As always, I appreciate your clear and balanced explanation of the COVID vaccine recommendations. I am a healthy 45 year old woman, with no risk factors, but I am a teacher and share the care of my 72 year old mother, who is in treatment for lung cancer and is immunocompromised. I would like to be able to get a booster in order to protect her, and to minimize the severity of a COVID infection if I do get it again. I hope there is room in the new guidelines for people in my situation. Not all risk is limited to an individual.
Once again, thank you for your expertise and common sense.
My main concern is that health policies have been put into the hands of people that are not of the medical/science community. Another concern is freedom of choice. Is this the beginning of banning future Covid or any other vaccines available? Will the millions who will lose their health insurance be able to pay for the vaccines?
Politicizing medicine is gravely dangerous. I will listen to scientists and my physician regarding my health over any politician. I just shake my head…
I share your concerns, Elaine. And I agree that choice is important; I also think shared decision-making when it comes to medical decisions is critical. The subject of medical paternalism versus choice is something I’d like to discuss this afternoon with Dr. Cifu today in our live talk.
@Adam Cifu, MD said it well in his recent Substack post: “Medicine should offer care that people need, not care that people want.” To some, this may sound paternalistic. But it is our duty in medicine to offer evidence-based guidance, to understand patients’ nuanced medical situations and risks (and their tolerance for risk), and to help patients make the best decisions for themselves…. not simply to give people exactly what they want or think they want.
That said, the inherent problem with insisting on shared decision-making (as opposed to patients making their own decisions based on their own personal opinions) is that 100M+ people don’t have a doctor to share health decisions with!
Trust is certainly a huge part of the conversation when it comes to the CDC. Can I trust that the science behind creating the most effective vaccines for the upcoming flu/covid season hasn’t been compromised by politics? Never thought I’d have a concern like this.
I don't think I can make the live today but how do I discuss this with my doctor? I am the only person who has not had COVID in my household but I've always been unwell and without diagnosis for over a year. I just had surgery for something unrelated and my exposure risk is high with young kids who to to school.
Personally I wouldn't get the COVID shot for the sole purpose of reducing the risk of LC. I also wouldn't discourage you from getting the vaccine. Dr. Cifu and I discussed this today .. will send out the recording soon !
I have a vaccine injury from my COVID MRNA booster and cannot have an MRNA vaccine. Last year, for the first time in 3 years, I got the Novovax non-MRNA vaccine and was finally protected. I read that there has been some change federally with Novovax. It was previously not approved by the FDa by you could get it on an emergency basis. What is the state of the Novovax vaccine and will I be able to obtain a shot this fall? Thank you!
Wonderful article. We messed up pandemic policy so badly. Even in a pandemic, medicine should be individualized, and not one-size-fits-all. As a result, I think it never occurs to most Americans to ask their doctors if they might benefit from a Covid booster.
My biggest concern regarding vaccinations: we have trouble acknowledging, and figuring out why, a small but significant number of people had injuries from the mRNA vaccines. I think I’ve read about ten different things that are wrong with them. How can we move forward, either fix the problems or go with a different sort of platform, and come clean to the population of the planet that some of what we were told about Covid vaccines may not have been accurate?
Well, as a for instance, the old J&J vaccine was paused after it became clear that it was causing thrombocytopenia in younger women. I think this happened at the rate of 1 in 1 million, or 1 in 500K, something like that. Yet, myocarditis/pericarditis happened more frequently in young people, especially males, without even a recommendation to maybe use a different vaccine, or perhaps to space the doses further apart. I’ve heard about other vaccine injuries, such as neurological symptoms similar to those experienced by long Covid patients. Can a vaccine producing such effects really be described as extremely safe?
Is the dose for those 65 and older this year a lower dose vaccine? Seems like I heard this. If so, why? It concerns me since I have asthma, and COPD. I will be 72 in August.
Lucy: this was a very thorough, thoughtful and nuanced summary of the issues. My biggest concerns revolve around those people who are confused by the issues, form an uneducated opinion about the facts, and choose to ignore good scientific recommendations. While I was in practice, one of the challenges in recommending surgery to patients was trying to convince them that surgery was a reasonable and necessary treatment. I really didn't like being a 'salesman', but that;s what it felt like, and we are in the same situation with Covid vaccine as well as all the others.
