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The upcoming fall and winter months are about to bring the usual crop of respiratory illnesses—influenza, respiratory syncytial virus (RSV), and, of course, COVID. But this will be the first time since COVID vaccines were developed that many people in the U.S. will not have easy access to immunization against SARS-CoV-2, the virus that causes the disease, which has contributed to the deaths of more than 1.2 million Americans to date.

Public health experts had nervously tracked U.S. health agencies’ actions on vaccines in general and COVID vaccines in particular since February, when longtime antivaccine activist Robert F. Kennedy, Jr., took the reins of the Department of Health and Human Services. Conflicting messaging and ambiguous guidance from the Centers for Disease Control and Prevention and the Food and Drug Administration shook up the usual launch of annual vaccines.

“We typically have this very clear set of dominoes for a vaccine rollout: it’s smooth; it’s synchronized; it’s sequenced,” says Katelyn Jetelina, an epidemiologist and founder of the newsletter Your Local Epidemiologist. “But we have these missing or wobbling dominoes right now, and so the rest of the chain is backed up.”

On August 27, one of those dominoes fell when Kennedy announced in a post on X that the FDA had approved the updated COVID vaccines only for adults aged 65 or older and those with underlying health conditions that increase risk of severe infection. The decision leaves healthy children and adults without easy access; they may be limited to receiving vaccines at physicians’ offices instead of pharmacies, and health insurance might not cover the full cost for everyone.

Scientific American spoke with experts about what the public can expect in terms of COVID-19 vaccines this fall.

COVID Cases Are Rising Again

All signs suggest that COVID cases in the U.S. are ticking up. Wastewater surveillance showed moderate, high, and very high levels of SARS-CoV-2 in much of the nation, as of the week ending on August 9. Rates of positive COVID tests and emergency department visits were also up as of the week ending August 16. All three measurements are early indicators of increased viral prevalence.

Although COVID death rates are currently low, they will likely rise on a delay from those early indicators. Regardless, SARS-CoV-2 continues to take lives: More than 100 people in the U.S. have died of COVID every single week of this year, according to the CDC. Similarly, rates of new long COVID diagnoses have slowed since the early days of the pandemic, but new infections continue to trigger the lingering and disabling syndrome.

Assessing COVID’s current risks is a tricky balance, says David Higgins, a pediatrician and vaccine delivery specialist at the University of Colorado School of Medicine. “We are clearly in a different place than we were in 2020 and 2021, and that is a good thing,” he says. “At the same time, I think the fact that we are in such a different place can maybe lead some people to underappreciate that COVID is still causing harm for many people.”

What COVID Vaccines Are Available This Year?

Three manufacturers have produced COVID vaccines this year: Moderna and Pfizer have made mRNA vaccines, and Novavax has made a protein-based shot. The two mRNA manufacturers, at least, tailored their vaccines to the LP.8.1 variant, the version of the COVID-causing virus that was increasing in prevalence when vaccine scientists decided which version to target this year.

As of the week ending on August 9, a newer variant called XFG represented 65 percent of infections. XFG and LP.8.1 are both members of the JN.1 family, which arose at the end of 2023. Experts expect this year’s formula to shield against XFG, although the exact degree of protection is always difficult to predict at the beginning of the season.

Why Is COVID Vaccine Access Changing?

COVID vaccines go through two separate federal government procedures that determine who can access them and how they can do so. This year, neither process has gone particularly smoothly.

One system is the CDC’s Advisory Committee on Immunization Practices (ACIP), which makes recommendations for who should receive which vaccines. This procedure governs access because insurance companies must fully cover the costs of recommended vaccines, according to the Affordable Care Act.

Earlier this year, Kennedy removed all existing members from the panel and appointed new ones—a highly unusual and criticized move—shortly before the scheduled June meeting. At that gathering, the committee was supposed to decide on this year’s COVID vaccine recommendations, but the replacement members declined to vote. It’s unclear when ACIP will meet next. The CDC’s website references a meeting that will occur in August or September but notes “dates TBD”; the next formally scheduled meeting is slated for October 22.

