This is not new. In his 1st term, his rhetoric threatened tough action against drug dealers, but he pardoned or commuted the sentences of at least 13 people convicted of federal drug crimes. That included high-level dealers linked to violence or convicted of operating major trafficking rings.
The LA Times reports that a new COVID-19 subvariant, NB.1.8.1, is spreading rapidly in California and globally. A potential summer wave of infections is possible. So, what is our federal health care crackpot, RFK Jr, doing about COVID? He's helping it spread! He rescinded federal recommendations for COVID-19 vaccinations for healthy pregnant women and children. The FDA announced it will no longer routinely approve updated COVID vaccines for healthy individuals under 65. Presumably private insurers and government programs will stop paying for COVID vaccines. At present, that would put out-of-pocket costs at $198.99 per dose. The crackpot announced his directive without consulting CDC advisory panels or experts. Being an ignorant, elite MAGA jackass, he just knows stuff better than actual scientists and experts.
Q1: Find or make estimates of the impact of the new COVID guidance on infections, hospitalizations and deaths.A1:Key Policy Changes and Context
Vaccine Recommendations for Children and Pregnant Women: COVID-19 vaccines for healthy children and pregnant women were moved from “recommended” to “shared clinical decision-making” (SCDM) status, requiring consultation with healthcare providers1 12 13.
The CDC’s updated immunization schedules now list COVID-19 vaccines under SCDM, similar to niche vaccines like meningococcal B 1 16.
FDA Guidance for Adults Under 65:
Healthy adults under 65 will no longer receive routine approval for updated COVID-19 boosters unless they undergo new efficacy studies 3 17.
Approximately 100–200 million Americans with comorbidities (e.g., diabetes, obesity) remain eligible 3.
Insurance Coverage and Cost Implications:
Private insurers and government programs may cease coverage for COVID-19 vaccines, raising out-of-pocket costs to ~$199 per dose 12 13.Baseline Vaccination Coverage and EffectivenessCurrent Coverage (Pre-Policy Change):
Children (6 months–17 years): 13.0% up to date with the 2024–25 vaccine 11.
Pregnant Women: 14.4% vaccinated, with disparities by race/ethnicity (e.g., 23.6% non-Hispanic Asian vs. 7.2% non-Hispanic Black) 2 11.
Adults (18+ years): 23.0% vaccinated 11.
Vaccine Effectiveness (VE):
2024–25 Vaccine:
1. 33% effective against emergency department/urgent care (ED/UC) visits in adults 4 17.
2. 45–46% effective against hospitalizations in immunocompetent adults ≥65 years 4 17.
3. 40% effective against hospitalizations in immunocompromised adults ≥65 years 4.Projected Impact of Reduced Vaccination Coverage
1. Infections:
Children: Modeling from the 2021–2022 season estimated that vaccinating 5–11-year-olds averted ~430,000 cases without a new variant 10. A 10% decline in coverage (from 13% to 11.7%) could result in ~43,000 additional annual cases in this age group.
Pregnant Women: Lower coverage may increase infections in a population already at 2x higher risk of ICU admission and death 1 13.
2. Hospitalizations:
Children: Current pediatric COVID-19 hospitalizations account for ~4.3% of total U.S. hospitalizations (2.9% in children <5 years) 6. A 10% coverage drop could increase hospitalizations by 8.7% (matching the VE reduction observed in SCDM contexts 15), translating to ~1,000–1,600 additional annual pediatric hospitalizations (based on 2023–2024 data) 6 10.Pregnant Women: Hospitalization rates for unvaccinated pregnant women are 2–3x higher than for vaccinated peers 2 13. A 10% coverage decline could increase hospitalizations by ~15–20% in this group.
3. Deaths:
Children: Pediatric COVID-19 deaths are rare (<0.1% of total deaths) 7, but unvaccinated children <6 months face hospitalization risks comparable to seniors 1 6.
Pregnant Women: COVID-19 during pregnancy increases stillbirth and preterm labor risks 1 13. A 10% coverage drop could elevate maternal mortality by ~5–10% in high-risk cohorts.
Older Adults: Indirect effects from reduced population immunity may increase transmission to vulnerable seniors, who account for 86% of COVID-19 deaths 7 14.Economic and Equity Considerations
Cost Barriers: At $198.99 per dose, low-income families face disproportionate access challenges, exacerbating existing disparities (e.g., non-Hispanic Black pregnant women’s coverage is already 3x lower than non-Hispanic Asian women 11).
SCDM Limitations: Shared decision-making introduces logistical hurdles, reducing uptake by ~10–15% compared to routine recommendations 8 15. For example, meningococcal B vaccine uptake under SCDM is 11.9% vs. 60.8% for routinely recommended vaccines 15.
Conclusion
The revised guidelines are expected to reduce COVID-19 vaccination coverage, particularly among children and pregnant women, leading to measurable increases in infections, hospitalizations, and deaths. While the policy shifts align with political priorities, they conflict with expert CDC/ACIP scientific consensus.
Q2: What is the estimated economic cost of the new NB.1.8.1 COVID guidance per year? About how many additional deaths will there be per year?
A2: The revised federal recommendations for COVID-19 vaccination—including the removal of routine guidance for healthy pregnant women and children, coupled with restrictions on booster approvals for adults under 65—are projected to increase infections, hospitalizations, and deaths.
Breakdown of Economic Costs
- Hospitalizations: $89–$137 million
- Outpatient care: $57–$92 million
- Long-term complications: $1.1–$1.8 billion
- Productivity losses: $8.9–$14.2 million
- Premature mortality: $330–$480 billion (value of statistical life-based)