Coronavirus pandemic

A surge in chikungunya cases has hit southern China, fuelled by climate change, urbanisation and global travel. Experts warn the next pandemic is inevitable – but have we learned enough from COVID-19 to be prepared?

Presenter: Stefanie Dekker

Guests:
Carmen Perez Casas – Head of pandemic prevention, Unitaid
Albert Fox Cahn – Founder, Surveillance Technology Oversight Project (STOP)

Former US vaccine chief Demetre Daskalakis says the country’s health department is being led by a ‘chaos agent’ who is putting vulnerable people in harm’s way.

Dr Daskalakis was one of three directors to resign in August, following a decision to fire the head of the Centres for Disease Control, Susan Monarez, after her months-long dispute with health secretary Robert F Kennedy Jr.

Since then, Dr Daskalakis has publicly criticised Kennedy, saying he is knowingly dismantling the country’s vaccine programme by sidelining experts and pushing his own ideology.

Winter is approaching in the United States and COVID-19 cases are rising. Questions about accessing protective vaccines are swirling.

Nearly five years since the first US patient was vaccinated to help stem what was then a raging coronavirus pandemic, doctors, patients and pharmacists are navigating a radically different public health landscape.

The US Food and Drug Administration (FDA) on August 27 announced it had approved some COVID-19 vaccines – but for far fewer people than in years past.

If you tried to schedule a COVID-19 vaccine this week, your pharmacy’s online scheduler might have told you it isn’t available yet.

Meanwhile, leading medical organisations disagree with the government’s latest COVID-19 vaccine guidance.

If all that leaves you wondering about your ability to get a COVID-19 shot, you’re not alone. It’s confusing.

We sought answers.

Q: Who can get a COVID-19 vaccine?

First, what we do know: The FDA approved the 2025-26 vaccines for anyone age 65 and older and any person six months and older who has at least one underlying health condition that increases their risk of severe COVID-19 infection.

So, people in those groups should be able to schedule vaccinations as soon as healthcare providers who are authorised to administer the vaccine receive it – likely in the next few weeks.

Q: I don’t fit into those categories. Am I banned from getting a COVID-19 vaccine?

Not “banned”, per se. But it may require more legwork on your end. You’ll need to consult your doctor, who can legally prescribe a COVID-19 vaccine for you even if you don’t fall within the categories the FDA specified.

“Physicians can prescribe medications and vaccines that are beyond the label, beyond the licence,” said Dr William Schaffner, Vanderbilt University Medical Center professor of infectious diseases.

That’s true for adults and children – and the practice of prescribing medications and vaccines for “off-label” use is fairly common in paediatrics, he said.

Q: OK, so will insurance still cover COVID-19 vaccinations under these new rules?

If you’re in one of the two FDA-approved categories, the outlook is probably better than if you’re not.

Federal law requires that most health insurance plans fully cover vaccines recommended by the US Centers for Disease Control and Prevention and its vaccine advisory committee.

Here’s the rub: Because the CDC hasn’t yet adopted 2025-26 COVID-19 vaccine recommendations, whether the shots will be covered by insurance is a grey area.

The CDC’s panel of experts, the Advisory Committee on Immunisation Practices (ACIP), had planned to vote on updated COVID-19 vaccine recommendations at its June meeting, but did not. And it’s unclear when or if the ACIP will vote on the recommendations.

But there could be another avenue for people to get insurance-covered COVID-19 vaccines. The CDC’s vaccine recommendations typically include a provision for what’s known as “shared clinical decision making”, Schaffner said.

That means, for example, “If you were 52 years old and otherwise healthy, but you nonetheless wanted to get the vaccine, you could discuss that with your doctor – shared clinical decision-making – and you could receive the vaccine, and insurance companies would honour that,” he said.

That provision could be important for healthy people who want to avoid COVID-19 infection because they are close contacts with or care for people with high-risk conditions.

But again, without CDC recommendations, “We don’t know if that provision is still there,” Schaffner said.

To confirm whether your insurance will cover your COVID-19 shot, Schaffner recommends talking to your doctor and, potentially, your insurance provider. But first, give it a little more time: healthcare providers themselves are still working out the details.