The other system is the FDA’s labeling process, which recently decided on access for healthy children and adults. This influences how vaccines are given. Agency personnel inspect the vaccines, ensure they are safe, and outline prescribing guidelines for health care providers. This process matters because pharmacists are generally not allowed to administer vaccines outside of what the label permits—typically, only doctors can provide vaccines “off-label.”

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The shooter who opened fire at a church on the south side of Minneapolis on Wednesday morning has been identified.

Law enforcement sources told the Associated Press that Robin Westman attacked the church, adjacent to Annunciation Catholic School, as school children were celebrating Mass at the start of the academic year. Westman once attended the school.

Authorities have confirmed that two children were killed and 17 others were injured, 14 of them children, two of whom are in critical condition. A witness from inside the church said the shooter “pepper-sprayed through the stained-glass windows into the building, 50 to 100 shots.”

Westman was initially described by authorities as “a man” in his early twenties, dressed all in black and armed with a rifle, a shotgun, and a pistol. However, court documents later revealed that in 2019, the shooter changed their name from Robert to Robin and that they identified as a woman.

No motive is known at this time, and Westman took their own life.

President Donald Trump has offered condolences to Minnesota Governor Tim Walz.

A distraught Minneapolis Mayor Jacob Frey rejected offers of “thoughts and prayers,” saying at a press conference: “You cannot put into words the gravity, tragedy, or absolute pain of the situation.”

What you need to know…

• A shooting occurred at Annunciation Church and Catholic School in Minneapolis on Wednesday morning as schoolchildren were attending Mass to mark the start of the academic year.
• The assailant, Robin Westman, formerly Robert, whose name was legally changed after identifying as a woman, opened fire from outside the church, using a rifle, shotgun, and pistol, to fire through the stained-glass windows after barricading some of the doors.
• Two children, aged eight and ten, were killed in the attack, and 17 other individuals were injured, including 14 children, two of whom are in critical condition.

Recap: The victims

Here’s what we know about the victims of Wednesday’s tragic incident at a church, adjacent to Annunciation Catholic School.

Authorities said that two children, ages 8 and 10, were killed. Both were students at the Annunciation School.

In addition, fourteen other children were injured. They ranged in age between six and 15.

Three adult parishioners attending the mass at the time of the shooting were also injured, but survived, according to police.

Minneapolis Archbishop calls for end to gun violence, which are ‘far too commonplace’

In his statement, Archbishop Bernard A. Hebda called for an end to gun violence and the “horrific acts of violence” that he said were “far too commonplace.”

“That today’s tragedy occurred only a day after the tragic shooting near Cristo Rey High School increases the sadness about the pain and anger that is present in our communities,” Hebda said.

“We need an end to gun violence. Our community is rightfully outraged at such horrific acts of violence perpetrated against the vulnerable and innocent. They are far too commonplace.

“While we need to commit to working to prevent the recurrence of such tragedies, we also need to remind ourselves that we have a God of peace and of love, and that it is his love that we will need most as we strive to embrace those who are hurting so deeply.”

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What if we could control Earth’s climate like a thermostat? This video explores a wild but serious proposal to combat global warming—geoengineering. Learn how humanity might someday regulate the planet’s temperature to prevent ecological catastrophe.

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Long-term exposure to extreme heat events accelerates the body’s ageing process and increases vulnerabilities to health issues, finds a long-term study of 24,922 people in Taiwan.

The study, published today in Nature Climate Change, suggests that moderate increases in cumulative heatwave exposure increase a person’s biological age, to an extent comparable to regular smoking or alcohol consumption. The more extreme-heat events that people were exposed to, the more their organs aged. This is the latest study to show that extreme heat can have invisible effects on the human body and accelerate the biological clock.

