefit from taking Paxlovid. If you don’t have a health care provider, the nationwide Test to Treat program (link is external) helps people access low- or no-cost treatments quickly. Anyone who tests positive for COVID (or flu) can also access free telehealth care and treatment through the Home Test to Treat program (link is external) . Aliza Rosen is a digital content strategist in the Office of External Affairs at the Johns Hopkins Bloomberg School of Public Health. Related: What to Know About JN.1, the Latest Omicron Variant Mouse Model of COVID-19 in Pregnancy Shows Benefit of Paxlovid Treatment What to Know About the Updated COVID-19 Vaccine for Fall/Winter 2023
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But not nearly as many people who could benefit from it are being prescribed it, says [Amesh Adalja, MD, FIDSA](https://publichealth.jhu.edu/faculty/3528/amesh-adalja), a senior scholar at the [Johns Hopkins Center for Health Security](https://www.centerforhealthsecurity.org/ "(opens in a new window)") who specializes in infectious diseases and pandemic preparedness. Adalja says that both patients and providers need to be better informed about the benefits of Paxlovid and other antivirals like it. Paxlovid is extremely effective when taken within five days of symptom onset. In clinical trials, it reduced the risk of hospitalization and death by almost 90% in unvaccinated people. “It’s a tremendous tool that's completely underutilized,” says Adalja. How does Paxlovid work? “Paxlovid is a class of antiviral drug called a protease inhibitor,” explains Adalja. It prevents the SARS-CoV-2 virus, which causes COVID-19 infection, from replicating in the body. At a molecular level, “Paxlovid works by disrupting the protein cutting process of SARS-CoV-2,” he explains. “It blocks an essential step in the virus’s life cycle.” Who is Paxlovid recommended for? Paxlovid is designed to benefit people at high risk of severe illness who are at least 12 years old and weigh at least 88 pounds. Its purpose is to prevent hospitalization and death, not to decrease symptoms or to help you recover faster, although patients who take it may experience one or both of those benefits. Who is considered “high risk” for severe COVID-19 illness, hospitalization, or death? According to the CDC, people are more likely to experience severe COVID-19 illness if they are over 50 years old, unvaccinated or not up to date on COVID-19 vaccination, immunocompromised, or have [certain medical conditions](https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html "(opens in a new window)"). “Any medical condition such as diabetes, hypertension, heart disease, any lung condition like asthma or COPD, would be considered high risk,” says Adalja. Other common risk factors include being overweight, obese, or pregnant. “The majority of Americans probably have some high risk factor,” he says. “A lot of people would benefit from Paxlovid just based on their weight status.” > [View this post on Instagram](https://www.instagram.com/p/C3A4MMXP8Mw/?utm_source=ig_embed&utm_campaign=loading "(opens in a new window)") > > [A post shared by Johns Hopkins Public Health (@johnshopkinssph)](https://www.instagram.com/p/C3A4MMXP8Mw/?utm_source=ig_embed&utm_campaign=loading "(opens in a new window)") Is Paxlovid being prescribed as often as it should be? “Antiviral prescribing is underutilized in the United States,” Adalja says. “There are many people with high risk conditions who are not being prescribed Paxlovid \[or\] an alternative antiviral like molnupiravir.” This may be due to misconceptions, including by physicians, about who should take Paxlovid. “Some might say, ‘we're gonna wait, you don't look that bad,’ which is a complete misunderstanding of how the drug works,” says Adalja. Paxlovid is designed to be given early on to prevent symptoms from becoming more severe. The decision to prescribe someone Paxlovid for a COVID infection should be made based on a patient’s risk factors for severe disease, regardless of symptom severity. The same problem exists with antivirals for influenza. “Many high-risk people do not get prescribed an influenza antiviral despite evidence that they benefit,” says Adalja. Doctors may be more comfortable prescribing Tamiflu because they’re more familiar with it, but Tamiflu is also underutilized. How can we improve patient education around