Q: If my insurance doesn’t cover vaccination, how much might it cost?

Vaccine manufacturers report that COVID-19 vaccines cost about $142, according to the CDC’s price lists. It’s unclear whether that would be the out-of-pocket cost for patients receiving a COVID-19 vaccine not covered by insurance.

Q: Are COVID-19 vaccines still recommended during pregnancy? And if I’m pregnant and want one, what can I do? 

Health and Human Services Secretary Robert F Kennedy Jr in May announced he had unilaterally removed COVID-19 vaccines from the recommended immunisation schedule for healthy children and pregnant women. The health-focused news outlet STAT reported that no one from the CDC or ACIP was consulted before Kennedy announced this change. Vaccine experts called the move concerning and unprecedented.

Removing the vaccines from the immunisation schedule could limit vaccine access by reducing insurance companies’ coverage of the shot. But again, by consulting with your doctor, you might still be able to access it. Some pharmacies also might be able to provide it, because the CDC lists pregnancy as a factor that increases the risk of severe COVID-19 infection.

Q: Is there anyone who should not get the COVID-19 shot?

Broad health guidance always comes with exceptions. For example, people who have had “a very severe adverse reaction to a previous COVID-19 vaccine” should not get this season’s version, Schaffner said. You should discuss your health situation with your physician for personalised guidance.

Q: Why is the outlook for COVID-19 vaccines so different this year?

In short, Kennedy has long been broadly critical of vaccinations and, now that he’s in charge of the nation’s healthcare policy, has taken actions to overhaul their regulation and distribution.

Typically, the CDC recommends vaccines based on guidance from ACIP. ACIP’s recommendations become CDC policy if they’re adopted by the CDC director. This year, Kennedy fired all 17 members of ACIP and replaced them with new members, many of whom have expressed anti-vaccine views. CDC Director Susan Monarez was fired on August 27 amid a dispute with Kennedy over vaccine policy.

In previous years, the CDC recommended annual COVID-19 vaccines for everyone aged six months and older. The committee still hasn’t issued COVID-19 vaccine recommendations for this year.

Q: Aren’t there some medical organisations that recommend COVID-19 vaccinations for most people, though? 

Yes. In recent months, professional organisations have issued their own recommendations that contradict new messaging from the federal government.

The American Academy of Pediatrics recommends routine COVID-19 vaccines for all children aged six months to 23 months and for children aged two to 18 in some situations, including if they’re at high risk of COVID-19, have never been vaccinated against it or live in a household with people who are high risk.

And the American College of Obstetricians and Gynecologists recommends that anyone pregnant or lactating receive updated or “booster” COVID-19 vaccines.

Dr Tina Tan, president of the Infectious Disease Society of America, said the FDA’s decision to limit the COVID-19 vaccine’s approval “contradicts the evidence base, severely undermines trust in science-driven policy and dangerously limits vaccine access”.

Q: What qualifies as an underlying health condition that puts someone at higher risk? 

The FDA and HHS did not point us to a list of health conditions that meet the high-risk requirements.

The CDC’s website catalogues a number of underlying conditions that it said demonstrate “a conclusive increase in risk for at least one severe COVID-19 outcome”. They included: chronic lung diseases, cancer, certain chronic kidney and liver diseases, diabetes, some disabilities, heart conditions, HIV, physical inactivity, primary immunodeficiencies and some mental health conditions.

Q: But I clicked on those lists and both say ‘pregnancy and recent pregnancy’ are risk factors. How do I square that with the latest changes?

You’re right. These lists are inconsistent with the messaging coming from top HHS officials. Again, the American College of Obstetricians and Gynecologists continues to recommend COVID-19 vaccines for people who are pregnant and lactating. Talk to your doctor.

Q: Is this season’s COVID-19 vaccine formula different from last season’s?

Yes. After the FDA passed its recommendations to vaccine manufacturers in May, the COVID-19 vaccines were updated to target the viral strain expected to circulate this year. The changes align with the World Health Organization’s recommendations.

Q: When will the updated COVID-19 shots be available? 

