Top 5 Takeaways

  1. Oral Antivirals for COVID-19: The study analyzes the dispensing of oral antiviral drugs, Paxlovid and Lagevrio, for COVID-19 treatment, focusing on zip code-level social vulnerability in the U.S. from December 23, 2021, to August 28, 2022.
  2. Disparities in Dispensing Rates: Initial data showed significant disparities in dispensing rates across high, medium, and low social vulnerability zip codes, with high-vulnerability areas receiving fewer treatments.
  3. Increased Overall Dispensing: Between April and August 2022, the dispensing of these antivirals increased by 57%, with a notable increase in high-vulnerability areas, indicating progress towards equitable access.
  4. Intervention Strategies: HHS implemented various strategies to improve equitable dispensing, including education, teleprescribing programs, and strategic distribution to health centers in high-vulnerability areas.
  5. Remaining Challenges and Limitations: Despite improvements, challenges such as limited pharmacy prescribing due to regulatory constraints and the need for further efforts to ensure equitable access persist. The analysis has limitations like reliance on self-reported data and lack of detailed patient-specific outcomes.

Original Article Author and Citation

Corresponding Author

Meghan E. Pennini,

Suggested Citation

Sullivan M, Perrine CG, Kelleher J, et al. Notes From the Field: Dispensing of Oral Antiviral Drugs for Treatment of COVID-19 by Zip Code–Level Social Vulnerability — United States, December 23, 2021–August 28, 2022. MMWR Morb Mortal Wkly Rep 2022;71:1384–1385. DOI:


The study examines the distribution of two oral antiviral drugs, Paxlovid and Lagevrio, for treating COVID-19. Initially, high-vulnerability zip codes showed significantly lower dispensing rates compared to medium- and low-vulnerability areas. However, with targeted intervention strategies by HHS, there was a significant increase in dispensing rates in high-vulnerability areas, reducing the disparity.


Data on dispensed courses of oral antivirals were collected regularly from provider sites. The analysis included weekly dispensing rates by zip code social vulnerability level, using criteria consistent with previous reports.


The increased dispensing in high-vulnerability areas reflects efforts towards equitable access. The role of HHS in coordinating and implementing targeted interventions is highlighted, along with the challenges faced, particularly in pharmacy prescribing due to regulatory and reimbursement issues.


The study shows progress in addressing disparities in access to COVID-19 oral antivirals. Continued efforts and additional strategies are needed to further close the gap in equitable distribution, considering the limitations and challenges identified.


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