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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

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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

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Meredith Kercher’s killer faces new trial over sexual assault allegations

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Meredith Kercher's killer faces new trial over sexual assault allegations

The man convicted of the murder of British student Meredith Kercher has been charged with sexual assault against an ex-girlfriend.

Rudy Guede, 38, was the only person who was definitively convicted of the murder of 21-year-old Ms Kercher in Perugia, Italy, back in 2007.

He will be standing trial again in November after an ex-girlfriend filed a police report in the summer of 2023 accusing Guede of mistreatment, personal injury and sexual violence.

Guede, from the Ivory Coast, was released from prison for the murder of Leeds University student Ms Kercher in 2021, after having served about 13 years of a 16-year sentence.

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Since last year – when this investigation was still ongoing – Guede has been under a “special surveillance” regime, Sky News understands, meaning he was banned from having any contact with the woman behind the sexual assault allegations, including via social media, and had to inform police any time he left his city of residence, Viterbo, as ruled by a Rome court.

Guede has been serving a restraining order and fitted with an electronic ankle tag.

The Kercher murder case, in the university city of Perugia, was the subject of international attention.

Ms Kercher, a 21-year-old British exchange student, was found murdered in the flat she shared with her American roommate, Amanda Knox.

The Briton’s throat had been cut and she had been stabbed 47 times.

(L-R) Raffaele Sollecito, Meredith Kercher and Amanda Knox. Pic: AP
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(L-R) Raffaele Sollecito, Meredith Kercher and Amanda Knox. File pic: AP

Ms Knox and her then-boyfriend, Raffaele Sollecito, were placed under suspicion.

Both were initially convicted of murder, but Italy’s highest court overturned their convictions, acquitting them in 2015.

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RWAs build mirrors where they need building blocks

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RWAs build mirrors where they need building blocks

RWAs build mirrors where they need building blocks

Most RWAs remain isolated and underutilized instead of composable, DeFi-ready building blocks. It’s time to change that.

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In rare earth metals power struggle with China, old laptops, phones may get a new life

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In rare earth metals power struggle with China, old laptops, phones may get a new life

A stack of old mobile phones are seen before recycling process in Kocaeli, Turkiye on October 14, 2024.

Anadolu | Anadolu | Getty Images

As the U.S. and China vie for economic, technological and geopolitical supremacy, the critical elements and metals embedded in technology from consumer to industrial and military markets have become a pawn in the wider conflict. That’s nowhere more so the case than in China’s leverage over the rare earth metals supply chain. This past week, the Department of Defense took a large equity stake in MP Materials, the company running the only rare earths mining operation in the U.S.

But there’s another option to combat the rare earths shortage that goes back to an older idea: recycling. The business has come a long way from collecting cans, bottles, plastic, newspaper and other consumer disposables, otherwise destined for landfills, to recreate all sorts of new products.

Today, next-generation recyclers — a mix of legacy companies and startups — are innovating ways to gather and process the ever-growing mountains of electronic waste, or e-waste, which comprises end-of-life and discarded computers, smartphones, servers, TVs, appliances, medical devices, and other electronics and IT equipment. And they are doing so in a way that is aligned to the newest critical technologies in society. Most recently, spent EV batteries, wind turbines and solar panels are fostering a burgeoning recycling niche.

The e-waste recycling opportunity isn’t limited to rare earth elements. Any electronics that can’t be wholly refurbished and resold, or cannibalized for replacement parts needed to keep existing electronics up and running, can berecycled to strip out gold, silver, copper, nickel, steel, aluminum, lithium, cobalt and other metals vital to manufacturers in various industries. But increasingly, recyclers are extracting rare-earth elements, such as neodymium, praseodymium, terbium and dysprosium, which are critical in making everything from fighter jets to power tools.

“Recycling [of e-waste] hasn’t been taken too seriously until recently” as a meaningful source of supply, said Kunal Sinha, global head of recycling at Swiss-based Glencore, a major miner, producer and marketer of metals and minerals — and, to a much lesser but growing degree, an e-waste recycler. “A lot of people are still sleeping at the wheel and don’t realize how big this can be,” Sinha said. 

Traditionally, U.S. manufacturers purchase essential metals and rare earths from domestic and foreign producers — an inordinate number based in China — that fabricate mined raw materials, or through commodities traders. But with those supply chains now disrupted by unpredictable tariffs, trade policies and geopolitics, the market for recycled e-waste is gaining importance as a way to feed the insatiable electrification of everything.