Since the FDA’s approval, updated vaccines are set to start shipping immediately and might even be available now in some pharmacies. Pfizer said it was shipping immediately and would be available across the US “in the coming days”. Sanofi, the company distributing the Novavax non-mRNA vaccines, said its vaccine should be available “in the early fall”.

But what that means for how quickly you can access it could depend on where you live, your age and your health. (See next question.)

Q: Where can I get the updated COVID-19 shots? 

We knew you were going to ask. And we wish we had a straightforward answer.

If you typically get your COVID-19 shots at a local pharmacy, it might not be that easy this year.

As of August 29, the scheduling apps for Walgreens and CVS notified patients in some locations that they could not schedule a COVID-19 vaccine appointment because of state restrictions, inventory or the need for a prescription.

In 18 states and Washington, DC, pharmacists’ authority to administer vaccines is linked to the CDC’s recommendations, said Brigid Groves, the American Pharmacists Association’s vice president of professional affairs. The states are: Colorado, Connecticut, Georgia, Iowa, Kentucky, Maine, Maryland, Massachusetts, Montana, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, South Carolina, Virginia and West Virginia.

That means even though the FDA has issued its approval, in those 19 places, pharmacists cannot administer it because it isn’t on the CDC immunisation schedule yet, Groves said.

The American Pharmacists Association has asked those states’ governors to issue executive orders granting pharmacists broader authority to administer vaccines.

In the other 32 states, with some exceptions, it’s possible that a pharmacy can administer the updated COVID-19 shots for patients who fall within the FDA-approved categories of recipients.

If you are getting it “off label”, however, because you don’t have one of those underlying conditions, you might need to get it straight from your prescribing doctor.

One caveat: if ACIP votes on recommendations for COVID-19 vaccines that include giving them to healthy people through the “shared clinical decision making” process, Groves said pharmacists would be able to vaccinate almost anyone. That’s because pharmacists are considered clinicians who can conduct that shared decision-making.

Q: When might ACIP vote on COVID-19 vaccine recommendations? 

The committee has a September 18-19 meeting scheduled, according to the CDC’s website. A meeting agenda hasn’t been published yet.

Q: How will a pharmacy know if I have an underlying condition?

Typically, pharmacies ask patients to self-attest whether they have an underlying condition, Groves said. For example, a person who is under age 65 but has severe asthma would self-attest to that when making a vaccine appointment. So far, all signs point to that self-attestation still being the case.

Q: When is the best time to get vaccinated? 

During fall and winter months, when COVID-19 infections are typically expected to spike alongside other respiratory infections.

Q: What do the administration’s vaccine changes mean for future COVID-19 vaccines?

Kennedy recently cancelled $500m in funding for mRNA vaccine development. Two of the most effective COVID-19 vaccines are mRNA. Some companies had been researching combined mRNA flu and COVID-19 shots, and those projects’ status is unclear.

The FDA also recently announced that vaccine makers seeking approval for future COVID-19 vaccines, or boosters, would need to conduct new randomised clinical trials of healthy populations. That move, combined with the decision to narrow the FDA’s vaccine approval for certain segments of the population, is expected to limit COVID-19 vaccine access.

Trump’s administration halts mRNA vaccine development, sparking WHO fears for emerging pandemic preparedness.

The decision by US President Donald Trump’s administration to terminate 22 federal contracts for mRNA-based vaccines is a major blow to a hugely promising platform, the World Health Organization said.

“This is, of course, a significant blow,” WHO immunisation figurehead Joachim Hombach told the UN correspondents’ association ACANU on Thursday.

The Department of Health and Human Services (HHS) announcement that it will wind down mRNA vaccine development activities under its biomedical research unit is the latest development under US Health Secretary Robert F Kennedy Jr, a long-time vaccine sceptic who has been making sweeping changes to reshape vaccines, food and medicine policies.

“mRNA vaccines are a very important technology and platform which has served us extremely well for COVID. We also know there is very promising work going on in relation to influenza vaccines,” Hombach said. “From our perspective, the platform is particularly useful in relation to developing vaccines against emerging and pandemic threats, because these platforms can be very rapidly adapted.”

Unlike traditional vaccines, which often use weakened or inactivated forms of the target virus or bacteria, mRNA shots deliver genetic instructions into the host’s cells, prompting them to produce a harmless decoy of the pathogen and train the immune system to fight the real thing.

