A highly transmissible COVID subvariant known as NB.1.8.1 has been detected in California, raising alarms about the potential for a summer wave of infections.
This news coincides with recent controversial changes by the Trump administration regarding COVID-19 vaccination recommendations, which some health experts warn could hinder access to vaccines for many Americans.
In an unexpected move, Health and Human Services Secretary Robert F. Kennedy Jr. announced the withdrawal of federal recommendations urging pregnant women and healthy children to receive COVID vaccinations, effective immediately.
Dr. Marty Makary, commissioner of the U.S. Food and Drug Administration, has stated that the FDA will no longer routinely approve updated COVID-19 vaccinations for healthy individuals under the age of 65.
“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,” Dr. Makary and colleague Dr. Vinay Prasad noted in the New England Journal of Medicine.
They argue that this policy will facilitate necessary evidence generation for vaccine efficacy.
However, some experts express concern that the mandated need for additional testing could lead to delays in vaccine access, especially as the winter flu and COVID season approaches.
The American Academy of Pediatrics’ Committee on Infectious Diseases chair, Dr. Sean O’Leary, highlighted the heightened risk of hospitalization from COVID for pregnant women, infants, and young children, emphasizing the proven safety of COVID vaccines.
The U.S. Centers for Disease Control and Prevention (CDC) supports the notion that receiving an updated COVID vaccine enhances protection against emergency room and urgent care visits related to COVID.
Notably, the changes in federal guidelines could potentially lead to private insurance companies and government insurers ceasing to cover the cost of COVID vaccines for large segments of the population, particularly infants and children.
Without federal recommendations, many Americans may find themselves bearing the entire cost of vaccines, which could reach up to $198.99 at pharmacies like CVS.
While the emergency phase of the pandemic may have ended, authorities stress that COVID remains a significant public health concern.
Dr. Peter Chin-Hong, an infectious diseases expert from UC San Francisco, pointed out that NB.1.8.1, which was documented in January and has begun spreading in California, has been designated as a “Variant Under Monitoring” by the World Health Organization (WHO).
This subvariant has been rapidly increasing in prevalence worldwide, particularly in regions like Europe and Asia, with recent WHO data indicating that it represented 10.7% of genetically analyzed viral samples globally for the week ending April 27.
This marks a significant rise from just 2.5% of samples during the week ending April 6.
WHO noted that while the number of cases remains relatively low, the concurrent increase in hospitalizations in some countries where NB.1.8.1 is prevalent is concerning.
Though NB.1.8.1 has not yet reached levels significant enough for the CDC to track in the U.S., another strain, LP.8.1, accounted for an estimated 73% of coronavirus samples nationally for the preceding two weeks.
Dr. Yvonne Maldonado from Stanford University indicated that while early data suggest NB.1.8.1 does not cause more severe illness, it is certainly more transmissible based on global observations and laboratory findings.
In Taiwan, a health official recently reported a rapid increase in cases linked to NB.1.8.1, along with a rise in severe and fatal outcomes.
This trend has resulted in a shortage of COVID testing kits in the region, reflecting growing public health concerns as the island anticipates that the current surge may not peak for another four to six weeks.
Data indicates that COVID positivity rates in Los Angeles County have slightly increased in recent weeks, though the overall rate remains low at 3.5%.
Additionally, coronavirus levels detected in local wastewater have seen a 6% increase over three weeks, marking levels about one-eighth of what they peaked at last summer.
California experienced a relatively mild winter this year, coming off a powerful summer wave that had seen surges not experienced in years.
Despite the ongoing debate over the necessity of vaccinations for healthy individuals, many experts endorse the effectiveness of available COVID vaccines in reducing the severity of symptoms and warding off infections.
However, the recent decision to change vaccine guidelines raises questions about whether children and healthy adults should be vaccinated.
Kennedy, a noted vaccine skeptic, claimed through a video message that he anticipated positive reactions regarding the guidance change.
He declared that the COVID vaccine for healthy children and pregnant women has been omitted from the CDC’s recommended immunization schedule.