Pete - I agree. Trust in medicine and public health is at an all-time low. People are taking matters into their own hands and, in many cases, choosing not to get even the most basic and essential vaccines. It's terribly sad. The problem, as you know, is that the absence of certainty is one of the central tenets of medicine and public health - and this is being weaponized to undermine trust in vaccines writ large. In my humble opinion, regaining trust in medicine and public health requires 1) improving access to primary care/medical "homes" where people can be seen and heard and where people can make individualized decisions about their health with a trusted guide and 2) issuing more nuanced messaging in the public square about vaccines and other public health matters, trusting the public with facts and information and the natural uncertainties about science. The iterative nature of science doesn't mean we should distrust it. It's a process! :)
I have the same concern. Dr Lucy, I haven’t had COVID. I’ve received the original series of COVID shots (in early 2021) and several boosters. I will be getting the new vaccine this fall because I am 73. I am in good health, but my concern about Long Covid is well founded. When I was 33, I was diagnosed with Chronic Fatigue Syndrome. It was a very difficult post-viral syndrome and it took me several years to feel fully recovered. Long COVID has been compared to CFS. I will ask my primary care doctor for Paxlovid if I have COVID because I do not want to develop Long COVID.
P.S. I hope you will be able to post a video of today’s Iive stream as I won’t be able to watch it live.🌸
So glad to have discovered your Substack through Dr. Cifu. It is interesting that our providers have not been recommend blanket boosters since 2022. Whenever I say that, there is pearl clutching and gasping and critique of their abilities as clinicians. But, Paul Offitt himself has also said since 2022 that the benefits for folks under 65 without co-morbidities are unclear. And he has not received them either. I think the blanket recommendations have fueled the anti vaccine movement. And it did not need fueling.
My husband and I got our first Covid shots as soon as we could, in January 2021, and we vaccinated our children in November of that year. My experiences with Moderna 2 and 3 were miserables I have never been that sick with an actual illness in my life- constant vomiting, brutal headache, and weird neuro issues that persisted for several weeks. Maybe Pfizer or Novavax would be easier on my system, but, if I am honest, I am too scared to try. Interestingly enough, we have only had one confirmed case of Covid in our home- my teen son in 2023.
Thank you for sharing about Novovax being available this fall! It has been a huge help to be vaccinated and able to be out and about during times of high COVID infections!
The new guidance will make vaccines more expensive and is likely to drive even more companies from the market. I guess you flunked medical ethics. It is unethical to give a placebo to a person when you know a current vaccine is safe and effective. You change an epitope and you compare it to current and see if it's better! That's Ethical! I can't believe you don't know this. Google epitope if you forgot that too! You selling any supplements on your site soon? We going to placebo study flu vaccines too . Look up child deaths and vaccination rates for flu last year. How many kids died from flu vaccines. Answer... none? Over 200 died from flu! 90% of deaths unvaccinated! I'm hoping this DATA has you recommend flu vaccines! If not then guess we need to change our handle to are you ethical?
For all the complaining Dr. Makary did about the Biden Administrations messaging around COVID, this communications/messaging strategy ( if there was one) was a mess!
If people didn’t hear the revised message the next day… oh well! Will they inform/remind people in the Fall or is that funding gone??
When asked on PBS about whether the vax would be covered by insurance if it’s not recommended by FDA, he couldn’t say. And how much is a vax out of pocket and can people, especially those getting kicked off Medicaid and the poor who are also vulnerable in many ways, afford it?
Makary also would not answer any questions about the many fake citations in the poorly written MAHA report thats another can of worms. So much for trust.
Maybe sometime you can do a talk on the MAHA report….
Is the dose for those 65 and older this year a lower dose vaccine? Seems like I heard this. If so, why? It concerns me since I have asthma, and COPD. I will be 72 in August.
Is the dose for those 65 and older this year a lower dose vaccine? Seems like I heard this. If so, why? It concerns me since I have asthma, and COPD. I will be 72 in August.
Dr. McBride,
As always, I appreciate your clear and balanced explanation of the COVID vaccine recommendations. I am a healthy 45 year old woman, with no risk factors, but I am a teacher and share the care of my 72 year old mother, who is in treatment for lung cancer and is immunocompromised. I would like to be able to get a booster in order to protect her, and to minimize the severity of a COVID infection if I do get it again. I hope there is room in the new guidelines for people in my situation. Not all risk is limited to an individual.