“The United States imports a lot of electronics, and all of that is coming with gold and aluminum and steel,” said John Mitchell, president and CEO of the Global Electronics Association, an industry trade group. “So there’s a great opportunity to actually have the tariffs be an impetus for greater recycling in this country for goods that we don’t have, but are buying from other countries.”

With copper, other metals, ‘recycling is going to play huge role’

Although recycling contributes only around $200 million to Glencore’s total EBITDA of nearly $14 billion, the strategic attention and time the business gets from leadership “is much more than that percentage,” Sinha said. “We believe that a lot of mining is necessary to get to all the copper, gold and other metals that are needed, but we also recognize that recycling is going to play a huge role,” he said.

Glencore has operated a huge copper smelter in Quebec, Canada, for almost  20 years on a site that’s nearly 100-years-old. The facility processes mostly mined copper concentrates, though 15% of its feedstock is recyclable materials, such as e-waste that Glencore’s global network of 100-plus suppliers collect and sort. The smelter pioneered the process for recovering copper and precious metals from e-waste in the mid 1980s, making it one of the first and largest of its type in the world. The smelted copper is refined into fresh slabs that are sold to manufacturers and traders. The same facility also produces refined gold, silver, platinum and palladium recovered from recycling feeds. 

The importance of copper to OEMs’ supply chains was magnified in early July, when prices hit an all-time high after President Trump said he would impose a 50% tariff on imports of the metal. The U.S. imports just under half of its copper, and the tariff hike — like other new Trump trade policies — is intended to boost domestic production.

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Price of copper year-to-date 2025.

It takes around three decades for a new mine in the U.S. to move from discovery to production, which makes recycled copper look all the more attractive, especially as demand keeps rising. According to estimates by energy-data firm Wood Mackenzie, 45% of demand will be met with recycled copper by 2050, up from about a third today.

Foreign recycling companies have begun investing in the U.S.-based facilities. In 2022, Germany’s Wieland broke ground on a $100-million copper and copper alloy recycling plant in Shelbyville, Kentucky. Last year, another German firm, Aurubis, started construction on an $800-million multi-metal recycling facility in Augusta, Georgia.

“As the first major secondary smelter of its kind in the U.S., Aurubis Richmond will allow us to keep strategically important metals in the economy, making U.S. supply chains more independent,” said Aurubis CEO Toralf Haag.

Massive amounts of e-waste

The proliferation of e-waste can be traced back to the 1990s, when the internet gave birth to the digital economy, spawning exponential growth in electronically enabled products. The trend has been supercharged by the emergence of renewable energy, e-mobility, artificial intelligence and the build-out of data centers. That translates to a constant turnover of devices and equipment, and massive amounts of e-waste.

In 2022, a record 62 million metric tons of e-waste were produced globally, up 82% from 2010, according to the most recent estimates from the United Nations’ International Telecommunications Union and research arm UNITAR. That number is projected to reach 82 million metric tons by 2030.

The U.S., the report said, produced just shy of 8 million tons of e-waste in 2022. Yet only about 15-20% of it is properly recycled, a figure that illustrates the untapped market for e-waste retrievables. The e-waste recycling industry generated $28.1 billion in revenue in 2024, according to IBISWorld, with a projected compound annual growth rate of 8%.

Whether it’s refurbished and resold or recycled for metals and rare-earths, e-waste that stores data — especially smartphones, computers, servers and some medical devices — must be wiped of sensitive information to comply with cybersecurity and environmental regulations. The service, referred to as IT asset disposition (ITAD), is offered by conventional waste and recycling companies, including Waste Management, Republic Services and Clean Harbors, as well as specialists such as Sims Lifecycle Services, Electronic Recyclers International, All Green Electronics Recycling and Full Circle Electronics.

“We’re definitely seeing a bit of an influx of [e-waste] coming into our warehouses,” said Full Circle Electronics CEO Dave Daily, adding, “I think that is due to some early refresh cycles.”

That’s a reference to businesses and consumers choosing to get ahead of the customary three-year time frame for purchasing new electronics, and discarding old stuff, in anticipation of tariff-related price increases.

Daily also is witnessing increased demand among downstream recyclers for e-waste Full Circle Electronics can’t refurbish and sell at wholesale. The company dismantles and separates it into 40 or 50 different types of material, from keyboards and mice to circuit boards, wires and cables. Recyclers harvest those items for metals and rare earths, which continue to go up in price on commodities markets, before reentering the supply chain as core raw materials.

