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New Trump vaccine policy limits access to COVID shots to those 65+ or with demonstrated health issues; likely blocks access to others

ThatRobGuy

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Yes, those are all good arguments, I'm sure. But it makes no difference to the Trump administration so long as people who want it have to pay big Pharma the $200 for the shot themselves.
...but shouldn't that be how all medically unnecessary interventions are approached?

It'll still be covered by private insurers and government funded insurance for those who fit the criteria.

For example:

If a 58 year old needs finasteride for their BPH and urinary issues, that gets covered by their insurance (or Medicaid if they're low income)

I, as a healthy person in my early 40s, taking finasteride for maintaining my hairline, that's not covered and I pay out of pocket for it every 90's days since it's not medically necessary (despite it being the same drug). And if I were broke, well...then it looks like I would be getting out the buzz clippers and going with the Jason Statham look. Because the rest of society shouldn't be forced to chip in me keeping my hairline because it's not actually medically necessary.


I feel the same way about all of the new weight loss drugs that have been all the craze.

If a person is 62, obese, and is diabetic, sure, insurance and Medicaid should pick up the cost of their GLP-1 medications if their doctor feels that's their best option.

For a 30-something who's not diabetic, just a little overweight, but just wants an easy, willpower-free way to drop 15-20 lbs before beach season...then no, that shouldn't be covered... that's on them to pay for themselves if they don't want to make the other changes required.
 
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BCP1928

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...but shouldn't that be how all medically unnecessary interventions are approached?
Not so fast, slick. You and others have repeated your line of argument frequently on CF with many of the same links and quite frankly I haven't paid all that much attention. I don't know enough about immunology research to know if your argument has any merit or not, but you are a bit premature in expecting me to accept it as an axiom that the Covid vaccine is ineffective.
It'll still be covered by private insurers and government funded insurance for those who fit the criteria.
I imagine the insurance companies will follow the criteria. But somebody has to pay the $200 bucks. The Trump admiration just wants it not to be the government
For example:

If a 58 year old needs finasteride for their BPH and urinary issues, that gets covered by their insurance (or Medicaid if they're low income)

I, as a healthy person in my early 40s, taking finasteride for maintaining my hairline, that's not covered and I pay out of pocket for it every 90's days since it's not medically necessary (despite it being the same drug). And if I were broke, well...then it looks like I would be getting out the buzz clippers and going with the Jason Statham look. Because the rest of society shouldn't be forced to chip in me keeping my hairline because it's not actually medically necessary.


I feel the same way about all of the new weight loss drugs that have been all the craze.

If a person is 62, obese, and is diabetic, sure, insurance and Medicaid should pick up the cost of their GLP-1 medications if their doctor feels that's their best option.

For a 30-something who's not diabetic, just a little overweight, but just wants an easy, willpower-free way to drop 15-20 lbs before beach season...then no, that shouldn't be covered... that's on them to pay for themselves if they don't want to make the other changes required.
And all of these are prescription drugs which are advertised on television. Did you ever wonder why a prescription drug should be advertised on television? Wake up! I have no idea whether the Covid vaccine is any use. But you are being pranked, regardless.
 
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probinson

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I don't know enough about immunology research to know if your argument has any merit or not, but you are a bit premature in expecting me to accept it as an axiom that the Covid vaccine is ineffective.

The COVID boosters were approved from the results of increased antibodies in eight mice. This was after the previous FDA director said that antibodies were not a good correlate of protection. When COVID boosters were initially approved in 2021, the top two vaccine regulators at the FDA (Gruber and Krause) resigned in protest over the political pressures to approve boosters.

There has never been any evidence that COVID boosters provide any benefit to young, healthy people. The new FDA policy aims to require the vaccine manufacturers to run the necessary trials to determine if the vaccine provides benefit to healthy people under the age of 65. At this time, no such evidence exists.
 
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ThatRobGuy

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Not so fast, slick. You and others have repeated your line of argument frequently on CF with many of the same links and quite frankly I haven't paid all that much attention. I don't know enough about immunology research to know if your argument has any merit or not, but you are a bit premature in expecting me to accept it as an axiom that the Covid vaccine is ineffective.
I didn't say it wasn't effective, I wouldn't have gotten 3 of them myself back in 2021-22 (and encouraged my elderly relatives and/or ones with comorbidities to get them) if I thought it was ineffective.

