Paxlovid Fails to reduce COVID-19 hospitalizations and all cause mortality among vaxxed elderly adults

A natural experiment consisting of an analysis of aggregate data for vaxxed COVID-19 patients between 65-74 years of age from Institute for Clinical Evaluation Sciences linked Ontario health databases between April 2022 and November 2022 (n = 1,620,884) found no significant difference in hospitalizations and mortality outcomes between patients just above and just below the age cut off for Paxlovid treatment (70 years). The differences in hospitalization and mortality outcomes between seniors just below and just above the age cut off for Paxlovid treatment were also similar in 2021 before Paxlovid was available. The authors conclude ‘a more than doubled rate of nirmatrelvir-ritonavir prescriptions was not associated with reductions in hospitalizations or mortality among highly vaccinated older adults in Ontario.’ Stratified by age, Paxlovid prescriptions lead to a non-significant absolute risk reduction of only 1.3% for COVID-19 related hospitalizations among vaxxed senior patients. While this is not an RCT and therefore cannot allow us to make causal inferences, it is the fourth major study in the past year in which Paxlovid failed to significantly improve on primary clinical endpoints. One reason why Paxlovid has been largely ineffective might be due to the fact that it creates selection pressures for drug resistant sub variants of the virus, which as I mentioned in September of last year, was first discovered in a viral genome sequencing study and replicated in a hamster model and cell culture experiment.