A question regarding masking: You mentioned that, with Covid cases on the rise, you’re returning to masking in “indoor crowded areas, like the airport.”
I am always a bit confused by statements like this. Epidemiologist Dr. Michael Osterholm awhile back shared that he *thinks* he got Covid from an elevator ride with a few friends (virus lingering there from a previous occupant). Back-to-school events often have 25 to 30 adults in a classroom, etc. and no ventilation. Isn’t that a crowded indoor event? Would you mask there, or would the social pressure to not mask inhibit you if no one else was masking?
How about the fitting room at TJ Maxx on a busy Saturday morning, where every spot is taken? Or a public restroom, etc.? Or any public indoor place with poor ventilation? It’s so hard to gauge what is “safer,” while knowing that you can’t entirely eliminate risk.
Early in the pandemic I began using an Aranet meter to monitor CO2 (serves as a proxy for ventilation and potential airborne virus risk), and sometimes the waiting areas in airports are much better than other places people go every day. (It’s boarding, deplaning, and waiting to take off where air quality is poor, according to my CO2 meter.)
I’m embarrassed to still be asking these questions 5+ years on and appreciate any guidance you can give on this topic.
None of my doctors or their staffs are masking, even during a Covid wave in our area. Not at the urgent care (where I just went for routine lab work because they share the same space) - and the waiting room was full of unmasked people coughing and complaining of fevers and sore throats when they checked in! A friend had to take her husband (who is receiving chemo) to the local hospital emergency room last week and no staff there were masked, though they advised my friend’s husband not to stay overnight “because the hospital is full of Covid.”
I feel like I live in upside down world, and I’m the only one who still cares about this.
"I feel like I live in upside down world, and I’m the only one who still cares about this."
You aren't the only one, for whatever consolation that provides. I completely share your concerns - it is hard to not feel paranoid when so many around you, even people in their 70s and 80s are acting/living like it was still 2019. And medical staff - horrifying!
My primary care doctor's office masks. Others don't. I recently forgot to mask when entering the hospital for surgery. But when I go to doctors' offices I always mask. The only place I don't mask is in my small grocery store which is not crowded when I shop, and that is only during the summer. Based on today's column, I think it's time to start masking there also. I can assure you that you are not the only one who cares about this. I am an older person with asthma, and psychological issues around breathing, so I care a lot about staying safe.
The providers in my office are masking to see sick visits. Usually during flu season, the office puts out a mask mandate. I suggested my husband mask on his recent flight for a business trip. He did not and he got covid and shared it with the entire household.
My husband, kids and I mask in most indoor places--office buildings, grocery stores, pharmacies, restaurants, etc. I take a mask-first approach--enter wearing a mask, then decide. Sometimes when I look around, I decide to take off my mask because there are very few people there and the benefits of having my whole face visible and my voice unhindered outweigh the unlikelihood of catching COVID-19 in that space.
My grandson went back to school 3 weeks ago and tested positive for Covid on Friday. He's doing okay, but there are no guidelines from the school on when to return, other than to say "when he feels better". Just an FYI from California. Thanks again for all you do!
Any thoughts on the claim that RFK and Trump are planning to fully ban the COVID vaccine? Just reported this morning by a single source so I'm not sure it holds a ton of water but it also doesn't seem out of the realm of possibility for what they'd do.
For those of us who got a 2024 booster, is it worth it to re-up that now in case we don't have access to a 2025 one, even if it isn't the most updated strains?
Question please: when will the rest of the vaccine integrity research be shared? I loved seeing it, especially appreciating the thorough screening methods employed to identify studies to include in the recommendations.
Thank you, and eagerly awaiting the deep dive on COVID (and hopefully vaccine updates) later this week! Seems like last Friday came and went without any anticipated announcements?
Friday came and went without a peep from Kennedy et al. on the what and when of the fall COVID jabs, but the American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) made their own recommendations for their patients last week (https://covidandvaccineupdate.substack.com/p/medical-organizations-restoring-choice). Although these recommendations do not conform with Kennedy's previous restrictive directive and FDA's "framework" for COVID vaccines, off-label use is both possible and complicated, e.g., insurance coverage and potential provider liability.