I used the phrasing "medically unnecessary" with respect to certain cohorts of people.


For younger healthy people in their 20's and 30's, covid boosters aren't medically necessary. Per what I linked before (the Dr. Paul Offit interview -- Offit of course, being on the FDA vaccine advisory panel for Biden, and one of the most prominent vaccine experts in the world), Offit stated that there's not a lot of benefit in younger healthy people getting boosted as it becomes "diminishing returns", and the only benefit it provides is making an already mild infection just a tad more mild if you happen to catch it in the 3 months after the booster.

That's not the kind of situation we (financially) pull out all the stops for.

And we're not talking about small potatoes in terms of the cost either.

Courtesy of Perplexity:

  • Average cost per booster (government negotiated price): $28.89 per dose

If the government paid for a COVID booster for every person in the U.S. over the age of 21, the total estimated cost would be approximately $5.69 billion.

The estimated cost for the government to pay for a COVID booster for everyone over age 65 and for younger adults with COVID comorbidities would be approximately
$2.85 billion


We're talking about a difference of $3 billion dollars a year ($6 billion if they go with the "booster every six months" thing)

That's not a solid public investment if the only upside is "that young adult's throat is a little less scratchy during an Omicron case"


I used the GLP-1 example before, but perhaps a better example would be.


Sure, getting a head-to-toe MRI probably isn't going to "hurt" anyone, and it may even spot an undetected cancer or hemorrhage that someone didn't know they had in a tiny number of people. But that, in and of itself, wouldn't be a solid enough justification for public funds to pay for every citizen over 21 get a yearly full-body MRI. As, for the overwhelming majority, the only upside will likely be a slight bit of mental reassurance.



A certain amount of pragmatism has to be employed when a public system is being leveraged instead of a private one.

Hence the reason why NHS is doing the following for their publicly provided covid jabs:

The NHS is not providing COVID-19 vaccines to everyone in spring 2025. The current eligibility is limited to:
  • Adults aged 75 years and over (including those who will turn 75 by June 17, 2025)
  • Residents in care homes for older adults
  • Individuals aged 6 months and over with a weakened immune system due to certain health conditions or treatments
People outside these groups, including healthy individuals under 75 without immunosuppression, are not eligible for the NHS COVID-19 vaccine during the spring 2025 campaign



So there may be a way people can pay for one out of pocket at a GPs office or pharmacy (our British friends will have to elaborate on that), but as far as the government funded ones, they're limiting it to an even stricter criteria than we're using (by going with 75 instead of 65)
 
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KCfromNC

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There has never been any evidence that COVID boosters provide any benefit to young, healthy people.
The actual research says otherwise, of course. For example, Effectiveness of COVID-19 booster vaccines against COVID-19-related symptoms, hospitalization and death in England - PMC

The relative effectiveness against symptomatic disease 14–34 days after a BNT162b2 or mRNA-1273 (Moderna) booster after a ChAdOx1-S (AstraZeneca) and BNT162b2 as a primary course ranged from around 85% to 95%. Absolute vaccine effectiveness ranged from 94% to 97% and was similar in all age groups. Limited waning was seen 10 or more weeks after the booster. Against hospitalization or death, absolute effectiveness of a BNT162b2 booster ranged from around 97% to 99% in all age groups irrespective of the primary course, with no evidence of waning up to 10 weeks.
 
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ThatRobGuy

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I know you were responding to someone else there, but in terms of public policy making, "efficacy" and "medical necessity" are two different concepts.

And broadly speaking, booster doses aren't medically necessary for healthy 20-30-somethings with no comorbidities.

Sure, there could be a few random outliers, but we can't build public policies and spending plans around exceedingly rare outliers.

For example:
In terms of efficacy, there's a lot of drugs that would be effective, but not necessary - broadly speaking.

For instance, if we give statin drugs to a 31 year old, it will lower their serum cholesterol, it will be effective at what it's supposed to do. However, that doesn't mean we should be recommending statins to everyone in that age group with an LDL over 120 given that atherosclerosis related heart attacks are extremely rare in that age group.
 