Paxlovid? One reason not enough people know about Paxlovid is that it was under emergency use authorization for quite a while, which prohibited Pfizer from advertising the drug. Instead, they relied on doctors to bring it up. Starting in 2023, Pfizer began promoting Paxlovid to consumers through social media ads and commercials. “People complain about direct-to-patient advertising, but it works,” says Adalja. “When patients know a drug by name, they’re more likely to ask their doctor about it.” It’s important that patients feel empowered to ask their health care providers about any and all treatment options, he says. “Patients should be asking their doctors, ‘Would I benefit from Paxlovid?’ ‘Would I benefit from Tamiflu?’ ‘Do I really need this antibiotic?’ Are there alternatives to Paxlovid? Currently there are two other treatments to prevent hospitalization from COVID: [Molnupiravir](https://www.covid19treatmentguidelines.nih.gov/therapies/antivirals-including-antibody-products/molnupiravir/ "(opens in a new window)"), which is another oral antiviral taken at home, and [remdesivir](https://www.covid19treatmentguidelines.nih.gov/therapies/antivirals-including-antibody-products/remdesivir/ "(opens in a new window)"), which is a three-day daily IV infusion given in a health care facility. Molnupiravir is a good alternative for individuals taking medications that may interact with Paxlovid, says Adalja. Are there any downsides to taking Paxlovid if you don’t have a risk factor for severe illness? “It’s always a risk-benefit ratio,” says Adalja. If you don't have risk factors for severe disease and you take Paxlovid, you may experience the side effects—an altered sense of taste, possible gastrointestinal upset, and possible rebound symptoms—without the benefits the medication is designed to provide. Can Paxlovid help prevent long COVID? While some early studies signaled that Paxlovid might reduce a person’s chance of developing long COVID, more recent research indicates that it does not. This includes a [study](https://onlinelibrary.wiley.com/doi/10.1002/jmv.29333 "(opens in a new window)") published in January 2024 that found no connection between Paxlovid treatment and long COVID symptoms in vaccinated, non-hospitalized individuals. There are newer antivirals not yet available in the U.S. that have a stronger signal for preventing long COVID, says Adalja. *Do concerns about COVID rebound\ outweigh the benefits of taking Paxlovid?** No. “\[Rebound\] doesn’t happen to everyone—studies show maybe 1 in 5 people who take Paxlovid experience rebound symptoms,” says Adalja. “But even those who do get rebound—with or without taking Paxlovid— don’t do badly.” For people who take Paxlovid and experience rebound, symptoms are generally mild to moderate and they do not require hospitalization. “COVID rebound was really made out to be a bigger and more common issue than it is, due to news stories about people like President Biden experiencing it,” he explains. The risk of rebound—whether or not it can be definitively linked to Paxlovid—shouldn't preclude someone who's high risk from taking Paxlovid, and it definitely shouldn’t preclude doctors from prescribing it. \COVID rebound is the return of symptoms after someone initially recovers from COVID. The order of events generally looks like this: A person is infected with COVID and feels symptomatic; their symptoms subside over the course of the infection; they may even test negative for COVID on a home antigen test; a few days later, their symptoms return, and they may test positive again on a home antigen test.* How much does Paxlovid cost? Through the end of 2023, Paxlovid was free for Americans, with the costs covered by the federal government. An [agreement between Pfizer and the U.S. Department of Health and Human Services](https://www.hhs.gov/about/news/2023/10/13/hhs-and-pfizer-reach-agreement-to-increase-patient-access-to-paxlovid.html "(opens in a new window)") will ensure Paxlovid remains free through the end of 2024 for patients who are insured through Medicare and Medicaid or uninsured. It will continue to be free through 2028 for individuals who are uninsured and underinsured. Paxlovid is covered by many private insurance plans (costs vary by plan). How can I get a prescription for Paxlovid? If you test positive for COVID, talk to your doctor as soon as possible about any factors that put