A New Era of Vaccines Leaves Old Questions About Prices Unanswered

Published

2 years ago

October 30, 2023

admin

The world is entering a new era of vaccines. Following the success of covid-19 mRNA shots, scientists have a far greater capacity to tailor shots to a viruss structure, putting a host of new vaccines on the horizon.

This story also ran on Time. It can be republished for free.

The most recent arrivals as anyone on the airwaves or social media knows are several new immunizations against respiratory syncytial virus, or RSV.

These shots are welcome since RSV can be dangerous, even deadly, in the very old and very young. But the shots are also expensive about $300 for those directed at adults, and up to $1,000 for one of the shots, a monoclonal antibody rather than a traditional vaccine, intended for babies. Many older vaccines cost pennies.

So their advent is forcing the United States to face anew questions it has long sidestepped: How much should an immunization that will possibly be given maybe yearly to millions of Americans cost to be truly valuable? Also, given the U.S. is one of two countries that permit direct advertising to consumers: How can we ensure the shots get into the arms of people who will truly benefit and not be given, at great expense, to those who will not?

Already, ads on televisions and social media show active retirees playing pickleball or going to art galleries whose lives are cut short by RSV. This explains the lines for the shot at my local pharmacy.

But indiscriminate use of expensive shots could strain both public and private insurers already tight budgets. Email Sign-Up

Subscribe to KFF Health News' free Morning Briefing. Your Email Address Sign Up

Other developed countries have deliberate strategies for deciding which vulnerable groups need a particular vaccine and how much to pay for it. The U.S. does not, and as specialized vaccines proliferate, public programs and private insurers will need to grapple with how to use and finance shots that can be hugely beneficial for some but will waste precious health dollars if taken by all.

A seasonal viral illness, RSV can cause hospitalization or, in rare cases, death in babies and in people age 75 or older, as well as those with serious underlying medical conditions such as heart disease or cancer. For most people who get RSV, it plays out as a cold; youve likely had RSV without knowing it.

But RSV puts about 2% of babies under age 1 in the hospital and kills between 100 and 300 of those under 6 months, because their immune systems are immature and their airways too narrow to tolerate the inflammation. Merely having a bad case of RSV in young childhood increases the risk of long-term asthma.

Thats why Barney Graham, the scientist who spent decades at the governments National Institutes for Health perfecting the basic science that led to the current shots, said: The most obvious use is in infants, not adults.

Thats also why European countries trying to figure out how best to use these vaccines without breaking the bank focused first on babies and determining a sensible price. Though more of the very old may die of RSV, the years of life lost are much greater for the very young. (Babies can get the monoclonal antibody shot or gain protection through a traditional vaccine given to the mother near the end of pregnancy, conferring immunity through the womb.)

A consortium of European experts led by Philippe Beutels, a professor in health economics at the University of Antwerp in Belgium, calculated that the shots would only be worth it in terms of the lives saved and hospitalizations averted in infants if the price were under about $80, he said in a phone interview. Thats because almost all babies make it through RSV with supportive care.

The calculation will be used by countries such as Belgium, England, Denmark, Finland, and the Netherlands to negotiate a set price for the two infant shots, followed by decisions on which version should be offered, depending partly on which is more affordable.

They have not yet considered how to distribute the vaccines to adults considered less pressing because studies show that RSV rarely causes severe disease in adults who live outside of care settings, such as a nursing home.

Why did the United States and Europe approach the problem from opposite directions?

In the U.S., there was a financial incentive: Roughly 3.7 million babies are born each year, while there are about 75 million Americans age 60 and older the group for whom the two adult vaccines were approved. And about half of children get their vaccines through the Vaccines for Children program, which negotiates discounted prices.

Also, babies can get vaccinated only by their clinicians. Adults can walk into pharmacies for vaccinations, and pharmacies are only too happy to have the business.

But which older adults truly benefit from the shot? The two manufacturers of the adult vaccines, GSK and Pfizer, conducted their studies presented to the FDA for approval in a population of generally healthy people 60 and older, so thats the group to whom they may be marketed. And marketed they are, even though the studies didnt show the shots staved off hospitalization or death in people ages 60 to 75.

That led to what some have called a narrow endorsement from the Centers for Disease Control and Preventions Advisory Committee on Immunization Practices for people 60 to 75: Patients in that age range could get the shot after shared clinical decision-making with a health provider.

It is likely that because of this fuzzy recommendation, some Americans 60 and over with commercial insurance are finding that their insurers wont cover it. Under Obamacare, insurers are generally required to cover at no cost vaccines that are recommended by the ACIP; however, if a provider recommends vaccination, then it must be covered by insurance.

(In late September, the ACIP recommended immunization of all babies with either the antibody or the maternal vaccine. Insurers have a year to commence coverage and many have been dragging their feet because of the high price.)

There are better and more equitable ways to steer the shots into the arms of those who need it, rather than simply administering it to those who have the right insurance or, swayed by advertising, can pay. For example, insurers, including Medicare, could be required to cover only those ages 60 to 75 who have a prescription from a doctor, indicating shared decision-making has occurred.