Even before the Trump administration’s efforts to revitalize American manufacturing by reworking trade deals, and recent changes in tax credits key to the industry in Trump’s tax and spending bill, entrepreneurs have been launching e-waste recycling startups and developing technologies to process them for domestic OEMs.

“Many regions of the world have been kind of lazy about processing e-waste, so a lot of it goes offshore,” Sinha said. In response to that imbalance, “There seems to be a trend of nationalizing e-waste, because people suddenly realize that we have the same metals [they’ve] been looking for” from overseas sources, he said. “People have been rethinking the global supply chain, that they’re too long and need to be more localized.” 

China commands 90% of rare earth market

Several startups tend to focus on a particular type of e-waste. Lately, rare earths have garnered tremendous attention, not just because they’re in high demand by U.S. electronics manufacturers but also to lessen dependence on China, which dominates mining, processing and refining of the materials. In the production of rare-earth magnets — used in EVs, drones, consumer electronics, medical devices, wind turbines, military weapons and other products — China commands roughly 90% of the global supply chain.

The lingering U.S.–China trade war has only exacerbated the disparity. In April, China restricted exports of seven rare earths and related magnets in retaliation for U.S. tariffs, a move that forced Ford to shut down factories because of magnet shortages. China, in mid-June, issued temporary six-month licenses to certain major U.S. automaker suppliers and select firms. Exports are flowing again, but with delays and still well below peak levels.

The U.S. is attempting to catch up. Before this past week’s Trump administration deal, the Biden administration awarded $45 million in funding to MP Materials and the nation’s lone rare earths mine, in Mountain Pass, California. Back in April, the Interior Department approved development activities at the Colosseum rare earths project, located within California’s Mojave National Preserve. The project, owned by Australia’s Dateline Resources, will potentially become America’s second rare earth mine after Mountain Pass. 

A wheel loader takes ore to a crusher at the MP Materials rare earth mine in Mountain Pass, California, U.S. January 30, 2020. Picture taken January 30, 2020.

Steve Marcus | Reuters

Meanwhile, several recycling startups are extracting rare earths from e-waste. Illumynt has an advanced process for recovering them from decommissioned hard drives procured from data centers. In April, hard drive manufacturer Western Digital announced a collaboration with Microsoft, Critical Materials Recycling and PedalPoint Recycling to pull rare earths, as well as copper, gold, aluminum and steel, from end-of-life drives.

Canadian-based Cyclic Materials invented a process that recovers rare-earths and other metals from EV motors, wind turbines, MRI machines and data-center e-scrap. The company is investing more than $20 million to build its first U.S.-based facility in Mesa, Arizona. Late last year, Glencore signed a multiyear agreement with Cyclic to provide recycled copper for its smelting and refining operations.

Another hot feedstock for e-waste recyclers is end-of-life lithium-ion batteries, a source of not only lithium but also copper, cobalt, nickel, manganese and aluminum. Those materials are essential for manufacturing new EV batteries, which the Big Three automakers are heavily invested in. Their projects, however, are threatened by possible reductions in the Biden-era 45X production tax credit, featured in the new federal spending bill.

It’s too soon to know how that might impact battery recyclers — including Ascend Elements, American Battery Technology, Cirba Solutions and Redwood Materials — who themselves qualify for the 45X and other tax credits. They might actually be aided by other provisions in the budget bill that benefit a domestic supply chain of critical minerals as a way to undercut China’s dominance of the global market.

Nonetheless, that looming uncertainty should be a warning sign for e-waste recyclers, said Sinha. “Be careful not to build a recycling company on the back of one tax credit,” he said, “because it can be short-lived.”

Investing in recyclers can be precarious, too, Sinha said. While he’s happy to see recycling getting its due as a meaningful source of supply, he cautions people to be careful when investing in this space. Startups may have developed new technologies, but lack good enough business fundamentals. “Don’t invest on the hype,” he said, “but on the fundamentals.”

Glencore, ironically enough, is a case in point. It has invested $327.5 million in convertible notes in battery recycler Li-Cycle to provide feedstock for its smelter. The Toronto-based startup had broken ground on a new facility in Rochester, New York, but ran into financial difficulties and filed for Chapter 15 bankruptcy protection in May, prompting Glencore to submit a “stalking horse” credit bid of at least $40 million for the stalled project and other assets.

Even so, “the current environment will lead to more startups and investments” in e-waste recycling, Sinha said. “We are investing ourselves.”

MP Materials CEO on deal with the Defense Department

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