Exposure to extreme heat, especially over long periods of time, strains organs and can be lethal, but “the fact that heatwaves age us is surprising”, says Paul Beggs, an environmental-health scientist at Macquarie University in Sydney, Australia, who was not involved in the research. “This study is a wake-up call that we are all vulnerable to the adverse impacts of climate change on our health. It reinforces calls for urgent and deep reduction in greenhouse-gas emissions,” he adds.

Accelerating ageing

Age isn’t just a result of time. Previous studies have linked a number of factors — including environmental and social stress, genetics and medical

interventions — to signs of ageing-related physiological changes. This puts people at a higher risk of cardiovascular disease, cancer, diabetes and dementia.

To study the long-term impacts of heatwaves on ageing, the researchers analysed data from medical examinations between 2008 and 2022. During that time, Taiwan experienced around 30 heatwaves, which the study defined as a period of elevated temperature over several days. The researchers used results from several medical tests, including assessments of liver, lung and kidney function, blood pressure and inflammation, to calculate biological age. They then compared biological age with the total cumulative temperature that participants were probably exposed to on the basis of their address in the two years before their medical visit.

The study found that the more extreme-heat events that people experienced, the faster they aged — for every extra 1.3 °C a participant was exposed to, around 0.023–0.031 years, on average, was added to their biological clock.

“While the number itself may look small, over time and across populations, this effect can have meaningful public-health implications,” says Cui Guo, an environmental epidemiologist at the University of Hong Kong, who led the study.

Manual workers and people living in rural areas experienced the largest health impacts, probably because these groups are less likely to have access to air conditioning. But there was an unexpected upside: the impact of heatwaves on ageing decreased over the 15-year study period. The reasons behind this heat adaptation are unclear, but improved access to cooling technology could play a part, Guo says.

Still, “the message is that heat makes you age a bit faster than you normally would, and that this is something you would like to avoid”, says Alexandra Schneider, an environmental epidemiologist at Helmholtz Munich in Germany, who was not involved in the study.

Rising heat

In 2023, research in Germany found that higher air temperatures were associated with more epigenetic markers of ageing. And a study in more than 3,600 older people in the United States similarly concluded, through analysing DNA markers, that extreme heat prematurely aged participants.

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As the Wall Street Journal reports that Donald Trump wants to quickly nominate a replacement for Lisa Cook, the Federal Reserve governor who is resisting his attempt to force her out, the president told reporters he has a favorite candidate.

Asked about possible replacements for Cook during his marathon televised cabinet meeting on Tuesday, Trump said: “We have some very good people for that position.”

“I think, maybe in my own mind, I have somebody that I like,” Trump added, before saying that he would also consult Scott Bessant, the treasury secretary, and Howard Lutnick, the commerce secretary.

Trump appears to be considering the possibility of naming his economic adviser Stephen Miran to serve out the remainder of Cook’s term, which does not expire until 2038. Earlier this month, Trump nominated Miran to serve for a much shorter term, as a replacement for another member of the Fed’s board, Adriana Kugler, a Biden nominee who was due to be replaced in five months.

Cook has said that she will sue to keep her position as a governor of the independent central bank and her lawyer, Abbe Lowell, called Trump’s move to fire her “illegal”.

In May, when the supreme court’s conservative majority ruled that the president could fire members of other independent agencies without cause, they rejected the argument that allowing him to do so would also permit him to replace members of the Federal Reserve. The court’s order on the other agencies, the justices wrote, had no bearing on “the constitutionality of for-cause removal protections” for members of the central bank.

“The Federal Reserve is a uniquely structured, quasi-private entity that follows in the distinct historical tradition of the First and Second Banks of the United States,” the conservative justices wrote.

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Donald Trump during the cabinet meeting on Tuesday. Photograph: Aaron Schwartz/Pool/Aaron Schwartz – Pool/CNP/Shutterstock

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Law enforcement officials searching a car after a traffic stop in Washington last week. President Donald Trump has cast his crackdown on crime as a success, and suggested on Friday that it was a blueprint he would seek to apply to other cities, including Chicago.Credit…Eric Lee for The New York Times

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