you at greater risk for severe illness and whether you would benefit from taking Paxlovid. If you don’t have a health care provider, the nationwide [Test to Treat program](https://aspr.hhs.gov/TestToTreat/Pages/default.aspx "(opens in a new window)") helps people access low- or no-cost treatments quickly. Anyone who tests positive for COVID (or flu) can also access free telehealth care and treatment through the [Home Test to Treat program](https://www.test2treat.org/ "(opens in a new window)"). Aliza Rosen is a digital content strategist in the Office of External Affairs at the Johns Hopkins Bloomberg School of Public Health. ## Related: - [What to Know About JN.1, the Latest Omicron Variant](https://publichealth.jhu.edu/2024/jn1-the-dominant-variant-in-the-covid-surge) - [Mouse Model of COVID-19 in Pregnancy Shows Benefit of Paxlovid Treatment](https://publichealth.jhu.edu/2023/mouse-model-of-covid-19-in-pregnancy-shows-benefit-of-paxlovid-treatment) - [What to Know About the Updated COVID-19 Vaccine for Fall/Winter 2023](https://publichealth.jhu.edu/2023/what-to-know-about-the-updated-covid-19-vaccine-for-fall/winter-2023) ## More from the Bloomberg School - [See latest headlines](https://publichealth.jhu.edu/headlines) - [Learn more about the Department of Environmental Health and Engineering](https://publichealth.jhu.edu/departments/environmental-health-and-engineering) ## Related Content [![A patient fills out a form while her blood and saliva are screened for Hepatitis C and HIV in Spencer, West Virginia, on September 28, 2017.](https://publichealth.jhu.edu/sites/default/files/styles/related_content/public/2026-04/hep-c.jpg?h=4f4378cb&itok=zR0m9KTH)](https://publichealth.jhu.edu/2026/what-to-know-about-hepatitis-c) ### [What to Know About Hepatitis C](https://publichealth.jhu.edu/2026/what-to-know-about-hepatitis-c) April 10, 2026 ### [Why Review of the U.S.’s Measles Elimination Status Has Been Delayed](https://publichealth.jhu.edu/2026/why-review-of-the-uss-measles-elimination-status-has-been-delayed) April 09, 2026 [![Veterinarian seated in front of client with small dog on her lap lets dog sniff his hand while he speaks to the client.](https://publichealth.jhu.edu/sites/default/files/styles/related_content/public/2026-02/pet-vaccines-veterinarian.jpg?h=f321a05b&itok=pykOpVbz)](https://publichealth.jhu.edu/2026/vaccinating-your-dog-or-cat-can-also-protect-you) ### [Why We Vaccinate Our Dogs and Cats](https://publichealth.jhu.edu/2026/vaccinating-your-dog-or-cat-can-also-protect-you) February 27, 2026 [![A fact sheet for measles sits on a table at a mobile clinic offering free vaccinations on February 6, 2026, in Spartanburg, South Carolina](https://publichealth.jhu.edu/sites/default/files/styles/related_content/public/2026-02/measles-alert.jpg?h=f321a05b&itok=ZGLwxGrm)](https://publichealth.jhu.edu/2026/what-is-a-measles-exposure-alert) ### [There's a Measles Alert in My Area. Now What?](https://publichealth.jhu.edu/2026/what-is-a-measles-exposure-alert) February 24, 2026 [![Screenshots from two videos assigned to participants in the study. Top left corner: a Brazilian man in a suit poses as an executive of a fictitious tobacco company. Top right: The same man holds 12 cigarettes in his hands. Bottom right: a woman in a white lab coat holding a vial, posing as an employee of a fictitious tobacco company's lab. Bottom left: the same woman reads data displayed on a desktop computer screen. ](https://publichealth.jhu.edu/sites/default/files/styles/related_content/public/2026-01/2240x1260px-News-Item-2026.02-CSR-Brazil.jpg?h=5eaa5dc3&itok=VbdQTyA6)](https://publichealth.jhu.edu/221/2026/cigarettes-lies-and-videotape-study-links-consumer-perceptions-with-tobacco-industry-deceptions) ### [Cigarettes, Lies, and Videotape: Study Links Consumer Perceptions with Tobacco Industry Deceptions](https://publichealth.jhu.edu/221/2026/cigarettes-lies-and-videotape-study-links-consumer-perceptions-with-tobacco-industry-deceptions) February 04, 2026 Johns Hopkins Bloomberg School of Public Health [615 N. 