I think that is a very sane reason to get a booster! I hope (and suspect) that you will be able to get a booster shot if you want one.
Once again, thank you for your expertise and common sense.
My main concern is that health policies have been put into the hands of people that are not of the medical/science community. Another concern is freedom of choice. Is this the beginning of banning future Covid or any other vaccines available? Will the millions who will lose their health insurance be able to pay for the vaccines?
Politicizing medicine is gravely dangerous. I will listen to scientists and my physician regarding my health over any politician. I just shake my head…
I share your concerns, Elaine. And I agree that choice is important; I also think shared decision-making when it comes to medical decisions is critical. The subject of medical paternalism versus choice is something I’d like to discuss this afternoon with Dr. Cifu today in our live talk.
@Adam Cifu, MD said it well in his recent Substack post: “Medicine should offer care that people need, not care that people want.” To some, this may sound paternalistic. But it is our duty in medicine to offer evidence-based guidance, to understand patients’ nuanced medical situations and risks (and their tolerance for risk), and to help patients make the best decisions for themselves…. not simply to give people exactly what they want or think they want.
That said, the inherent problem with insisting on shared decision-making (as opposed to patients making their own decisions based on their own personal opinions) is that 100M+ people don’t have a doctor to share health decisions with!
Trust is certainly a huge part of the conversation when it comes to the CDC. Can I trust that the science behind creating the most effective vaccines for the upcoming flu/covid season hasn’t been compromised by politics? Never thought I’d have a concern like this.
I hear you!
I don't think I can make the live today but how do I discuss this with my doctor? I am the only person who has not had COVID in my household but I've always been unwell and without diagnosis for over a year. I just had surgery for something unrelated and my exposure risk is high with young kids who to to school.
Personally I wouldn't get the COVID shot for the sole purpose of reducing the risk of LC. I also wouldn't discourage you from getting the vaccine. Dr. Cifu and I discussed this today .. will send out the recording soon !
Hi Dr. McBride,
I have a vaccine injury from my COVID MRNA booster and cannot have an MRNA vaccine. Last year, for the first time in 3 years, I got the Novovax non-MRNA vaccine and was finally protected. I read that there has been some change federally with Novovax. It was previously not approved by the FDa by you could get it on an emergency basis. What is the state of the Novovax vaccine and will I be able to obtain a shot this fall? Thank you!
My understanding is that Novavax will still be available this fall
https://ir.novavax.com/press-releases/2025-05-19-U-S-FDA-Approves-BLA-for-Novavaxs-COVID-19-Vaccine
A really good, reasonable piece. I love your clarity regarding recommendations AND your personal plans. Thanks.
Wonderful article. We messed up pandemic policy so badly. Even in a pandemic, medicine should be individualized, and not one-size-fits-all. As a result, I think it never occurs to most Americans to ask their doctors if they might benefit from a Covid booster.
My biggest concern regarding vaccinations: we have trouble acknowledging, and figuring out why, a small but significant number of people had injuries from the mRNA vaccines. I think I’ve read about ten different things that are wrong with them. How can we move forward, either fix the problems or go with a different sort of platform, and come clean to the population of the planet that some of what we were told about Covid vaccines may not have been accurate?
In general the mRNA vaccines have been shown to be extremely safe. But of course the risk is not zero (as is true for any medical intervention).
I am not sure that answers your question but a risk free medical landscape is, sadly, not on the menu :)
Well, as a for instance, the old J&J vaccine was paused after it became clear that it was causing thrombocytopenia in younger women. I think this happened at the rate of 1 in 1 million, or 1 in 500K, something like that. Yet, myocarditis/pericarditis happened more frequently in young people, especially males, without even a recommendation to maybe use a different vaccine, or perhaps to space the doses further apart. I’ve heard about other vaccine injuries, such as neurological symptoms similar to those experienced by long Covid patients. Can a vaccine producing such effects really be described as extremely safe?
Is the dose for those 65 and older this year a lower dose vaccine? Seems like I heard this. If so, why? It concerns me since I have asthma, and COPD. I will be 72 in August.
same dose as in the past - as far as I know :)
Lucy: this was a very thorough, thoughtful and nuanced summary of the issues. My biggest concerns revolve around those people who are confused by the issues, form an uneducated opinion about the facts, and choose to ignore good scientific recommendations. While I was in practice, one of the challenges in recommending surgery to patients was trying to convince them that surgery was a reasonable and necessary treatment. I really didn't like being a 'salesman', but that;s what it felt like, and we are in the same situation with Covid vaccine as well as all the others.