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probinson

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The actual research says otherwise, of course. For example, Effectiveness of COVID-19 booster vaccines against COVID-19-related symptoms, hospitalization and death in England - PMC

The relative effectiveness against symptomatic disease 14–34 days after a BNT162b2 or mRNA-1273 (Moderna) booster after a ChAdOx1-S (AstraZeneca) and BNT162b2 as a primary course ranged from around 85% to 95%. Absolute vaccine effectiveness ranged from 94% to 97% and was similar in all age groups. Limited waning was seen 10 or more weeks after the booster. Against hospitalization or death, absolute effectiveness of a BNT162b2 booster ranged from around 97% to 99% in all age groups irrespective of the primary course, with no evidence of waning up to 10 weeks.

It should be noted that this observational study uses a test-negative control analysis:

In the test-negative design, only people with an acute respiratory infection who seek medical help for their complaints are included in the study.
...
The test-negative design cannot be used for conclusions about overall mortality in relation to the vaccine, and conclusions about hospitalization can only be drawn with great care. Finally, no diagnostic tool is perfect, and the effect of this can range from innocent to dramatic, depending on the properties of the test and the prevalence of the virus. Overall, one should be conservative and careful with estimates derived from a test-negative design study.
Moving forward, the FDA will require a higher standard for evidence:

The FDA’s new Covid-19 philosophy represents a balance of regulatory flexibility and a commitment to gold-standard science. The FDA will approve vaccines for high-risk persons and, at the same time, demand robust, gold-standard data on persons at low risk. These clinical trials will inform future directions for the FDA, but more important, they will provide information that is desperately craved by health care providers and the American people.
Also, the study referenced is talking about two doses vs. three. For some people, we're at ten or more doses now. And as the paper in the NEJM stated, "We simply don’t know whether a healthy 52-year-old woman with a normal BMI who has had Covid-19 three times and has received six previous doses of a Covid-19 vaccine will benefit from the seventh dose."
 
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BCP1928

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I didn't say it wasn't effective, I wouldn't have gotten 3 of them myself back in 2021-22 (and encouraged my elderly relatives and/or ones with comorbidities to get them) if I thought it was ineffective.

I used the phrasing "medically unnecessary" with respect to certain cohorts of people.


For younger healthy people in their 20's and 30's, covid boosters aren't medically necessary. Per what I linked before (the Dr. Paul Offit interview -- Offit of course, being on the FDA vaccine advisory panel for Biden, and one of the most prominent vaccine experts in the world), Offit stated that there's not a lot of benefit in younger healthy people getting boosted as it becomes "diminishing returns", and the only benefit it provides is making an already mild infection just a tad more mild if you happen to catch it in the 3 months after the booster.

That's not the kind of situation we (financially) pull out all the stops for.

And we're not talking about small potatoes in terms of the cost either.

Courtesy of Perplexity:

  • Average cost per booster (government negotiated price): $28.89 per dose

If the government paid for a COVID booster for every person in the U.S. over the age of 21, the total estimated cost would be approximately $5.69 billion.

The estimated cost for the government to pay for a COVID booster for everyone over age 65 and for younger adults with COVID comorbidities would be approximately
$2.85 billion


We're talking about a difference of $3 billion dollars a year ($6 billion if they go with the "booster every six months" thing)

That's not a solid public investment if the only upside is "that young adult's throat is a little less scratchy during an Omicron case"


I used the GLP-1 example before, but perhaps a better example would be.


Sure, getting a head-to-toe MRI probably isn't going to "hurt" anyone, and it may even spot an undetected cancer or hemorrhage that someone didn't know they had in a tiny number of people. But that, in and of itself, wouldn't be a solid enough justification for public funds to pay for every citizen over 21 get a yearly full-body MRI. As, for the overwhelming majority, the only upside will likely be a slight bit of mental reassurance.



A certain amount of pragmatism has to be employed when a public system is being leveraged instead of a private one.

