Paxlovid — the oral antiviral combination (nirmatrelvir/ritonavir) that the FDA authorized for COVID-19 in December 2021 and formally approved in 2023 — was a clinical breakthrough in its original context: a pill that dramatically reduced hospitalization and death in unvaccinated, high-risk COVID patients. That original evidence was strong, and its public health benefit was real.
The clinical landscape has changed significantly since then. Most high-risk adults in the United States are now vaccinated, and the question of whether Paxlovid provides the same dramatic benefit in vaccinated people with COVID has a more nuanced answer than the drug's original trial data suggested.