Then yesterday, noise from a Kennedy proxy planted the specter of the elimination of COVID vaccines, which would require FDA to pull their licenses. (FDA still has its VRBPAC advisors, who would certainly oppose such action, but they could be fired like their CDC ACIP counterparts.) Pfizer reportedly had been notified that its jab would not be approved for the youngest kids this fall (https://covidandvaccineupdate.substack.com/p/covid-keeps-coming).
Meanwhile, although ACIP still hasn't set a date to meet publicly on the fall shots, it has been busy housekeeping, including dismissing medical organizations, such as AAP, ACOG, and AMA, from participating with CDC scientists in the work group that collects and analyzes the data to inform the committee on its vaccine recommendations. On Monday, one of the more outspoken members of Kennedy's reconstituted ACIP, Retsef Levi, was put in charge of the work group, which will now not include CDC scientists. Levi is neither a physician nor a biomedical scientist. He has, however, echoed Kennedy's claim that the mRNA vaccines are the most dangerous things since sliced bread.
Thank you for the follow-up, though it’s unsettling! Axios is reporting this today: “State of play: Both Moderna and Pfizer still are awaiting FDA approval for updated COVID-19 boosters targeting the LP.8.1 strain.
Sources close to the deliberations tell Axios approval could come as early as this week.”
If the worse case comes to pass (pulling MRNA), do you think Novavax would be on a different trajectory?
Novavax (Nuvaxovid) has only been available for people older than 11 since its original emergency authorization. The recent license granted by FDA in May further restricts eligibility according to the agency's new "framework" for all COVID vaccines that only people over 64 or at risk for serious COVID if younger can get it. So without the mRNAs, there would be nothing for children under 12 regardless of underlying medical conditions.
As for Moderna and Pfizer, the latter has apparently been told its vaccine may no longer be approved for kids under 5, leaving only Moderna. It's unclear why there would be this distinction between Moderna and Pfizer.
For additional confusion, both mRNAs had been licensed by FDA for kids 6 months and older and everyone else, but FDA recently restricted children's eligibility for Moderna to only those 6 months to 11 years at risk for serious COVID. Moderna also has a newer design (mNEXSPIKE) that was approved according to the FDA framework - only for older people and at-risk younger populations 12 to 64 years.
So there's no transparency from Kennedy's HHS about what's coming or not for any COVID shots as we're already in a late-summer surge with kids back in school.
As the reply above was posted, the news broke that FDA approved the three US COVID vaccines according to the previously reported conditions. This was announced on X by Kennedy.
Eligibility will be limited by age (65+) and for the younger population, by risk for serious COVID. However, Kennedy also said everyone ("all patients") can get the shots with doctor's approval.
Moderna will be available for 6 months and older, Pfizer for 5 years and older, and Novavax for 12 and older.
Will there be an ACIP meeting to recommend implementation for the CDC director to endorse?
MAJOR CONCERN: Just read this morning that trump and kennedy are planning to remove ALL COVID vaccines from the US market. This is absolutely ridiculous- how can public health respond and save our lives????
New World Screwworm - veterinarians are on the front lines for this problem, and we are acutely aware of how much of a disaster it would be, if they make it into the US. It's the talk of the profession, especially here in Texas.
Why can we not have updated COVID vaccines available before school starts? This happens every year and the powers that be seem unable to adapt and even try to attempt to reduce the burden of COVID on families as kids return to school at the end of summer.
Question: As a brand new parent looking ahead (baby is only ten weeks old right now), I’d love to know how you suggest kids navigate COVID at school - would you have them mask during peaks or do you just hope for the best? I imagine it could be challenging socially, so if you do recommend masking, I’d love to know any tricks you’d suggest to help with integration. I admit that I want to protect my little, but it’s so tricky in our society now. Thanks!
I have a comment similar to Tina R -- I always mask in airports but how do we think about other places? For example, would you mask at large indoor weddings? (I have two this weekend). Thank you for your guidance -- I hope you know how much of an impact you make and how appreciated you are!
