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Important Update

State/Territory-Coordinated Distribution of Sotrovimab

December 17, 2021

Monoclonal Antibody Therapeutic Updates

The COVID-19 pandemic is rapidly evolving, and new updates are issued frequently. To view a full list of HHS/ASPR’s updates related to COVID-19 monoclonal antibody therapeutics, please see our full list of updates.

In late November, the federal government paused shipment of the monoclonal antibody therapeutic sotrovimab in order to help ensure a more balanced portfolio of monoclonal antibody products and to allow more time to assess data regarding the effectiveness of sotrovimab against the Omicron variant.

Early in vitro data suggests sotrovimab retains activity against the Omicron variant. As such, we are actively preparing approximately 55,000 doses of sotrovimab for immediate allocation to your jurisdictions. Shipment of product will begin soon, and jurisdictions will see product arrive as early as Tuesday, December 21, 2021.

Allocation of sotrovimab to state and territorial health departments was determined using the same methodology as before, which takes into account COVID-19 incidence rates and hospitalizations.

Please note that the federal government’s current supply of sotrovimab is extremely limited, and additional doses of the product will not be available until the week of January 3rd. We recommend that jurisdictions continue use of the bam/ete and REGEN-COV monoclonal antibody products while reserving sotrovimab for treatment of eligible outpatients at highest risk who are either:

  • diagnosed with a test that may identify a potential case of the Omicron variant (e.g., by S gene Target Failure in the ThermoFisher TaqPath assay); or
  • are present in local settings where reported prevalence of Omicron is greater than 20%.

Until local prevalence of Omicron is greater than 20%, jurisdictions are encouraged to direct sotrovimab to sites that can provide IV treatment (within 48 hours of collection of a patient sample) to highest risk, eligible individuals diagnosed with a test that may identify a potential case of the Omicron variant.

Highest risk criteria for severe COVID-19 can be determined by local prioritization schemes, but criteria may include age ≥65 years, major immune suppression (e.g., recently diagnosed hematologic malignancy, cancer chemotherapy, solid organ transplant on immune suppression), obesity with BMI >35-40 kg/m2, cardiovascular disease (including hypertension), pregnancy, poorly controlled diabetes, significantly reduced kidney function, COPD, stroke, and two or more risk factors.

Jurisdictions should also take into consideration the NIH COVID-19 Treatment Guidelines Panel’s Statement on prioritization when there are logistical or supply constraints.

Distribution Determinations for Sotrovimab: December 17, 2021

State/Territory Name Abbreviation sotrovimab
(units = doses)
Alaska AK 66
Alabama AL 318
Arkansas AR 372
American Samoa AS 12
Arizona AZ 1,644
California CA 2,658
Colorado CO 984
Connecticut CT 1,002
District of Columbia DC 108
Delaware DE 276
Department of Defense DD 96
Department of State DoS 12
Florida FL 1,050
Georgia GA 816
Guam GU 18
Hawaii HI 66
Iowa IA 774
Immigration and Customs Enforcement ICE 12
Idaho ID 180
Illinois IL 3,288
Indian Health Service IHS 180
Indiana IN 2,160
Kansas KS 726
Kentucky KY 1,140
Louisiana LA 228
Massachusetts MA 1,800
Maryland MD 384
Maine ME 414
Michigan MI 3,228
Minnesota MN 1,374
Missouri MO 1,338
Commonwealth of the Northern Mariana Islands MP 72
Mississippi MS 192
Montana MT 132
North Carolina NC 1,380
North Dakota ND 168
Nebraska NE 420
New Hampshire NH 498
New Jersey NJ 1,938
New Mexico NM 504
Nevada NV 378
New York NY 4,242
Ohio OH 3,888
Oklahoma OK 648
Oregon OR 318
Pennsylvania PA 3,750
Puerto Rico PR 42
Rhode Island RI 384
South Carolina SC 468
South Dakota SD 198
Tennessee TN 810
Texas TX 2,694
Utah UT 540
Virginia VA 1,128
Veterans Health Administration VHA 150
Virgin Islands VI 6
Vermont VT 156
Washington WA 552
Wisconsin WI 2,052
West Virginia WV 492
Wyoming WY 78
Totals   55,002