Hence the reason why NHS is doing the following for their publicly provided covid jabs:

The NHS is not providing COVID-19 vaccines to everyone in spring 2025. The current eligibility is limited to:
  • Adults aged 75 years and over (including those who will turn 75 by June 17, 2025)
  • Residents in care homes for older adults
  • Individuals aged 6 months and over with a weakened immune system due to certain health conditions or treatments
People outside these groups, including healthy individuals under 75 without immunosuppression, are not eligible for the NHS COVID-19 vaccine during the spring 2025 campaign



So there may be a way people can pay for one out of pocket at a GPs office or pharmacy (our British friends will have to elaborate on that), but as far as the government funded ones, they're limiting it to an even stricter criteria than we're using (by going with 75 instead of 65)
Yes, I noticed the $28,89 price. I wonder what our government pays. if you buy it out of pocket the cost will be around $200.
 
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ThatRobGuy

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Yes, I noticed the $28,89 price. I wonder what our government pays. if you buy it out of pocket the cost will be around $200.
The $28.89 is the government negotiated price for the ones they purchase for distribution for those who fall within the guidelines.

Based on the CDC's current 2025 vaccine schedule data

The private sector (commercial) retail price for a Pfizer COVID-19 booster dose is currently $122.75 per dose according to the CDC's April 2025 vaccine price list


Which actually lines up with information that was reported from Pfizer investor calls:
Pfizer has also indicated in investor calls that the retail price range for its COVID-19 vaccine is expected to be between $110 and $130 per dose



Access and Pricing:

  • The FDA’s new policy means vaccines will remain available for adults 65+ and for anyone (including younger adults and children) with underlying health conditions such as asthma, cancer, diabetes, pregnancy, chronic lung diseases, HIV, and others
  • These eligible groups will continue to receive the vaccine through government programs, insurance, or Medicare, and will pay the lower, negotiated government price rather than the higher commercial retail price.
  • Healthy adults under 65 and children without qualifying conditions will not be routinely approved for the vaccine and may have to pay out-of-pocket if they seek it privately

So, the only people impacted by this are healthy younger adults who may want one...and if we're being frank, most in that group haven't really showed interest in getting it even when it was available when it was free (or negotiated down).

Per the KFF Vaccine Monitor:
Relatively few healthy younger adults are getting the updated COVID-19 booster. According to the KFF COVID-19 Vaccine Monitor, only about 20% of all adults reported receiving the updated booster that became available in September 2024, with uptake highest among those ages 65 and older (34%). In contrast, just 13% of younger adults ages 18–39 reported getting the latest booster.

(for that matter, only a 1/3 of the people over 65 have been getting it)
 
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BCP1928

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The $28.89 is the government negotiated price for the ones they purchase for distribution for those who fall within the guidelines.

Based on the CDC's current 2025 vaccine schedule data

The private sector (commercial) retail price for a Pfizer COVID-19 booster dose is currently $122.75 per dose according to the CDC's April 2025 vaccine price list


Which actually lines up with information that was reported from Pfizer investor calls:
Pfizer has also indicated in investor calls that the retail price range for its COVID-19 vaccine is expected to be between $110 and $130 per dose
OK, the $200 figure I quoted came from google's AI so I will bow to your likely more accurate figures. How does that change things?
 
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ThatRobGuy

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OK, the $200 figure I quoted came from google's AI so I will bow to your likely more accurate figures. How does that change things?
Sorry, realized I didn't get my full reply in before you had replied to my post :)

Access and Pricing:
  • The FDA’s new policy means vaccines will remain available for adults 65+ and for anyone (including younger adults and children) with underlying health conditions such as asthma, cancer, diabetes, pregnancy, chronic lung diseases, HIV, and others
  • These eligible groups will continue to receive the vaccine through government programs, insurance, or Medicare, and will pay the lower, negotiated government price rather than the higher commercial retail price.
  • Healthy adults under 65 and children without qualifying conditions will not be routinely approved for the vaccine and may have to pay out-of-pocket if they seek it privately

So, the only people impacted by this are healthy younger adults who may want one...and if we're being frank, most in that group haven't really showed interest in getting it even when it was available when it was free (or negotiated down).

Per the KFF Vaccine Monitor:
Relatively few healthy younger adults are getting the updated COVID-19 booster. According to the KFF COVID-19 Vaccine Monitor, only about 20% of all adults reported receiving the updated booster that became available in September 2024, with uptake highest among those ages 65 and older (34%). In contrast, just 13% of younger adults ages 18–39 reported getting the latest booster.