The US health department’s Biomedical Advanced Research and Development Authority is “terminating 22 mRNA vaccine development investments because the data show these vaccines fail to protect effectively against upper respiratory infections like COVID and flu”, Kennedy said.

Hombach, executive secretary for the WHO’s strategic advisory group of experts on immunisation, called for work on the development of mRNA vaccines to continue around the world.

“This is, from our perspective, an unfortunate and untimely move, but we are confident that the research endeavour will continue because it’s an extremely promising technology,” he told reporters.

Shortly after his inauguration in January, Trump signed an executive order directing the United States to withdraw from the WHO, an organisation he has repeatedly criticised over its handling of the COVID-19 pandemic.

The Biomedical Advanced Research and Development Authority helps companies develop medical supplies to address public health threats, and had provided billions of dollars for the development of vaccines during the COVID-19 pandemic.

HHS said the wind-down includes cancellation of a contract awarded to Moderna MRNA.O for the late-stage development of its bird flu vaccine for humans and the right to buy the shots, as previously reported in May.

The US health agency said it was also rejecting or cancelling multiple pre-award solicitations, including proposals from Pfizer PFE.N, Sanofi Pasteur SASY.PA, CSL Seqirus CSL.AX, Gritstone and others.

Kennedy said the department is terminating these programmes because data show these vaccines “fail to protect effectively against upper respiratory infections like COVID and flu,” but did not offer scientific evidence.

“We’re shifting that funding toward safer, broader vaccine platforms that remain effective even as viruses mutate,” Kennedy said.

In total, the decision affects 22 projects worth nearly $500m, the agency said.

HHS said the decision follows a comprehensive review of mRNA-related investments initiated during the COVID-19 public health emergency.

WHO chief Tedros says ‘all hypotheses must remain on the table’ after critical information not provided to investigators.

The World Health Organization (WHO) says efforts to uncover the origin of the COVID-19 pandemic are still ongoing and incomplete, as critical information has “not been provided”.

WHO chief Tedros Adhanom Ghebreyesus said “all hypotheses must remain on the table” to determine the cause of the virus, also known as SARS-CoV-2, after an expert group investigating its origins reached an unsatisfying conclusion in its final report released on Friday.

“We continue to appeal to China and any other country that has information about the origins of COVID-19 to share that information openly, in the interests of protecting the world from future pandemics,” Tedros said.

The global pandemic, which began in 2020, killed millions worldwide, with countries enforcing lockdowns in an attempt to stop the spread of the virus. With the first cases detected in Wuhan, China, in late 2019, information from the country is seen as key to preventing future pandemics.

In 2021, Tedros launched the WHO Scientific Advisory Group for the Origins of Novel Pathogens (SAGO), a panel of 27 independent international experts.

Marietjie Venter, the group’s chair, said on Friday that most scientific data supports the hypothesis that the new coronavirus jumped to humans from animals.

But she added that after more than three years of work, SAGO was unable to get the necessary data to evaluate whether or not COVID was the result of a lab accident, despite repeated requests for detailed information made to the Chinese government.

“Therefore, this hypothesis could not be investigated or excluded,” she said, however adding, “It was deemed to be very speculative, based on political opinions and not backed up by science.”

Venter also said there was no evidence to prove that COVID had been manipulated in a lab, nor was there any indication that the virus had been spreading before December 2019 anywhere outside of China.

‘Remains inconclusive’

In 2021, a group of experts from the WHO first travelled to Wuhan to examine the origins of the virus with their Chinese counterparts.

By March of that year, their joint report found that the most likely hypothesis was from bats to humans via an intermediate animal.

They said at the time that a lab leak was “extremely unlikely”.

However, that investigation faced backlash for lacking transparency and access, and not taking the lab-leak theory seriously.

After that, SAGO was launched.

According to the SAGO report, “the weight of available evidence … suggests zoonotic [a disease spread between animals to humans] spillover … either directly from bats or through an intermediate host”.

“Until more scientific data becomes available, the origins of how SARS-CoV-2 entered human populations will remain inconclusive,” Venter said.

