How has veterinary ivermectin misuse during the COVID-19 pandemic affected poison center and hospital admission trends?
Executive summary
Veterinary ivermectin misuse during the COVID‑19 pandemic drove a measurable and well‑documented rise in poison‑control reports and a smaller but real increase in emergency‑department visits and hospitalizations tied to ivermectin toxicity, particularly among older men taking high doses or veterinary formulations; poison centers reported several‑fold increases compared with pre‑pandemic baselines and case series detail dozens of admitted patients with neurotoxic and gastrointestinal effects [1] [2] [3]. Public‑health agencies including the CDC and FDA issued alerts urging clinicians and the public to avoid veterinary products after poison‑control call volumes and pharmacy dispensing surged, while randomized trials ultimately failed to show clinical benefit of ivermectin for COVID‑19 [1] [4] NEJMc2114907" target="_blank" rel="noopener noreferrer">[5].
1. A sharp rise in poison‑control contacts, not a hidden epidemic of hospitalizations
Poison‑control centers across the U.S. reported a clear increase in human exposures to ivermectin in 2021 versus the pre‑pandemic baseline, with the CDC noting roughly a three‑fold spike in January 2021 and reports later in 2021 of calls five times higher than before the pandemic in some analyses; these data reflect contacts to poison centers—useful sentinel signals of misuse but not direct counts of all medical encounters or deaths [1] [2] [6].
2. Hospital admissions rose, but numbers in the literature remain limited and localized
Clinical toxicology case series and reports identify dozens of patients who required emergency care or hospitalization: an Oregon Poison Center study found 37 cases over a 24‑week window, with 13 treated in emergency departments and 21 hospitalized, and the NEJM described six hospitalizations in a smaller series—evidence that misuse translated into real inpatient burden, although these reports are geographically and temporally limited samples rather than national hospitalization tallies [3] [7] [5].
3. Veterinary formulations and overdoses drove severity and neurotoxic presentations
Multiple analyses and the Oregon case series show that people consuming veterinary ivermectin formulations tended to ingest higher doses and developed more frequent altered mental status and neurotoxic signs (confusion, decreased consciousness, hallucinations, seizures), alongside gastrointestinal and cardiovascular effects; regulators warned that veterinary products are formulated for large animals and can be far more concentrated and dangerous in humans [7] [2] [8].
4. Dispensing and demand surged—even prescriptions rose—complicating interpretation
Retail pharmacy dispensing of human ivermectin prescriptions rose dramatically during peaks of interest—CDC‑cited data describe a 24‑fold increase in prescriptions at one peak—which complicates attribution of poison‑center signals solely to veterinary product misuse because both veterinary purchases and human prescriptions expanded in tandem [8] [9].
5. Public‑health response framed the trend as misuse amplified by misinformation
Federal agencies responded with health advisories and letters to veterinarians and retailers after poison‑control centers and clinicians reported a “sharp spike” in adverse events from animal ivermectin use; these communications explicitly linked rising calls and hospitalizations to misuse prompted by claims—widely amplified on social media—that ivermectin prevented or treated COVID‑19 despite lack of supportive clinical evidence [4] [1] [5].
6. Limits of the reporting: signals, not a census of harm; causality and scope remain partly unresolved
Available sources are strong on trend signals—poison‑control call volumes, focused case series, and agency alerts—but they do not provide a complete national count of hospital admissions or long‑term outcomes, and poison‑center data can overrepresent symptomatic or concerned callers while undercapturing unreported cases; therefore the evidence supports a meaningful, measurable increase in misuse‑related healthcare encounters without proving a proportionally large nationwide hospitalization burden beyond these documented clusters [9] [3].
7. Competing narratives and incentives: chemistry, politics and commerce
Alternative viewpoints exist: some clinicians prescribed ivermectin early in the pandemic and some patients sought prescriptions rather than veterinary supplies, and the surge in dispensing suggests demand was fueled by both prescribers and lay consumers; however, randomized trials and systematic reviews did not demonstrate benefit for COVID‑19, and public‑health advisories framed the uptick in poison‑center reports as harm caused by misinformation and inappropriate use [5] [10] [8].
Conclusion
The best synthesis of the reporting is that veterinary ivermectin misuse produced a clear, multi‑fold increase in poison‑control calls and contributed to dozens of documented emergency‑department visits and hospitalizations with mainly neurotoxic and gastrointestinal presentations; regulators and poison centers used these sentinel data to warn the public, but national hospitalization totals and long‑term outcomes are not fully captured in the published series and administrative alerts [1] [3] [4].