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Readable Markdown	One of the best tools for preventing severe complications from COVID infection is the prescription antiviral drug Paxlovid. But not nearly as many people who could benefit from it are being prescribed it, says [Amesh Adalja, MD, FIDSA](https://publichealth.jhu.edu/faculty/3528/amesh-adalja), a senior scholar at the [Johns Hopkins Center for Health Security](https://www.centerforhealthsecurity.org/ "(opens in a new window)") who specializes in infectious diseases and pandemic preparedness. Adalja says that both patients and providers need to be better informed about the benefits of Paxlovid and other antivirals like it. Paxlovid is extremely effective when taken within five days of symptom onset. In clinical trials, it reduced the risk of hospitalization and death by almost 90% in unvaccinated people. “It’s a tremendous tool that's completely underutilized,” says Adalja. How does Paxlovid work? “Paxlovid is a class of antiviral drug called a protease inhibitor,” explains Adalja. It prevents the SARS-CoV-2 virus, which causes COVID-19 infection, from replicating in the body. At a molecular level, “Paxlovid works by disrupting the protein cutting process of SARS-CoV-2,” he explains. “It blocks an essential step in the virus’s life cycle.” Who is Paxlovid recommended for? Paxlovid is designed to benefit people at high risk of severe illness who are at least 12 years old and weigh at least 88 pounds. Its purpose is to prevent hospitalization and death, not to decrease symptoms or to help you recover faster, although patients who take it may experience one or both of those benefits. Who is considered “high risk” for severe COVID-19 illness, hospitalization, or death? According to the CDC, people are more likely to experience severe COVID-19 illness if they are over 50 years old, unvaccinated or not up to date on COVID-19 vaccination, immunocompromised, or have [certain medical conditions](https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html "(opens in a new window)"). “Any medical condition such as diabetes, hypertension, heart disease, any lung condition like asthma or COPD, would be considered high risk,” says Adalja. Other common risk factors include being overweight, obese, or pregnant. “The majority of Americans probably have some high risk factor,” he says. “A lot of people would benefit from Paxlovid just based on their weight status.” Is Paxlovid being prescribed as often as it should be? “Antiviral prescribing is underutilized in the United States,” Adalja says. “There are many people with high risk conditions who are not being prescribed Paxlovid \[or\] an alternative antiviral like molnupiravir.” This may be due to misconceptions, including by physicians, about who should take Paxlovid. “Some might say, ‘we're gonna wait, you don't look that bad,’ which is a complete misunderstanding of how the drug works,” says Adalja. Paxlovid is designed to be given early on to prevent symptoms from becoming more severe. The decision to prescribe someone Paxlovid for a COVID infection should be made based on a patient’s risk factors for severe disease, regardless of symptom severity. The same problem exists with antivirals for influenza. “Many high-risk people do not get prescribed an influenza antiviral despite evidence that they benefit,” says Adalja. Doctors may be more comfortable prescribing Tamiflu because they’re more familiar with it, but Tamiflu is also underutilized. How can we improve patient education around Paxlovid? One reason not enough people know about Paxlovid is that it was under emergency use authorization for quite a while, which prohibited Pfizer from advertising the drug. Instead, they relied on doctors to bring it up. Starting in 2023, Pfizer began promoting Paxlovid to consumers through social media ads and commercials. “People complain about direct-to-patient advertising, but it works,” says Adalja. “When patients know a drug by name, they’re more likely to ask their doctor about it.” It’s important that patients feel empowered to ask their health care providers about any and all treatment options, he says. “Patients should be asking their doctors, ‘Would I benefit from Paxlovid?’ ‘Would I benefit from Tamiflu?’ ‘Do I really need this antibiotic?’ Are there alternatives to Paxlovid? Currently there are two other treatments to prevent hospitalization from COVID: [Molnupiravir](https://www.covid19treatmentguidelines.nih.gov/therapies/antivirals-including-antibody-products/molnupiravir/ "(opens in a new window)"), which is another oral antiviral taken at home, and [remdesivir](https://www.covid19treatmentguidelines.nih.gov/therapies/antivirals-including-antibody-products/remdesivir/ "(opens in a new window)"), which is a three-day daily IV infusion given in a health care facility. Molnupiravir is a good alternative for individuals taking medications that may interact with Paxlovid, says Adalja. Are there any downsides to taking Paxlovid if you don’t have a risk factor for severe illness? “It’s always a risk-benefit ratio,” says Adalja. If you don't have risk factors for severe disease and you take Paxlovid, you may experience the side effects—an altered sense of taste, possible gastrointestinal upset, and possible rebound symptoms—without the benefits the medication is designed to provide. Can Paxlovid help prevent long COVID? While some early studies signaled that Paxlovid might reduce a person’s chance of developing long COVID, more recent research indicates that it does not. This includes a [study](https://onlinelibrary.wiley.com/doi/10.1002/jmv.29333 "(opens in a new window)") published in January 2024 that found no connection between Paxlovid treatment and long COVID symptoms in vaccinated, non-hospitalized individuals. There are newer antivirals not yet available in the U.S. that have a stronger signal for preventing long COVID, says Adalja. *Do concerns about COVID rebound\ outweigh the benefits of taking Paxlovid?** No. “\[Rebound\] doesn’t happen to everyone—studies show maybe 1 in 5 people who take Paxlovid experience rebound symptoms,” says Adalja. “But even those who do get rebound—with or without taking Paxlovid— don’t do badly.” For people who take Paxlovid and experience rebound, symptoms are generally mild to moderate and they do not require hospitalization. “COVID rebound was really made out to be a bigger and more common issue than it is, due to news stories about people like President Biden experiencing it,” he explains. The risk of rebound—whether or not it can be definitively linked to Paxlovid—shouldn't preclude someone who's high risk from taking Paxlovid, and it definitely shouldn’t preclude doctors from prescribing it. \COVID rebound is the return of symptoms after someone initially recovers from COVID. The order of events generally looks like this: A person is infected with COVID and feels symptomatic; their symptoms subside over the course of the infection; they may even test negative for COVID on a home antigen test; a few days later, their symptoms return, and they may test positive again on a home antigen test.* How much does Paxlovid cost? Through the end of 2023, Paxlovid was free for Americans, with the costs covered by the federal government. An [agreement between Pfizer and the U.S. Department of Health and Human Services](https://www.hhs.gov/about/news/2023/10/13/hhs-and-pfizer-reach-agreement-to-increase-patient-access-to-paxlovid.html "(opens in a new window)") will ensure Paxlovid remains free through the end of 2024 for patients who are insured through Medicare and Medicaid or uninsured. It will continue to be free through 2028 for individuals who are uninsured and underinsured. Paxlovid is covered by many private insurance plans (costs vary by plan). How can I get a prescription for Paxlovid? If you test positive for COVID, talk to your doctor as soon as possible about any factors that put you at greater risk for severe illness and whether you would benefit from taking Paxlovid. If you don’t have a health care provider, the nationwide [Test to Treat program](https://aspr.hhs.gov/TestToTreat/Pages/default.aspx "(opens in a new window)") helps people access low- or no-cost treatments quickly. Anyone who tests positive for COVID (or flu) can also access free telehealth care and treatment through the [Home Test to Treat program](https://www.test2treat.org/ "(opens in a new window)"). Aliza Rosen is a digital content strategist in the Office of External Affairs at the Johns Hopkins Bloomberg School of Public Health. ## Related: - [What to Know About JN.1, the Latest Omicron Variant](https://publichealth.jhu.edu/2024/jn1-the-dominant-variant-in-the-covid-surge) - [Mouse Model of COVID-19 in Pregnancy Shows Benefit of Paxlovid Treatment](https://publichealth.jhu.edu/2023/mouse-model-of-covid-19-in-pregnancy-shows-benefit-of-paxlovid-treatment) - [What to Know About the Updated COVID-19 Vaccine for Fall/Winter 2023](https://publichealth.jhu.edu/2023/what-to-know-about-the-updated-covid-19-vaccine-for-fall/winter-2023)
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