Experts expressed shock at the political nature of this decision, noting that it bypasses the established processes for vaccine recommendations typically advised by panels of scientists to the FDA and CDC.
“It’s kind of chilling,” Dr. Chin-Hong remarked, emphasizing that the move diverges from the trustworthy and systematic norms that experts have relied upon.
In light of Kennedy’s directive, the L.A. County Department of Public Health urged him to heed expert opinions, specifically from the CDC’s Advisory Committee on Immunization Practices slated to meet next month.
As of Thursday, the CDC continues to uphold the previous vaccine recommendations, suggesting that individuals aged six months and older should receive the most recent COVID-19 vaccine introduced in September.
The CDC also advises seniors aged 65 and up to obtain a second vaccine dose six months following their first dose.
Reports indicate that the CDC officials were unaware of Kennedy’s directive until it was made public, prompting them to seek clarity on its implications.
Experts conveyed that the practical impact of this directive, if officially recognized, could result in significantly higher vaccine costs for certain demographics.
The L.A. County Department of Public Health emphasized that without CDC recommendations, insurance companies would not be obligated to cover vaccine expenses.
Consequently, many healthier individuals who wish to get vaccinated may face barriers to access, whether to protect themselves or because they are in contact with higher-risk individuals.
Without an FDA license for new COVID vaccinations for younger and healthier adults, individuals may only receive vaccinations ‘off label’ at their discretion of healthcare providers.
Pharmacy chains such as Walgreens and CVS have indicated that their teams operate in compliance with applicable laws regarding COVID vaccinations, while Kaiser Permanente Southern California is maintaining adherence to existing guidance pending any formal directives.
Meanwhile, the L.A. County Department of Public Health reaffirmed existing recommendations that allow both pregnant women and healthy children to receive COVID vaccinations.
Dr. Chin-Hong pointed out the troubling statistic that around 150 pediatric deaths occurred in the U.S. due to COVID-19 in a recent one-year period, comparable to the 231 pediatric flu deaths noted this season.
He questioned why COVID vaccination recommendations would differ from flu vaccinations, given similar risks.
In a video, Dr. Makary emphasized that many countries have already ceased recommending COVID vaccinations for children.
Nonetheless, Dr. Maldonado argued that the U.S. should not base its vaccine recommendations on the practices of other nations, noting that the U.S. endorses vaccines like the meningococcal vaccine for children, despite lower prevalence than COVID.
Differences in vaccine recommendations also vary significantly by country; for instance, Canada recommends updated COVID vaccines for seniors and certain groups while allowing everyone 6 months and older to receive the vaccine.
While children, in general, face a lower risk of serious COVID illness, Dr. Maldonado mentioned that infants under six months have similar risks of complications as the older adult population.
Recent CDC data indicates that hospitalization rates for COVID are highest among children aged six months to four years.
“What parent wouldn’t want to protect their child from a disease that could potentially send them to the hospital?” Maldonado questioned, advocating for allowing parents to make informed choices.
Moreover, the CDC maintains that vaccination during pregnancy builds protective antibodies for babies, while studies indicate that vaccinated mothers transferring antibodies through breastfeeding can further shield infants.
An estimated 260,000 to 430,000 hospitalizations due to COVID have been reported since October, adding significant strain to the healthcare system.
This period has also witnessed around 30,000 to 50,000 COVID-19 related deaths.
Health professionals emphasize that COVID remains a significant cause of morbidity and mortality, especially among older adults, while also affecting younger individuals, particularly those with underlying health conditions.
COVID continues to be a leading cause of pediatric hospitalizations even among generally healthy children, raising further concerns about the implications of changing vaccination recommendations.
Experts suspect that should a summer wave of COVID emerge this year, children could be among those affected by an increase in hospitalizations.
image source from：https://www.latimes.com/california/story/2025-05-30/a-new-covid-subvariant-spreads-rapidly-as-trump-pivots-away-from-vaccines