One factor to consider with one-time events such as weddings and funerals is that someone who is sick might feel compelled to attend despite the risk that this may pose to others.
Can they even do that, and if so is there any effective way to try to stop them?
Currently none of our local (we are a rural Virginia area) pharmacies will schedule a COVID vaccine until further notice, even to those over 65. Yesterday I got a call from CVS from a real person (where we have gotten most of our vaccines) asking if we had any plans of getting either Flu or COVID vaccine in the next month (which would be one year and 6 months respectively for us) - and that seemed very odd. Do they know something we don't?
Since we have zero guidance from the CDC, some northeast states got together to assess the requirements for healthcare providers to quarantine with Covid infections. There are some nuances (ie immunosuppression, fever) but CT DPH is now saying they are changing the guidelines to have healthcare workers quarantine for 3 days with Covid.
Is there no guidance currently still in effect? And I thought that there was a five day period recommended for everybody. Or was that phased out to be a 3 day quarantine after testing positive and then five days of masking after that. It's become impossible for me to keep track of all this stuff - even if I thought the CDC wasn't erring on the side of meeting people's "willingness to comply" with its guidance - a practice which started long before RFK Jr. Now, of course, it's hopeless - guidance is just lies and misinformation.
Our hospital was still doing 7 days for healthcare providers which was honestly killing staffing! 3 will be much more manageable when it is rolled out.
A question regarding masking: You mentioned that, with Covid cases on the rise, you’re returning to masking in “indoor crowded areas, like the airport.”
I am always a bit confused by statements like this. Epidemiologist Dr. Michael Osterholm awhile back shared that he *thinks* he got Covid from an elevator ride with a few friends (virus lingering there from a previous occupant). Back-to-school events often have 25 to 30 adults in a classroom, etc. and no ventilation. Isn’t that a crowded indoor event? Would you mask there, or would the social pressure to not mask inhibit you if no one else was masking?
How about the fitting room at TJ Maxx on a busy Saturday morning, where every spot is taken? Or a public restroom, etc.? Or any public indoor place with poor ventilation? It’s so hard to gauge what is “safer,” while knowing that you can’t entirely eliminate risk.
Early in the pandemic I began using an Aranet meter to monitor CO2 (serves as a proxy for ventilation and potential airborne virus risk), and sometimes the waiting areas in airports are much better than other places people go every day. (It’s boarding, deplaning, and waiting to take off where air quality is poor, according to my CO2 meter.)
I’m embarrassed to still be asking these questions 5+ years on and appreciate any guidance you can give on this topic.
None of my doctors or their staffs are masking, even during a Covid wave in our area. Not at the urgent care (where I just went for routine lab work because they share the same space) - and the waiting room was full of unmasked people coughing and complaining of fevers and sore throats when they checked in! A friend had to take her husband (who is receiving chemo) to the local hospital emergency room last week and no staff there were masked, though they advised my friend’s husband not to stay overnight “because the hospital is full of Covid.”
I feel like I live in upside down world, and I’m the only one who still cares about this.
"I feel like I live in upside down world, and I’m the only one who still cares about this."
You aren't the only one, for whatever consolation that provides. I completely share your concerns - it is hard to not feel paranoid when so many around you, even people in their 70s and 80s are acting/living like it was still 2019. And medical staff - horrifying!
My primary care doctor's office masks. Others don't. I recently forgot to mask when entering the hospital for surgery. But when I go to doctors' offices I always mask. The only place I don't mask is in my small grocery store which is not crowded when I shop, and that is only during the summer. Based on today's column, I think it's time to start masking there also. I can assure you that you are not the only one who cares about this. I am an older person with asthma, and psychological issues around breathing, so I care a lot about staying safe.
The providers in my office are masking to see sick visits. Usually during flu season, the office puts out a mask mandate. I suggested my husband mask on his recent flight for a business trip. He did not and he got covid and shared it with the entire household.