“Understanding the origins of SARS-CoV-2 and how it sparked a pandemic is needed to help prevent future pandemics, save lives and livelihoods, and reduce global suffering,” she added.

Tedros said it was a “moral imperative” to determine how COVID began, noting that the virus killed at least 20 million people, wiped at least $10tn from the global economy and upended the lives of billions.

US President Trump-appointed Health Secretary and vaccine sceptic will replace panel with his own selections.

United States Health and Human Services (HHS) Secretary Robert Kennedy Jr has purged a 17-member panel at the Centers for Disease Control and Prevention (CDC) that provides expertise on vaccines.

Kennedy, who before taking a position in the administration of President Donald Trump was a vocal anti-vaccine activist, has said he will replace the panel with his own picks.

“Today, we are prioritising the restoration of public trust above any specific pro- or anti-vaccine agenda,” Kennedy said. “The public must know that unbiased science – evaluated through a transparent process and insulated from conflicts of interest – guides the recommendations of our health agencies.”

Kennedy’s reorganisation of the CDC’s Advisory Committee on Immunization Practices (ACIP) is the latest move by the Trump administration to shake up US health practices, sometimes by pushing ideas that depart strongly from the existing scientific consensus on issues such as vaccinations and fluoride.

“That’s a tragedy,” a former chief scientist of the Food and Drug Administration (FDA), Jesse Goodman, said of the firings.

“This is a highly professional group of scientists and physicians and others … It’s the kind of political meddling that will reduce confidence rather than increase confidence.”

The HHS said that all 17 members of the panel were selected during the administration of former President Joe Biden, and that keeping them on would have prevented Trump from choosing the majority of the panel’s members until 2028.

The department said that the ACIP will convene its next meeting on June 25-27. While the Food and Drug Administration (FDA) approves vaccinations for public use, the ACIP reviews data in public meetings before voting on whether to recommend a vaccine.

India has reported a sudden rise in COVID cases, starting from late May. Authorities said the number of active cases of the disease has surpassed 5,000.

India is the latest of a number of countries to report an uptick in COVID cases this year as, more than five years after the virus was declared a global pandemic, waves of new strains continue to emerge.

Here is what we know about the new variant of COVID and where it has spread:

How many COVID cases are there in India?

As of Thursday this week, there are 5,364 active cases in India, according to India’s Ministry of Health and Family Welfare. Since January 1, more than 4,700 people have recovered from COVID in India, while 55 people have died from the virus.

Which variants are causing new cases and where?

The main coronavirus variant causing a new spread of the disease is known as NB.1.8.1. Cases caused by this variant have been reported in the United Kingdom, the United States, Australia, Thailand, China and Hong Kong, among other countries. It is now the dominant variant in China and Hong Kong.

A second variant, LF.7, is also responsible for some of the cases in India.

The UK Health Security Agency (UKHSA) said it had recorded 13 cases of the NB.1.8.1 variant in England, with “small numbers” detected across the UK.

By late April, NB.1.8.1 comprised about 10.7 percent of submitted sequences globally, according to the World Health Organization (WHO). This rose from just 2.5 percent one month before.

What do we know about the NB.1.8.1 variant?

The Omicron variant NB.1.8.1 was first detected in January this year.

It is a “recombinant” variant, which means it has arisen from the genetic mixing of two or more existing variants.

On May 23, 2025, the WHO declared the NB.1.8.1 strain a “variant under monitoring” (VUM).

According to a 2023 definition by the WHO, a VUM is a variant which has undergone genetic changes that scientists believe could potentially affect the behaviour of the virus; early data suggests that this variant can grow faster or spread more easily than others, but this has not yet been confirmed.

The evidence of the variant’s impact on health, immunity or transmission is still unclear.

Why are there so many new cases?

While the NB.1.8.1 strain is still being researched, the evidence so far suggests that the strain may spread more easily, virologist Lara Herrero wrote for The Conversation on May 28.

Researchers using lab-based models have found that of several variants tested, the new strain had the strongest ability to bind to human cell receptors. This suggests that the strain may “infect cells more efficiently than earlier strains”, Herrero wrote.

