Paxlovid Rebound: FDA Investigating Reports Of Covid-19 Relapses After Taking Pfizer Antiviral

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While the FDA is investigating Paxlovid rebound, Ty and Charlene Bollinger say that Pfizer pills are causing secondary Covid.

Ty and Charlene Bollinger are members of The Disinformation Dozen.

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Excerpts from: Paxlovid Rebound: FDA Investigating Reports Of Covid-19 Relapses After Taking Pfizer Antiviral

Paxlovid Rebound: FDA Investigating Reports Of Covid-19 Relapses After Taking Pfizer Antiviral

Bruce Y. Lee

Senior Contributor

I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order.

May 19, 2022, 09:30pm EDT

Having a rebound of Covid-19 after taking Paxlovid is not exactly the same as having a rebound relationship. Although both could make you sick in different ways. A post-Paxlovid rebound may come after you feel better from taking Paxlovid for a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The rebound is when at some point after the five-day course of the medication is completed, you experience a relapse of Covid-19 symptoms. And it seems like more and more people have been reporting such relapses.

Reports of Post-Paxlovid Covid-19 Rebound Cases But No Formal Studies Yet

For example, there’s that pre-print case report uploaded to Research Square on April 26, 2022, of a 71-year-old man who had been fully vaccinated and boosted against Covid-19. He began taking Paxlovid as soon as he had tested positive for Covid-19, two days after he had gotten exposed to the virus. His Covid-19 symptoms essentially disappeared after two days of Paxlovid, which seemed like a good thing. Yet, nine days after he had first tested positive and four days after he had completed the five-day course of Paxlovid, guess what happened? His runny nose, sore throat, and difficulty breathing returned, along with SARS-CoV-2 levels in his body going up again. It was like déjà eww all over again. Viral genome sequencing showed that during both his initial symptoms and his return of symptoms, he was infected with the BA.1 Omicron subvariant of the SARS-CoV-2. This suggested that he has experienced not two separate infections but a single one that improved before subsequently getting worse.

Of course, a pre-print is not the same as a peer-reviewed article, and anyone with opposable thumbs, a laptop, and Internet access could in theory upload a pre-print. But the authors of the case report (Kalpana Gupta, MD, Judith Strymish, MD, Gary Stack, MD, PhD, and Michael Charness, MD) are legitimate doctors from legitimate healthcare systems, the VA Connecticut and Boston Healthcare Systems. Plus this certainly hasn’t been the only report of such a rebound. For example, here’s what Tatiana Prowell, MD, an Associate Professor of Oncology at the Johns Hopkins School of Medicine, tweeted:

And Peter Hotez, MD, PhD, Dean of the National School of Tropical Medicine at Baylor Medical College, described his case of possible post-Paxlovid relapse in the following tweet:

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Rebound Covid-19 Cases Don’t Necessarily Mean that Paxlovid is Not Working
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Do these rebound cases then mean that Paxlovid is not doing its job? No, not necessarily. Just because symptoms return doesn’t mean that things wouldn’t have been even worse without the medication. Plus, it’s not yet clear what percentage of people have been experiencing such relapses. Again, stories on Twitter and a pre-print case report ain’t the same as peer-reviewed studies. While Pfizer’s clinical trial did show possible rebound Covid-19 occurring in about 2% of those who had received Paxlovid, around 1.5% of those who had received only placebo also suffered similar relapses. With these two percentages not being statistically significantly different from each other, the conclusion from the clinical trial was that these rebounds weren’t specific to Paxlovid. Of course, what happens or doesn’t happen in a clinical trial doesn’t necessarily mean the same will apply exactly in the real world.

Potential Reasons for the Covid-19 Rebound Cases

So what’s going on, in the words of Marvin Gaye? One possibility is that the five-day course of the medication is turning out to be not long enough for everyone.
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Another possibility is that the Omicron variant may be different enough from previous versions of the virus that the medication may not be quite as effective. Remember Pfizer’s clinical trial occurred last year while the Delta variant was dominant. So all results from the clinical trial may be more Delta-specific.

A third possibility is that the virus has been developing resistance to the antiviral medication. While resistance may not be futile, it can reduce the effectiveness of the medication.
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A fourth possibility is re-infection. Could some of the supposed relapse cases actually be people getting infected and then re-infected in a short period of time? I did cover for Forbes a case of someone getting infected with the Omicron variant within 20 days of first getting infected with the Delta variant. But it’s not clear how common such getting two separate infections within such a short time period may be.
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So if you do have a rebound case of Covid-19 after taking Paxlovid, what should you do? …There is not enough evidence about what to do. And the EUA only covers taking the medication for a single five day course. So hold off on taking another course of Paxlovid unless you doctor indicates that you should.
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All of This Is Further Reason to Maintain Other Covid-19 Precautions

Don’t think that the existence of Covid-19 treatments can allow you to forego other Covid-19 precautions such as face mask wearing and vaccination against Covid-19.

https://www.forbes.com/sites/brucelee/2022/05/19/paxlovid-rebound-some-suffering-covid-19-relapses-after-taking-pfizer-antiviral/?sh=301ed01fb8e4

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