Keep up the good work. Pete Petrucci
Pete - I agree. Trust in medicine and public health is at an all-time low. People are taking matters into their own hands and, in many cases, choosing not to get even the most basic and essential vaccines. It's terribly sad. The problem, as you know, is that the absence of certainty is one of the central tenets of medicine and public health - and this is being weaponized to undermine trust in vaccines writ large. In my humble opinion, regaining trust in medicine and public health requires 1) improving access to primary care/medical "homes" where people can be seen and heard and where people can make individualized decisions about their health with a trusted guide and 2) issuing more nuanced messaging in the public square about vaccines and other public health matters, trusting the public with facts and information and the natural uncertainties about science. The iterative nature of science doesn't mean we should distrust it. It's a process! :)
Can you comment on the benefit of the Covid vaccine for reducing risk of long COVID? That is my biggest worry. Thank you!
I have the same concern. Dr Lucy, I haven’t had COVID. I’ve received the original series of COVID shots (in early 2021) and several boosters. I will be getting the new vaccine this fall because I am 73. I am in good health, but my concern about Long Covid is well founded. When I was 33, I was diagnosed with Chronic Fatigue Syndrome. It was a very difficult post-viral syndrome and it took me several years to feel fully recovered. Long COVID has been compared to CFS. I will ask my primary care doctor for Paxlovid if I have COVID because I do not want to develop Long COVID.
P.S. I hope you will be able to post a video of today’s Iive stream as I won’t be able to watch it live.🌸
We will discuss on the live podcast at 5 pm! Will send out the recording tomorrow, too :)
Thank you!!
So glad to have discovered your Substack through Dr. Cifu. It is interesting that our providers have not been recommend blanket boosters since 2022. Whenever I say that, there is pearl clutching and gasping and critique of their abilities as clinicians. But, Paul Offitt himself has also said since 2022 that the benefits for folks under 65 without co-morbidities are unclear. And he has not received them either. I think the blanket recommendations have fueled the anti vaccine movement. And it did not need fueling.
My husband and I got our first Covid shots as soon as we could, in January 2021, and we vaccinated our children in November of that year. My experiences with Moderna 2 and 3 were miserables I have never been that sick with an actual illness in my life- constant vomiting, brutal headache, and weird neuro issues that persisted for several weeks. Maybe Pfizer or Novavax would be easier on my system, but, if I am honest, I am too scared to try. Interestingly enough, we have only had one confirmed case of Covid in our home- my teen son in 2023.
Thank you for sharing about Novovax being available this fall! It has been a huge help to be vaccinated and able to be out and about during times of high COVID infections!
The new guidance will make vaccines more expensive and is likely to drive even more companies from the market. I guess you flunked medical ethics. It is unethical to give a placebo to a person when you know a current vaccine is safe and effective. You change an epitope and you compare it to current and see if it's better! That's Ethical! I can't believe you don't know this. Google epitope if you forgot that too! You selling any supplements on your site soon? We going to placebo study flu vaccines too . Look up child deaths and vaccination rates for flu last year. How many kids died from flu vaccines. Answer... none? Over 200 died from flu! 90% of deaths unvaccinated! I'm hoping this DATA has you recommend flu vaccines! If not then guess we need to change our handle to are you ethical?
For all the complaining Dr. Makary did about the Biden Administrations messaging around COVID, this communications/messaging strategy ( if there was one) was a mess!
If people didn’t hear the revised message the next day… oh well! Will they inform/remind people in the Fall or is that funding gone??
When asked on PBS about whether the vax would be covered by insurance if it’s not recommended by FDA, he couldn’t say. And how much is a vax out of pocket and can people, especially those getting kicked off Medicaid and the poor who are also vulnerable in many ways, afford it?
Makary also would not answer any questions about the many fake citations in the poorly written MAHA report thats another can of worms. So much for trust.
Maybe sometime you can do a talk on the MAHA report….
Is the dose for those 65 and older this year a lower dose vaccine? Seems like I heard this. If so, why? It concerns me since I have asthma, and COPD. I will be 72 in August.
Is the dose for those 65 and older this year a lower dose vaccine? Seems like I heard this. If so, why? It concerns me since I have asthma, and COPD. I will be 72 in August.