COVID-19 Antiviral Use Declines Among Seniors Despite High Risk
Despite the proven benefits of antiviral treatments in reducing severe COVID-19 outcomes, a concerning trend is emerging: fewer older adults are receiving these potentially life-saving medications. Recent data reveals a significant decline in antiviral prescriptions for individuals aged 65 and older, even as they remain the most vulnerable population to severe illness, hospitalization, and death from the virus.
The Shifting Landscape of COVID-19 Treatment
A retrospective study analyzing data from over 482,000 outpatient encounters between June 2023 and September 2025 showed that only 31% of eligible older adults received an antiviral prescription. This figure represents a substantial decrease compared to earlier periods, with prescribing rates dropping from around 37% in the summer of 2023 to as low as 16.5% in the spring of 2025. The most commonly prescribed antiviral was nirmatrelvir/ritonavir (Paxlovid), accounting for 80% of prescriptions.
Interestingly, the decline in prescribing appears to correlate with fluctuations in SARS-CoV-2 circulation. Researchers suggest that perceptions of community transmission levels may be influencing treatment decisions, with fewer prescriptions issued during periods of lower reported cases.
Who is Most Likely – and Least Likely – to Receive Treatment?
The study identified several factors associated with antiviral receipt. Increasing age was linked to a slightly higher likelihood of treatment, with those aged 75-84 and 85 and older more likely to receive antivirals compared to those aged 65-74. Asian and Hispanic or Latino patients were also more likely to be prescribed antivirals than non-Hispanic White patients.
However, the presence of comorbidities – other existing health conditions – was associated with lower odds of receiving treatment. Patients with one or two or more comorbidities were less likely to be prescribed antivirals. Rural residence also correlated with lower prescribing rates compared to urban areas. Strongly associated with treatment was having received at least one COVID-19 vaccine dose within the prior 6 months.
Pro Tip: If you are over 65 and test positive for COVID-19, discuss treatment options with your doctor immediately, especially if you have underlying health conditions.
The Importance of Early Intervention
Antiviral therapies, such as nirmatrelvir/ritonavir, remdesivir, and molnupiravir, are most effective when initiated within the first few days of symptom onset. These medications operate by targeting specific parts of the virus to prevent it from multiplying, reducing the risk of severe illness, and hospitalization. The study found that 99% of patients who received treatment were prescribed antivirals within 7 days of diagnosis.
Age remains the strongest risk factor for severe COVID-19. Older adults are more likely to develop complications like pneumonia and organ damage. Timely treatment is crucial for mitigating these risks.
Challenges and Future Directions
The decline in antiviral use among older adults raises significant public health concerns. Investigators emphasize the demand for improved healthcare provider and patient education regarding the benefits of COVID-19 vaccination and antiviral treatments. Addressing disparities in access to care, particularly in rural areas and among individuals with comorbidities, is also critical.
Did you know? Vaccination significantly increases the likelihood of receiving antiviral treatment if you test positive for COVID-19.
FAQ
Q: What are the main COVID-19 antiviral treatments available?
A: The primary antivirals are nirmatrelvir/ritonavir (Paxlovid), remdesivir, and molnupiravir.
Q: How quickly do I need to start antiviral treatment after testing positive?
A: Antivirals are most effective when started within 5 days of symptom onset.
Q: Are there any factors that might make me less likely to receive an antiviral prescription?
A: Having comorbidities, living in a rural area, and not being up-to-date on your COVID-19 vaccinations may decrease your chances of receiving a prescription.
Q: Why is it important for older adults to get treated for COVID-19?
A: Older adults are at higher risk of severe illness, hospitalization, and death from COVID-19.
Want to learn more about protecting yourself from COVID-19? Visit the CDC website for the latest information and guidance.