Finally, during the pandemic emergency, the federal government purchased all covid-19 vaccines in bulk at a negotiated price, initially below $20 a shot, and distributed them nationally. If, to protect public health, we want vaccines to get into the arms of all who benefit, thats a more cohesive strategy than the patchwork one used now.

Vaccines are miraculous, and its great news that they now exist to prevent serious illness and death from RSV. But using such novel vaccines wisely directing them to the people who need them at a price they can afford will be key. Otherwise, the cost to the health system, and to patients, could undermine this big medical win.

Elisabeth Rosenthal: erosenthal@kff.org, @RosenthalHealth Related Topics Aging Health Care Costs Health Industry Pharmaceuticals Public Health CDC Children's Health Drug Costs Vaccines Contact Us Submit a Story Tip

Entertainment

Jonathan Pie: British satirist’s free speech warning to UK after Jimmy Kimmel show taken off air

Published

42 mins ago

September 20, 2025

admin

Jonathan Pie: British satirist's free speech warning to UK after Jimmy Kimmel show taken off air

The UK has to be “careful” and protect free speech as debate becomes “more and more toxic” on both sides of the Atlantic, a British satirist has said.

Tom Walker, better known as the ranting fictitious newsreader Jonathan Pie, has issued the warning after US talk show Jimmy Kimmel was taken off air for comments he made following the death of Charlie Kirk.

Speaking to Niall Paterson on the Sky News Daily podcast, Walker said he believes he wouldn’t be able work as a satirist in America today as the Trump administration appears to be cracking down on those who speak out against him.

He added: “I genuinely don’t think I would be allowed into the country. That might sound dramatic, but they go through your social media posts. I think Trump thinks that not agreeing with him is anti-American, whereas it’s not, it’s anti-Trump, it’s anti-Republican. So a lot of my posts would be seen as anti-American.”

Walker went viral in 2016 after posting a clip of Jonathan Pie passionately blaming “the left” for Mr Trump’s victory in the US election the same year.

The comedian argued that left-leaning people had “lost the art” of engaging with anyone with a different opinion to them and urged them to “stop thinking everyone who disagrees with you is evil, racist or sexist or stupid”.

Asked by Niall if he believes Kimmel, who has a long history of speaking out against Mr Trump, is partly responsible for the rise of the populist president, Walker said: “No, I don’t… Most of these late-night hosts are left-leaning and Trump is an own goal for satire.

“I don’t think there was much that Jimmy Kimmel said in his monologue the other day that was anywhere near as divisive as the rhetoric coming from Donald Trump or (vice president) JD Vance, so there is an inherent hypocrisy there.”

However, Walker believes “right-wingers” are not the only reason free speech is under a “huge amount of threat in America”.

The satirist, who counts himself as being left-wing, continued: “I think the left have enabled a culture where people don’t feel that they’re able to express their views.

“The left-wing were the flag-bearers of cancel culture. And now it’s sort of coming back to bite us in a terrifying way.”

Kimmel was taken off air months after US talk show host Stephen Colbert had his show cancelled – something his fans have attributed to his criticism of Mr Trump.

Meanwhile, the US president appeared to encourage NBC to cancel the talk shows of Jimmy Fallon and Seth Meyers in a Truth Social post on Thursday. Both presenters are known to have made jokes about Mr Trump in the past.

Asked whether the UK should be worried about free speech apparently being targeted in the UK in a similar way, Walker said: “I think that there are issues of free speech in this country. I don’t think it is quite as bad as what’s happening in America, but we have to be careful. The debate on both sides of the Atlantic is becoming more and more toxic, I think. And it’s divide and conquer. ‘You’re either with me or you’re against me’. And I think both sides have to take some responsibility for that.”

Walker pointed out that when he posted a satirical video on X called “The Death Of Discourse” in relation to the Kirk assassination, he was attacked by social media users on both the left and right of politics.

He added: “I think that’s the problem… We have forgotten how to talk and listen to people that we fundamentally disagree with.”

UK

Gender testing rules would have earned me an Olympic medal, says former UK athlete Lynsey Sharp

Published

42 mins ago

September 20, 2025

admin

Gender testing rules would have earned me an Olympic medal, says former UK athlete Lynsey Sharp

Former British athlete Lynsey Sharp has told Sky News she would have won a bronze medal at the Rio Olympics in 2016 had today’s gender testing rules been in place then.

Sharp came sixth in the women’s 800m final behind three now-barred athletes with differences in sexual development (DSD).

She told sports presenter Jacquie Beltrao the sport has changed considerably from when she was competing.

“Sometimes I look back and think I could have had an Olympic medal, but I gave it my all that day and that was the rules at the time,” she said.

“Obviously, I wish I was competing nowadays, but that was my time in the sport and that’s how it was.”