Wish there was a different response choice than “like.” I’m sorry your husband ignored your suggestion and your whole household got Covid. 😔
My husband, kids and I mask in most indoor places--office buildings, grocery stores, pharmacies, restaurants, etc. I take a mask-first approach--enter wearing a mask, then decide. Sometimes when I look around, I decide to take off my mask because there are very few people there and the benefits of having my whole face visible and my voice unhindered outweigh the unlikelihood of catching COVID-19 in that space.
My grandson went back to school 3 weeks ago and tested positive for Covid on Friday. He's doing okay, but there are no guidelines from the school on when to return, other than to say "when he feels better". Just an FYI from California. Thanks again for all you do!
Any thoughts on the claim that RFK and Trump are planning to fully ban the COVID vaccine? Just reported this morning by a single source so I'm not sure it holds a ton of water but it also doesn't seem out of the realm of possibility for what they'd do.
For those of us who got a 2024 booster, is it worth it to re-up that now in case we don't have access to a 2025 one, even if it isn't the most updated strains?
Thank you for reporting on the summer Covid wave. Disconcertingly, I'm not seeing any reporting on this in the mainstream media.
I don't think you will see anything. The MSM has basically given up on this subject, giving it only passing mention and rare articles, if any.
Question please: when will the rest of the vaccine integrity research be shared? I loved seeing it, especially appreciating the thorough screening methods employed to identify studies to include in the recommendations.
Ohhh good question! I can ask for you. Will circle back.
Thank you thank you. You and all epi / healthcare workers are now frontline litterally on a battlefront. You are seen and appreciated.
Thank you, and eagerly awaiting the deep dive on COVID (and hopefully vaccine updates) later this week! Seems like last Friday came and went without any anticipated announcements?
Yes which... isn't great.
Friday came and went without a peep from Kennedy et al. on the what and when of the fall COVID jabs, but the American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) made their own recommendations for their patients last week (https://covidandvaccineupdate.substack.com/p/medical-organizations-restoring-choice). Although these recommendations do not conform with Kennedy's previous restrictive directive and FDA's "framework" for COVID vaccines, off-label use is both possible and complicated, e.g., insurance coverage and potential provider liability.
Then yesterday, noise from a Kennedy proxy planted the specter of the elimination of COVID vaccines, which would require FDA to pull their licenses. (FDA still has its VRBPAC advisors, who would certainly oppose such action, but they could be fired like their CDC ACIP counterparts.) Pfizer reportedly had been notified that its jab would not be approved for the youngest kids this fall (https://covidandvaccineupdate.substack.com/p/covid-keeps-coming).
Meanwhile, although ACIP still hasn't set a date to meet publicly on the fall shots, it has been busy housekeeping, including dismissing medical organizations, such as AAP, ACOG, and AMA, from participating with CDC scientists in the work group that collects and analyzes the data to inform the committee on its vaccine recommendations. On Monday, one of the more outspoken members of Kennedy's reconstituted ACIP, Retsef Levi, was put in charge of the work group, which will now not include CDC scientists. Levi is neither a physician nor a biomedical scientist. He has, however, echoed Kennedy's claim that the mRNA vaccines are the most dangerous things since sliced bread.
Thank you for the follow-up, though it’s unsettling! Axios is reporting this today: “State of play: Both Moderna and Pfizer still are awaiting FDA approval for updated COVID-19 boosters targeting the LP.8.1 strain.
Sources close to the deliberations tell Axios approval could come as early as this week.”
If the worse case comes to pass (pulling MRNA), do you think Novavax would be on a different trajectory?
Novavax (Nuvaxovid) has only been available for people older than 11 since its original emergency authorization. The recent license granted by FDA in May further restricts eligibility according to the agency's new "framework" for all COVID vaccines that only people over 64 or at risk for serious COVID if younger can get it. So without the mRNAs, there would be nothing for children under 12 regardless of underlying medical conditions.
As for Moderna and Pfizer, the latter has apparently been told its vaccine may no longer be approved for kids under 5, leaving only Moderna. It's unclear why there would be this distinction between Moderna and Pfizer.