(for that matter, only a 1/3 of the people over 65 have been getting it)
 
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probinson

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Per the KFF Vaccine Monitor:
Relatively few healthy younger adults are getting the updated COVID-19 booster. According to the KFF COVID-19 Vaccine Monitor, only about 20% of all adults reported receiving the updated booster that became available in September 2024, with uptake highest among those ages 65 and older (34%). In contrast, just 13% of younger adults ages 18–39 reported getting the latest booster.

(for that matter, only a 1/3 of the people over 65 have been getting it)

Not even healthcare workers are getting COVID boosters any more:

Fewer than 1 in 6 health care workers in hospitals and nursing homes reported getting COVID-19 boosters during the 2023-2024 respiratory virus season, a Centers for Disease Control and Prevention study found.
...
But health workers in a recent survey also expressed low confidence in the effectiveness, safety and benefit of COVID-19 vaccines, though many still believe the virus is a serious health threat.
 
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BCP1928

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Sorry, realized I didn't get my full reply in before you had replied to my post :)

Access and Pricing:
  • The FDA’s new policy means vaccines will remain available for adults 65+ and for anyone (including younger adults and children) with underlying health conditions such as asthma, cancer, diabetes, pregnancy, chronic lung diseases, HIV, and others
  • These eligible groups will continue to receive the vaccine through government programs, insurance, or Medicare, and will pay the lower, negotiated government price rather than the higher commercial retail price.
  • Healthy adults under 65 and children without qualifying conditions will not be routinely approved for the vaccine and may have to pay out-of-pocket if they seek it privately

So, the only people impacted by this are healthy younger adults who may want one...and if we're being frank, most in that group haven't really showed interest in getting it even when it was available when it was free (or negotiated down).

Per the KFF Vaccine Monitor:
Relatively few healthy younger adults are getting the updated COVID-19 booster. According to the KFF COVID-19 Vaccine Monitor, only about 20% of all adults reported receiving the updated booster that became available in September 2024, with uptake highest among those ages 65 and older (34%). In contrast, just 13% of younger adults ages 18–39 reported getting the latest booster.

(for that matter, only a 1/3 of the people over 65 have been getting it)
Oh, gosh, I guess you must be right. The adminstration's plan is clearly nothing but a high-minded and virtuous attempt to prevent the working class from wasting their money on ineffective booster shots. Is that good enough for you? Or do I also have to pretend that the booster shots are part of a left-wing conspiracy to impose godless socialism on the American people?
 
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ThatRobGuy

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Oh, gosh, I guess you must be right. The adminstration's plan is clearly nothing but a high-minded and virtuous attempt to prevent the working class from wasting their money on ineffective booster shots. Is that good enough for you? Or do I also have to pretend that the booster shots are part of a left-wing conspiracy to impose godless socialism on the American people?

Not everything is an "economic class" thing...

And it's not "wasting on ineffective shots", it'd be wasting on shots for cohorts for which it is medically unnecessary.

Anyone who's 65+, or younger than that with a pre-existing condition, will be able to get one for free, or at the negotiated covered rate just like before.

This just simply means that if a healthy 20 or 30-something wants to get a booster dose, they'll have to pay for it themselves (much like they would any other elective intervention that's not medically necessary)


This is putting us more in-line with the policies like that of the UK, where they do have government-funded universal healthcare.


Can you make an objective case for why a healthy 30 year old with no pre-existing conditions (who has likely already had multiple doses and multiple infections) needs to keep getting government-funded booster doses?


For instance, why is it being looked at as a "evil right-wing capitalist plot to punish poor people" when the US implements the policy saying "it'll be subsidized for 65+ or those with underlying health issues, for the rest of the young people, if you absolutely feel like you want it, you'll have to pay for it yourself"

However, when we look at Finland's policy
Finland does not provide free COVID-19 booster doses to healthy young adults. Booster doses are recommended and provided free of charge only to people at risk of severe disease, which includes older adults and individuals with certain underlying health conditions.


Healthy younger adults (generally those aged 12–60 without risk factors) are not eligible for a free booster. However, they can still receive a booster dose if they wish, but must pay for it out of pocket at private vaccine clinics



Is Finland looking to punish poor people?


How about Denmark's policy?

