Navigating health recommendations can feel overwhelming, especially when guidance shifts amidst evolving threats. With a new covid-19 variant circulating, many Americans are seeking clarity on the latest vaccine advice. The situation in the U.S. has become particularly complex, leaving individuals wondering where to turn for reliable information on protection.
Recent developments have layered new questions onto existing challenges posed by ever-changing variants and concerns about health insurance coverage. This complex landscape emerges as cases, though far from pandemic peaks, continue to appear, highlighting ongoing risks, particularly for vulnerable individuals. Sorting through conflicting messages from federal agencies and independent medical experts requires careful attention to understand current best practices.
Understanding the Latest COVID Variant: NB.1.8.1
One reason for the renewed focus on guidance is the rise of a new variant known as NB.1.8.1. This version of the virus has quickly become the most common strain circulating across the United States. Experts describe NB.1.8.1 as an evolution, specifically a “slightly upgraded version” derived from the LP.8.1 variant that was previously widespread.
Research suggests NB.1.8.1 may possess increased transmissibility compared to its predecessor, LP.8.1. This could be linked to changes in the spike protein, which the virus uses to attach to and enter human cells, potentially binding more effectively to ACE2 receptors. Additionally, early indications suggest NB.1.8.1 might be better at evading antibodies developed from previous infections or vaccination compared to LP.8.1.
The rapid spread is evident in its prevalence data. In early April, NB.1.8.1 accounted for zero percent of reported COVID-19 cases in the U.S. By the two weeks ending June 21, it represented a significant majority, involved in 43% of sequenced cases, according to CDC data.
Symptoms associated with NB.1.8.1 largely mirror those seen with earlier COVID-19 strains. These include common signs like fever, chills, cough, and fatigue. Other typical symptoms are shortness of breath, difficulty breathing, congestion, a runny nose, muscle aches, headaches, nausea, vomiting, and sometimes a new loss of taste or smell. However, a notable feature reported by some patients infected with NB.1.8.1 is an exceptionally severe sore throat. This intense symptom has been vividly described as feeling like “razor blades,” standing out as a particularly painful manifestation. While severe sore throat can occur with other variants, it seems prominent with NB.1.8.1.
Despite the potential for increased transmission and the unique sore throat symptom, public health experts currently state there is no strong evidence that NB.1.8.1 causes more severe overall illness or leads to a higher rate of hospitalization compared to previous dominant variants. Nevertheless, the continued circulation of variants underscores the ongoing need for awareness and protective measures, especially for populations at higher risk for severe outcomes.
Shifting Federal Recommendations Stir Controversy
A primary source of the current confusion stems from recent changes announced by the Department of Health and Human Services (HHS). On May 27, HHS Secretary Robert F. Kennedy Jr. indicated that COVID-19 vaccines would be removed from the CDC’s recommended immunization schedule for healthy children and pregnant women. This decision diverged sharply from established expert consensus and reportedly bypassed the standard scientific review processes typically followed for such major public health guidance changes.
Under the revised approach signaled by HHS, routine COVID-19 vaccination would primarily be recommended only for individuals aged 65 and older, and those with pre-existing health conditions that increase their risk. Critics immediately voiced concerns that this change could significantly hinder access to vaccines for healthy individuals under 65 who might still wish to get vaccinated. This group includes healthcare workers, individuals living with vulnerable family members, or anyone seeking to lower their short-term risk of infection.
Access could become an issue because health insurance coverage in the U.S. often aligns with federal immunization recommendations. If COVID-19 vaccines are no longer on the standard CDC schedule for certain groups, insurance providers might cease covering the cost. This could leave individuals facing out-of-pocket expenses potentially averaging around $200 per dose, creating a financial barrier to vaccination. The exact response of insurance companies to this shift remains unclear.
Medical Organizations Break From HHS, Issue Own Calls
The unexpected change from HHS prompted a strong and unified reaction from numerous leading professional medical organizations across the country. These groups expressed significant concern and disappointment, emphasizing the importance of adhering to evidence-based public health guidance.
Organizations including the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) issued statements criticizing the HHS announcement. ACOG specifically highlighted concerns about the decision regarding pregnant individuals, stressing that COVID-19 infection during pregnancy can lead to “catastrophic” outcomes for both mother and infant. ACOG reaffirmed that extensive data show COVID-19 vaccines are safe during pregnancy and provide vital protection.
In a powerful display of unity, the American Medical Association (AMA), the AAP, and 80 other medical organizations published an open letter on June 25. This letter directly broke from the HHS position, urging physicians, healthcare systems, and insurance providers to continue supporting “evidence-based immunizations.” The organizations declared vaccines for illnesses like COVID-19, influenza, and RSV among the best tools available to protect public health and prevent severe complications.
The letter acknowledged the “uncertainty” created by recent federal policy changes but called upon physicians to align around clear, scientific guidance. Similarly, the AAP announced on June 26 its commitment to continue developing and publishing its own independent, evidence-based immunization recommendations and schedules. AAP President Susan J. Kressly stated that the process for creating federal immunization policy was “no longer a credible process,” signaling the AAP’s resolve to “step up” and provide trusted guidance based on science for pediatricians and families. These independent guidelines from the AMA, AAP, and others are anticipated soon.