For additional confusion, both mRNAs had been licensed by FDA for kids 6 months and older and everyone else, but FDA recently restricted children's eligibility for Moderna to only those 6 months to 11 years at risk for serious COVID. Moderna also has a newer design (mNEXSPIKE) that was approved according to the FDA framework - only for older people and at-risk younger populations 12 to 64 years.
So there's no transparency from Kennedy's HHS about what's coming or not for any COVID shots as we're already in a late-summer surge with kids back in school.
As the reply above was posted, the news broke that FDA approved the three US COVID vaccines according to the previously reported conditions. This was announced on X by Kennedy.
Eligibility will be limited by age (65+) and for the younger population, by risk for serious COVID. However, Kennedy also said everyone ("all patients") can get the shots with doctor's approval.
Moderna will be available for 6 months and older, Pfizer for 5 years and older, and Novavax for 12 and older.
Will there be an ACIP meeting to recommend implementation for the CDC director to endorse?
MAJOR CONCERN: Just read this morning that trump and kennedy are planning to remove ALL COVID vaccines from the US market. This is absolutely ridiculous- how can public health respond and save our lives????
New World Screwworm - veterinarians are on the front lines for this problem, and we are acutely aware of how much of a disaster it would be, if they make it into the US. It's the talk of the profession, especially here in Texas.
Could the sterile fly treatment be generalized to the Trump Administration? Just checking!
Why can we not have updated COVID vaccines available before school starts? This happens every year and the powers that be seem unable to adapt and even try to attempt to reduce the burden of COVID on families as kids return to school at the end of summer.
Question: As a brand new parent looking ahead (baby is only ten weeks old right now), I’d love to know how you suggest kids navigate COVID at school - would you have them mask during peaks or do you just hope for the best? I imagine it could be challenging socially, so if you do recommend masking, I’d love to know any tricks you’d suggest to help with integration. I admit that I want to protect my little, but it’s so tricky in our society now. Thanks!
With continued gratitude for everything you do!
I have a comment similar to Tina R -- I always mask in airports but how do we think about other places? For example, would you mask at large indoor weddings? (I have two this weekend). Thank you for your guidance -- I hope you know how much of an impact you make and how appreciated you are!
One factor to consider with one-time events such as weddings and funerals is that someone who is sick might feel compelled to attend despite the risk that this may pose to others.
Can someone on the YLE team investigate and report on the validity of this report about the administration possibly banning COVID vaccine completely soon: https://www.thedailybeast.com/donald-trump-and-robert-f-kennedy-junior-to-ban-covid-19-vaccine-within-months/?utm_source=Poynter+Institute&utm_campaign=7317533fb7-08262025+-+The+Poynter+Report&utm_medium=email&utm_term=0_-7317533fb7-428820700&mc_cid=7317533fb7&mc_eid=d0e2abb681
Can they even do that, and if so is there any effective way to try to stop them?
Currently none of our local (we are a rural Virginia area) pharmacies will schedule a COVID vaccine until further notice, even to those over 65. Yesterday I got a call from CVS from a real person (where we have gotten most of our vaccines) asking if we had any plans of getting either Flu or COVID vaccine in the next month (which would be one year and 6 months respectively for us) - and that seemed very odd. Do they know something we don't?
Thanks for any insights and guidance.
Since we have zero guidance from the CDC, some northeast states got together to assess the requirements for healthcare providers to quarantine with Covid infections. There are some nuances (ie immunosuppression, fever) but CT DPH is now saying they are changing the guidelines to have healthcare workers quarantine for 3 days with Covid.
Is there no guidance currently still in effect? And I thought that there was a five day period recommended for everybody. Or was that phased out to be a 3 day quarantine after testing positive and then five days of masking after that. It's become impossible for me to keep track of all this stuff - even if I thought the CDC wasn't erring on the side of meeting people's "willingness to comply" with its guidance - a practice which started long before RFK Jr. Now, of course, it's hopeless - guidance is just lies and misinformation.
Our hospital was still doing 7 days for healthcare providers which was honestly killing staffing! 3 will be much more manageable when it is rolled out.