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An Evidence-Based Approach to Covid-19 Vaccination
Authors: Vinay Prasad, M.D., M.P.H., and Martin A. Makary, M.D., M.P.H.Author Info & Affiliations
Published May 20, 2025
Over the past 5 years, the United States has moved toward an annual Covid-19 booster program. Each fall, Covid-19 booster shots are developed, alongside seasonal influenza vaccines, and are recommended for every American. As compared with vaccination policies in all European nations, the U.S. policy has been the most aggressive (see Figure 1).

1 While all other high-income nations confine vaccine recommendations to older adults (typically those older than 65 years of age), or those at high risk for severe Covid-19, the United States has adopted a one-size-fits-all regulatory framework and has granted broad marketing authorization to all Americans over the age of 6 months.

1 The U.S. policy has sometimes been justified by arguing that the American people are not sophisticated enough to understand age- and risk-based recommendations.
2 We reject this view.
Although the rapid development of multiple Covid-19 vaccines in 2020 represents a major scientific, medical, and regulatory accomplishment,
3 the benefit of repeat dosing — particularly among low-risk persons who may have previously received multiple doses of Covid-19 vaccines, had multiple Covid-19 infections, or both — is uncertain. The American people, along with many health care providers, remain unconvinced.

Over the past two seasons, uptake of the annual Covid-19 booster has been poor, according to the Centers for Disease Control and Prevention (CDC). Less than 25% of Americans received boosters each year, ranging from less than 10% of children younger than 12 years of age in the 2024–2025 season to 50% of adults over 75 years old.4 Even health care workers remain hesitant, with less than one third participating in the 2023–2024 fall booster program.5 There may even be a ripple effect: public trust in vaccination in general has declined,6 resulting in a reluctance to vaccinate that is affecting even vital immunization programs such as that for measles–mumps–rubella (MMR) vaccination, which has been clearly established as safe and highly effective. In recent years, reduced MMR vaccination rates have been a growing concern and have contributed to serious illness and deaths from measles. Against this context, the Food and Drug Administration (FDA) seeks to provide guidance and foster evidence generation.

Moving forward, the FDA will adopt the following Covid-19 vaccination regulatory framework: On the basis of immunogenicity — proof that a vaccine can generate antibody titers in people — the FDA anticipates that it will be able to make favorable benefit–risk findings for adults over the age of 65 years and for all persons above the age of 6 months with one or more risk factors that put them at high risk for severe Covid-19 outcomes, as described by the CDC (Figure 2). For all healthy persons — those with no risk factors for severe Covid-19 — between the ages of 6 months and 64 years, the FDA anticipates the need for randomized, controlled trial data evaluating clinical outcomes before Biologics License Applications can be granted. Insofar as possible, when approving a Covid-19 vaccine for high-risk groups, the FDA will encourage manufacturers to conduct randomized, controlled trials in the population of healthy adults as part of their postmarketing commitment.

ThE SCieNcE ZOMG tHe sCiENcE!!!

Heh, it's just a wise-ass thing.  It's supposed to indicate a mocking tone.  I'm not sure how it became an internet/social media thing but there we have it.

Heh, it's just a wise-ass thing.  It's supposed to indicate a mocking tone.  I'm not sure how it became an internet/social media thing but there we have it.

WASHINGTON — The U.S. Treasury is phasing out production of the penny and will soon stop putting new one-cent coins into circulation, the department said in a statement Thursday.

The news of the decision was first reported by the Wall Street Journal.


A Treasury spokesperson said the government made its final order of penny blanks this month, and the United States Mint will continue to manufacture pennies only as long as an inventory of penny blanks exists. Consumers with pennies will still be able to use them for purchases. But without new pennies moving into circulation, businesses that complete cash transactions will have to start rounding up or down to the nearest nickel.

The move is not a surprise. The production of a penny costs more than the value of the coin. President Donald Trump said in February that he ordered the U.S. Mint to stop making pennies, citing the cost.

“For far too long the United States has minted pennies which literally cost us more than 2 cents. This is so wasteful! I have instructed my Secretary of the US Treasury to stop producing new pennies. Let’s rip the waste out of our great nation's budget, even if it’s a penny at a time,” Trump said in a post to social media as he returned to Washington from the Super Bowl in February.

Trump actually undersold the cost argument — pennies cost more than three cents each to produce.

But the cost of a penny might be a smaller problem than the alternative. That’s because the Mint actually loses even more money on each nickel it produces. Each nickel costs 13.8 cents, with 11 cents of production costs and 2.8 cents of administrative and distribution costs. These figures are for the government’s most recent fiscal year, which ended in September.