Comparison between different passive antibody therapies
| Characteristic . | CP . | Human hyperimmune globulin . | mAb . |
|---|---|---|---|
| Speed of production after start of pandemic | Rapid—weeks Can be produced once patients have recovered from infection (14 to 28 days after recovery) | Slow—months Needs time to collect plasma from a large number of people who have recovered from infection | Slowest—months Need to identify potential antibodies that would be useful to develop as a mAb and then manufacture antibody |
| Can adapt to viral variants | Yes | Yes—more slowly than CP | No |
| Number of anti–SARS-CoV-2 antibodies product contains | Many—polyclonal | Many—polyclonal | One to 2 antibodies |
| Amount of antibody contained within the product | Very variable. Variability can be reduced by using mini-pools—used in Argentina but not all countries allowed to produce mini-pools | Fixed amount of total antibody | Fixed amount of neutralizing SARS-CoV-2 neutralizing antibody |
| Route of administration | Intravenous | Subcutaneous, intramuscular, or intravenous | Subcutaneous, intramuscular, or intravenous |
| Derived from blood* | Yes | Yes | No |
| Availability | Able to be produced in any country in which people have recovered from the infection and are able to produce plasma | Not able to be produced in every country but manufacturing requirements are not complex | Limited supply due to complex manufacturing requirements |
| Cost | Relatively cheap—$100 to $200 per dose Can be used in low- and middle-income countries | More expensive than CP but cheaper than mAb—may be able to be produced locally, in low- and middle-income countries | Expensive—$1000s per dose Cannot be afforded by low- and middle-income countries Can only be produced at a limited number of manufacturing sites |
| Characteristic . | CP . | Human hyperimmune globulin . | mAb . |
|---|---|---|---|
| Speed of production after start of pandemic | Rapid—weeks Can be produced once patients have recovered from infection (14 to 28 days after recovery) | Slow—months Needs time to collect plasma from a large number of people who have recovered from infection | Slowest—months Need to identify potential antibodies that would be useful to develop as a mAb and then manufacture antibody |
| Can adapt to viral variants | Yes | Yes—more slowly than CP | No |
| Number of anti–SARS-CoV-2 antibodies product contains | Many—polyclonal | Many—polyclonal | One to 2 antibodies |
| Amount of antibody contained within the product | Very variable. Variability can be reduced by using mini-pools—used in Argentina but not all countries allowed to produce mini-pools | Fixed amount of total antibody | Fixed amount of neutralizing SARS-CoV-2 neutralizing antibody |
| Route of administration | Intravenous | Subcutaneous, intramuscular, or intravenous | Subcutaneous, intramuscular, or intravenous |
| Derived from blood* | Yes | Yes | No |
| Availability | Able to be produced in any country in which people have recovered from the infection and are able to produce plasma | Not able to be produced in every country but manufacturing requirements are not complex | Limited supply due to complex manufacturing requirements |
| Cost | Relatively cheap—$100 to $200 per dose Can be used in low- and middle-income countries | More expensive than CP but cheaper than mAb—may be able to be produced locally, in low- and middle-income countries | Expensive—$1000s per dose Cannot be afforded by low- and middle-income countries Can only be produced at a limited number of manufacturing sites |
Any product derived from human blood requires viral testing to ensure that the transfused product does not cause a transfusion-transmitted infection. In high-income countries with good screening systems, transfusion-transmitted infection is very rare. In the United Kingdom, there were no transfusion-transmitted infections reported to the national hemovigilance system in 2020 (https://www.shotuk.org/wp-content/uploads/myimages/TTI-Supplementary-material-2020.pdf).