For healthy adults who do not fall high-risk groups, COVID-19 boosters are not available through the public system. Since October 2023, if a healthy young adult in Denmark wants a booster, they must pay for it privately at a clinic, as vaccines are now sold on the private market under normal market conditions. For example, a Pfizer booster at a private clinic in Copenhagen costs about 920 kroner (approximately $130 USD)


Why is a "problem" that we're implementing that same policy that Finland, Denmark, Norway, Iceland, and the UK implemented 1-2 years ago?


I personally agree with the approach that the aforementioned nations have taken. If you're a healthy 30 year old who isn't at risk of severe disease and you absolutely feel like you want a booster dose, pony up the $120. If you're over 65 or have an underlying condition, then sure, public funds can cover it for you.
 
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BCP1928

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Not everything is an "economic class" thing...

And it's not "wasting on ineffective shots", it'd be wasting on shots for cohorts for which it is medically unnecessary.

Anyone who's 65+, or younger than that with a pre-existing condition, will be able to get one for free, or at the negotiated covered rate just like before.

This just simply means that if a healthy 20 or 30-something wants to get a booster dose, they'll have to pay for it themselves (much like they would any other elective intervention that's not medically necessary)


This is putting us more in-line with the policies like that of the UK, where they do have government-funded universal healthcare.


Can you make an objective case for why a healthy 30 year old with no pre-existing conditions (who has likely already had multiple doses and multiple infections) needs to keep getting government-funded booster doses?
No, why should I?
For instance, why is it being looked at as a "evil right-wing capitalist plot to punish poor people"
I don't look at it that way. The only "evil right wing capitalist plot" is to make as much money as possible It's the Christians who want to punish poor people.
 
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ThatRobGuy

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No, why should I?

I don't look at it that way. The only "evil right wing capitalist plot" is to make as much money as possible It's the Christians who want to punish poor people.
Then what's the deal with this comment?
"The administration's plan is clearly nothing but a high-minded and virtuous attempt to prevent the working class from wasting their money on ineffective booster shots. Is that good enough for you? Or do I also have to pretend that the booster shots are part of a left-wing conspiracy to impose godless socialism on the American people?"



Why the pushback against the US implementing a covid booster policy that mirrors that of what Denmark's been doing for 2 years?

Did Denmark, Norway, and Finland all adjust their booster policy due to some underlying sentiment that booster shots were part of some "godless left-wing socialist conspiracy"?

Or did they simply take a pragmatic look at the situation, and recognize that's it's not good stewardship of public funds to keep buying booster doses to give out to healthy young people for free, who don't need them?

Their young people can still get them in private clinics, but per what I posted before, a healthy young person in Copenhagen who absolutely insists on getting one, pays the same $130 USD that our healthy young people will have to start paying if they want one.
 
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BCP1928

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Then what's the deal with this comment?
"The administration's plan is clearly nothing but a high-minded and virtuous attempt to prevent the working class from wasting their money on ineffective booster shots. Is that good enough for you? Or do I also have to pretend that the booster shots are part of a left-wing conspiracy to impose godless socialism on the American people?"



Why the pushback against the US implementing a covid booster policy that mirrors that of what Denmark's been doing for 2 years?

Did Denmark, Norway, and Finland all adjust their booster policy due to some underlying sentiment that booster shots were part of some "godless left-wing socialist conspiracy"?

Or did they simply take a pragmatic look at the situation, and recognize that's it's not good stewardship of public funds to keep buying booster doses to give out to healthy young people for free, who don't need them?

Their young people can still get them in private clinics, but per what I posted before, a healthy young person in Copenhagen who absolutely insists on getting one, pays the same $130 USD that our healthy young people will have to start paying if they want one.
Yes, there lots of good reasons. I'm not pushing back against any of them.
 
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KCfromNC

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I know you were responding to someone else there, but in terms of public policy making, "efficacy" and "medical necessity" are two different concepts.
Yes, I know when confronted with actual research various words in previous posts should probably be corrected to match the reality portrayed by such research. Let us wait and see if those corrections are forthcoming.
 
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KCfromNC

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It should be noted that this observational study uses a test-negative control analysis:
I appreciate the attempt to backtrack from the claim of "There has never been any evidence" to nit-picking about the types of analysis used on the evidence which very much does exist.
 
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