The Rio women’s 800m final saw South Africa’s Caster Semenya take gold, with Burundi’s Francine Niyonsaba and Margaret Wambui winning silver and bronze respectively. All three would have been unable to compete today.

Semenya won a total of two Olympic gold medals before World Athletics introduced rules limiting her participation in the female class.

In a major policy overhaul introduced this year, World Athletics now requires athletes competing in the female category at the elite level of the sport to take a gene test.

The tests identify the SRY gene, which is on the Y chromosome and triggers the development of male characteristics.

The tests replace previous rules whereby athletes with DSD were able to compete as long as they artificially reduced their testosterone levels.

Sharp says while she was competing, governing bodies “didn’t really deal with the issue head on”, and she was often portrayed as a “sore loser” over the issue.

Despite running a Scottish record in that race, her personal best, she described the experience as a “really difficult time”.

“Sadly, it did kind of taint my experience in the sport and at the Olympics in Rio,” she said.

Sharp added that despite the changes, it remains a “very contentious topic, not just in sport, but in society”.

Boxing has now also adopted a compulsory sex test to establish the presence of a Y chromosome at this month’s world championships.

The controversial Olympic champion Imane Khelif, who won Olympic welterweight gold in Paris 2024 in the female category, did not take it and couldn’t compete.

She has appealed to the Court of Arbitration for Sport against having to take the test.

Sharp’s comments come as British athletics star and Olympic champion Keely Hodgkinson is tipped to win her first world title in Sunday’s women’s 800m final at the World Athletics Championships in Tokyo.

She is returning from a year out after suffering two torn hamstrings.

UK

Speaker makes ‘strong and punchy’ protest to home secretary over dropping of Chinese spy charges

Published

42 mins ago

September 20, 2025

admin

Speaker makes 'strong and punchy' protest to home secretary over dropping of Chinese spy charges

Commons Speaker Sir Lindsay Hoyle has protested to the home secretary after prosecutors dropped charges against two men accused of spying for China and targeting MPs.

Sir Lindsay told Sky News the decision “leaves the door open” to foreigners spying on the House of Commons, and he has written a “strong and punchy” letter to Shabana Mahmood.

The Speaker says “all avenues” must be pursued to ensure the protection of MPs and Commons staff, and he is understood to be weighing up whether to carry out a private prosecution.

The men – Christopher Cash, a former parliamentary researcher and director of the China Research Group, and Christopher Berry – were charged last April under the Official Secrets Act.

The charges related to “espionage within parliament”, security minister Dan Jarvis told MPs on Monday, in a statement after the case was dropped by the Crown Prosecution Service at the Old Bailey.

The pair were accused of targeting the China Research Group of MPs, whose leading members are former Tory security minister Tom Tugendhat, shadow home office minister and former foreign affairs committee chair Alicia Kearns, and shadow minister Neil O’Brien.

Announcing the CPS decision, a spokesperson said: “In accordance with the Code for Crown Prosecutors, the evidence in this case has been kept under continuous review and it has now been determined that the evidential standard for the offence indicted is no longer met. No further evidence will be offered.”

Mr Cash and Mr Berry, who had both previously taught in China, said after the case against them was dropped that charges should never have been brought.

Speaking outside court, Mr Cash – previously a researcher for Ms Kearns – said: “While I am relieved that justice has been served today, the last two and a half years have been a nightmare for me and my family.”

He said he hoped “lessons are learned from this sorry episode”, while his lawyer said his client was “entirely innocent and should never have been arrested, let alone charged”.

Revealing that he has now written to the home secretary, Sir Lindsay told Sky News: “As Speaker, I take the security of this House incredibly seriously. I believe this leaves the door open to foreign actors trying to spy on the House.

“This door must be closed hard. We must pursue all avenues to ensure the protection of Members and people that work within the House of Commons. It will not be tolerated.”

Ahead of Mr Jarvis’s Commons statement on Monday, Sir Lindsay told MPs: “I found out only this morning that the charges against the two individuals relating to espionage for the Chinese authorities were to be dropped. I do not think that is good.

“I ask officials to consider whether any further steps should be taken-operational, strategic, or legal-to ensure that all those who work in this parliament are able to undertake their activities securely and without interference.”

And he concluded: “I am a very unhappy Speaker with what has happened. The fact that it has taken two years, until today, for somebody to withdraw this case is not good enough.”

Mr Jarvis told MPs: “The government remain gravely concerned about the threat of Chinese espionage. Parliament and our democracy are sacrosanct, and any attempt by any foreign power to infiltrate or interfere with parliamentary proceedings is completely unacceptable.”

He added: “This was an independent decision made by the CPS, and it is not for any government minister to speculate on the reasons behind it.

“The government are extremely disappointed with the outcome in this case, and we remain extremely concerned about the espionage threat posed to the United Kingdom.”

Responding to Mr Jarvis’s statement, Ms Kearns told MPs: “From a securities perspective, today’s events are disastrous. They will embolden our enemies and make us look unwilling to defend our own nation, even when attacked in this place, the mother of all parliaments.”