“It is more transmissible,” Subhash Verma, a professor of microbiology and immunology at the University of Nevada, Reno School of Medicine, told CBS News.

What are the symptoms?

Common symptoms of the NB.1.8.1 strain include a sore throat, cough, muscle aches, fever and nasal congestion.

It can also cause gastrointestinal symptoms such as nausea and diarrhoea.

Are COVID vaccines effective against the new strain?

Vaccines remain a powerful defence against COVID infections, severe sickness, hospitalisation and death, clinicians say.

However, virologist Herrero wrote that besides spreading more easily, NB.1.8.1 may “partially sidestep” immunity gained from the vaccines or prior infection.

For now, health authorities say current COVID jabs are expected to be effective against this coronavirus variant and protect people from severe illness.

Should we be concerned?

Health experts worldwide say there is no evidence that the new strain of the coronavirus is more severe or deadly than any previous strain. However, it does appear to spread more easily.

Since COVID spreads through airborne particles and droplets, the spread of the virus can be prevented by getting tested if symptoms show, wearing a mask and social distancing, clinicians have advised.

Accord aims to prevent repeat of disjointed response and international disarray that surrounded COVID-19 pandemic.

Members of the World Health Organization (WHO) have adopted an agreement intended to improve preparedness for future pandemics, but the absence of the United States casts doubt on the treaty’s effectiveness.

After three years of negotiations, the legally binding pact was adopted by the World Health Assembly in Geneva on Tuesday. WHO member countries welcomed its passing with applause.

The accord aims to prevent a repeat of the disjointed response and international disarray that surrounded the COVID-19 pandemic by improving coordination, surveillance and access to medicines during any future pandemics.

“It’s an historic day,” WHO chief Tedros Adhanom Ghebreyesus said after the vote.

The agreement’s text was finalised last month after multiple rounds of tense negotiations.

“The world is safer today thanks to the leadership, collaboration and commitment of our member states to adopt the historic WHO Pandemic Agreement,” Tedros said in a statement.

“The agreement is a victory for public health, science and multilateral action. It will ensure we, collectively, can better protect the world from future pandemic threats. It is also a recognition by the international community that our citizens, societies and economies must not be left vulnerable to again suffer losses like those endured during COVID-19,” he added.

The agreement aims to better detect and combat pandemics by focusing on greater international coordination and surveillance and more equitable access to vaccines and treatments.

The negotiations grew tense amid disagreements between wealthy and developing countries with the latter feeling cut off from access to vaccines during the COVID-19 pandemic.

Dr Esperance Luvindao, Namibia’s health minister and chairwoman of a committee that paved the way for the agreement’s adoption, said COVID-19 inflicted huge costs “on lives, livelihoods and economies”.

“We, as sovereign states, have resolved to join hands as one world together, so we can protect our children, elders, front-line health workers and all others from the next pandemic,” Luvindao added. “It is our duty and responsibility to humanity.”

Effective without US support?

The US, traditionally the WHO’s top donor, was not part of the final stages of the agreement process after the Trump administration announced the US pullout from the WHO and funding for the agency in January.

US Health and Human Services Secretary Robert F Kennedy Jr slammed the WHO as “moribund” during the annual assembly.

“I urge the world’s health ministers and the WHO to take our withdrawal from the organisation as a wake-up call,” he said in a video shown at the meeting in Geneva. “We’ve already been in contact with like-minded countries, and we encourage others to consider joining us.”

Kennedy accused the WHO of failing to learn from the lessons of the pandemic.

“It has doubled down with the pandemic agreement, which will lock in all of the dysfunction of the WHO pandemic response. … We’re not going to participate in that,” he said.

The treaty’s effectiveness will face doubts without the US, which poured billions into ensuring pharmaceutical companies develop COVID-19 vaccines quickly. Countries face no penalties if they ignore it, a common issue in international law.

Countries have until May 2026 to thrash out the details of the agreement’s pathogen access and benefit-sharing (PABS) mechanism.

The PABS mechanism deals with sharing access to pathogens with pandemic potential and then sharing the benefits derived from them, such as vaccines, tests and treatments.

Once the PABS system is finalised, countries can then ratify the agreement. Once 60 do so, the treaty will then enter into force.