Uncertainty Surrounds Federal Vaccine Committee
Adding another layer to the confusing landscape is the situation involving the Advisory Committee on Immunization Practices (ACIP). This federal committee typically plays a key role in developing U.S. vaccine recommendations. However, on June 9, HHS Secretary Robert F. Kennedy Jr. replaced all 17 existing members of the committee with new appointees. Critics have questioned the qualifications of some new members, noting that some, like Kennedy himself, have a history associated with anti-vaccine advocacy.
This significant change drew backlash, with calls for a delay in the committee’s scheduled meeting. Despite the controversy, the newly formed ACIP convened for the first time on June 25. During the meeting, comments by the new chair, Martin Kulldorf, reportedly indicated the panel would undertake “investigations” into long-established vaccines like MMR and other childhood immunizations.
The committee also reviewed data related to COVID-19 vaccines. Discussions reportedly included questioning the safety and effectiveness of these vaccines, as well as scrutinizing the study designs, methodologies, and surveillance systems used to collect and analyze the data. While experts present explained that such scrutiny of data is standard practice in medical research and aims to maximize benefits while minimizing harm, the committee did not proceed to vote on COVID-19 vaccine recommendations for the upcoming fall season. The next ACIP meeting where COVID-19 guidance might be discussed is reportedly not expected until September or October.
FDA Updates Vaccine Warning Labels
Separately from the guidance conflicts, the Food and Drug Administration (FDA) has taken steps to update information provided with mRNA COVID-19 vaccines. On June 25, the FDA announced revised requirements for the warning labels included with Comirnaty (Pfizer-BioNTech) and Spikevax (Moderna) vaccines.
The updated prescribing information for these vaccines will now feature more prominent warnings about a known, rare side effect: inflammation of the heart muscle (myocarditis) and the lining around the heart (pericarditis). While this risk was mentioned on previous labels, the updated information specifies that for the 2023-2024 vaccine formulations, this rare event occurred in approximately 8 cases per 1 million doses administered to individuals aged 6 months through 64 years. The updated label clarifies that these cases are most commonly observed in males between the ages of 12 and 24. The prior label had focused more on adolescents aged 12-17. This type of label update is a routine part of vaccine monitoring as more real-world data becomes available.
What the Guidance Means for Protection
Given the differing messages within the U.S., it’s helpful to look at guidance from other established health authorities and medical organizations. While the HHS has narrowed its recommendation, the World Health Organization (WHO) has maintained consistent advice. The WHO anticipates that currently approved COVID-19 vaccines will remain effective in providing protection against the dominant NB.1.8.1 variant and other circulating strains.
Before the recent HHS changes, a CDC webpage dated January 7 aligned with the WHO’s broader recommendation, advising everyone aged six months and older to receive the 2024-2025 COVID-19 vaccine formulation. Although that CDC page now includes a banner noting updated recommendations are pending, the advice from organizations like the WHO, AMA, and AAP represents a consensus among many global and independent medical experts.
Based on this broader consensus, specific populations are strongly encouraged to get vaccinated, including those who have never received a COVID-19 vaccine, individuals aged 65 and older, people who are immunocompromised, residents of long-term care facilities, and those who are pregnant, breastfeeding, or planning a pregnancy. Vaccination is also recommended for anyone who wishes to reduce their risk of acute COVID-19 illness or potential long COVID symptoms.
Beyond vaccination, other simple public health measures remain effective. These include staying home when sick, practicing good hand hygiene, improving indoor ventilation, and considering mask-wearing in crowded settings, particularly during periods of increased transmission. Testing when symptomatic can also help prevent spread. While cases are lower than pandemic peaks, COVID-19 remains a serious illness for many, and preventing infection through available tools is the best approach. The experience of healthcare workers on the front lines underscores the difference vaccination can make in preventing severe, life-threatening illness.
Frequently Asked Questions
What is the NB.1.8.1 COVID variant and are its symptoms different?
NB.1.8.1 is the dominant COVID-19 strain in the U.S. as of June 2025. It’s a descendant of the Omicron variant, potentially more transmissible than previous versions like LP.8.1. Symptoms are similar to earlier strains, but NB.1.8.1 is notable for reports of a particularly severe sore throat, often described as “razor blade throat.” Current data doesn’t suggest it causes more severe overall illness.
Where can I find reliable, evidence-based COVID-19 vaccine guidance right now?
While U.S. federal guidance from HHS has recently narrowed, leading medical organizations like the AMA and AAP are developing and publishing their own independent, evidence-based recommendations. The World Health Organization (WHO) also provides consistent global guidance. These sources generally recommend vaccination for broad populations, especially vulnerable groups and anyone wishing to reduce personal risk.
Should healthy individuals under 65 still consider getting the COVID-19 vaccine?
Yes, according to guidance from organizations like the WHO, AMA, and AAP. While recent U.S. federal changes may make access potentially more challenging or costly due to insurance coverage uncertainty, independent medical experts continue to recommend vaccination for healthy people under 65. This is especially true for healthcare workers, those living with vulnerable individuals, or anyone wanting to avoid illness and potential long COVID.
Staying Informed Amidst Conflicting Messages
The current state of COVID-19 vaccine guidance in the U.S. highlights the challenges of public health communication in a dynamic environment. The emergence of new variants like NB.1.8.1 and conflicting advice from different authorities can understandably cause confusion. However, a consensus remains among many leading medical organizations globally and within the U.S. that COVID-19 vaccination remains a crucial tool for preventing severe disease, hospitalization, and death. Consulting trusted healthcare professionals and referring to the guidance provided by independent medical associations can help individuals make informed decisions about protecting themselves and their communities as the virus continues to evolve.
