For most Americans, it’s pretty simple — at least, for now.
The past three years have taught us a hard truth: Covid-19 doesn’t pose the same risk to everyone it infects. Now, American public health agencies are trying to align Covid-19 vaccination recommendations with that fact.
This week, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices rolled out streamlined vaccine recommendations aimed at helping people figure out what to do right now.
Specifically, the guidance elevates the bivalent vaccine — introduced last fall as a tool to train immune systems to protect from both older and newer strains of the virus — from “booster” status. Under the new recommendations, the bivalent vaccine can be used as the first and only shot a person gets as their primary vaccine.
The new guidance applies to the updated, bivalent formulations of the mRNA vaccines produced by Moderna and Pfizer-BioNTech. The original vaccine series most Americans received earlier in the pandemic is no longer available: Earlier, monovalent formulations from Moderna and Pfizer are no longer authorized in the US, and others, like Novavax and Johnson and Johnson’s, have been used here only infrequently.
The upshot: For now, to be considered up-to-date, everyone should have at least one bivalent vaccine. However, only higher-risk people should be getting repeat bivalent vaccinations.
Also, while previous vaccination with the older, monovalent version of the vaccine used to be a prerequisite for bivalent vaccination, under the new guidelines, even people who haven’t gotten any Covid-19 vaccines can get a bivalent shot.
Bivalent vaccine uptake has not been great in the US. Only 42 percent of people 65 and over — who are at highest risk for severe disease and hospitalization due to Covid-19 — have received the shot. In all, fewer than 17 percent of all Americans have gotten a bivalent vaccine. In a statement, FDA’s Center for Biologics Evaluation and Research director Peter Marks said, “The agency believes that this approach will help encourage future vaccination.”
It’s worth noting that both the FDA and the CDC used “may” and not “should” language in much of this guidance (with one important exception). At this point, these agencies are avoiding language that suggests anyone who has already been vaccinated “should” get another. That’s because the data on repeat vaccination isn’t strong enough to support telling anyone they need to get another shot. Instead, the CDC and FDA highlight who is merely “eligible” for more doses.
Here’s the upshot of the latest recommendations.
If you’re a healthy person between the ages of 6 and 64 who’s already gotten a bivalent vaccine
This one is the simplest: The FDA said that for most people 6 and over, one dose of the bivalent vaccine, regardless of when they got it, is enough for now.
It’s not that repeat vaccination wasn’t protective against hospitalization in this age group last fall and winter, said the CDC — it was.
But lately, the risk of hospitalization has been so low among children and adults in these age groups, and the protection repeat vaccination provided was so fleeting — lasting only about two months — that repeat bivalent vaccination would end up being minimally beneficial in this group.
If you’ve never been vaccinated or have only gotten older, monovalent versions of the vaccine
The CDC made its strongest and most explicit recommendation for people who haven’t gotten a bivalent vaccine yet — whether because they haven’t gotten any Covid-19 vaccines yet or have only gotten original, monovalent versions of the vaccine that were available before August 2022. Those people should get a bivalent vaccine now, the agency said in a press release. That goes for everyone 6 and over — and with so few Americans having yet received a bivalent vaccine, this is the category most are in.
For people still unvaccinated, the reasoning is that even though they may have some immunity against Covid-19 due to prior infection — by this point, most people have been exposed to the virus — that’s generally less protective from severe disease than the broader protection that seems to comes from being both immunized and recovered from infection.
For people who’ve only received monovalent versions of the vaccine, the rationale is that there’s protection in the bivalent vaccine not only against the original strain of the virus, but against newer omicron variants, BA.4 and BA.5. And while very few of those strains are now circulating in the US, they’re still genetically closer to current strains than is the original virus.
Hence, a vaccine that trains the immune system to recognize both earlier and later strains of the virus is thought to provide better protection than one that only targets earlier strains.
If you’re 65 or older
People 65 or older can also get a bivalent vaccine now, even if they’ve already gotten one. For this group, the rationale for the FDA’s recommendation is that people 65 and older continue to be hospitalized for Covid-19 at higher rates than younger adults. Over the fall and winter, those in this age group who’d received bivalent vaccines died at far lower rates than those who hadn’t. For this group, the FDA recommended waiting at least four months after the most recent bivalent dose to get a repeat dose.
If you’re moderately to severely immunocompromised and 5 or older
According to the CDC, people who are “moderately to severely immunocompromised” include those who are or are about to be treated for cancer or receive organ transplants, those with advanced or untreated HIV and certain congenital immunocompromising conditions, and those taking a variety of immunosuppressive medications.
If you are moderately to severely immunocompromised and aged 5 or over, you can also get a bivalent vaccine now, even if you’ve already gotten one. (Immunocompromised kids under the age of 5 aren’t eligible for a repeat bivalent dose under the FDA’s new recommendations because the agency didn’t have data to justify it. Several pediatricians at the CDC meeting this week expressed concern that this decision left a highly vulnerable group unprotected.)
There are a few reasons for this recommendation. For starters, this group may not have as robust an antibody response to Covid-19 vaccines. But another problem is that the monoclonal antibody treatments — which used to offer an added layer of protection for immunocompromised people — no longer work against omicron variants and are no longer FDA-authorized except in unusual cases.
The FDA recommended immunocompromised people wait at least two months after the most recent bivalent dose to get a repeat dose. They also said people with certain kinds of immunocompromise — like those receiving or about to receive a stem cell transplant, medications that lower B-cell levels, or treatment with CAR-T cells, a certain kind of cancer therapy — can continue receiving repeat doses every two months going forward. People in this category should speak with their health care providers about what’s best for them.
Kids 6 months through 5 years old can get bivalent doses if they’re unvaccinated
Different manufacturers have different dosing regimens and different age thresholds for the pediatric versions of their bivalent vaccines: Moderna’s pediatric vaccine is given in a two-dose series for kids 6 months through 17 years, and Pfizer’s is given in a three-dose series for kids 6 months through 4 years. So when it comes to kids, it’s less complicated to talk about full versus partial series than number of doses.
According to the new guidelines, unvaccinated kids can go straight to the full bivalent vaccine series, much like healthy younger adults. Meanwhile, kids who’ve gotten the full or partial series of the older, monovalent vaccines can also get at least one dose of bivalent vaccine. (How many they get will depend on how many monovalent doses they got, and of which manufacturer. Parents should ask their pediatrician what to do for their child.)
Prepare for more changes ahead
This fall, when manufacturers will likely release updated versions of the bivalent vaccine tailored to protect from the latest viral variants, recommendations will probably change again.
But in the meantime, the new guidance outlines a game plan for most people on how to best protect themselves using vaccines.
Four big questions about the operation the world is waiting for.
The long-awaited, long-expected, much-anticipated Ukrainian counteroffensive is looming, forthcoming, set to happen, or happening imminently — go ahead, pick your preferred word combo. But the message is the same: The next stage of the Ukraine war is Kyiv’s spring push.
The Russians are readying for it. Western governments provided training and new military equipment in advance of it. Ukraine has promised it’s happening. But the timing, the strategy, the specific terrain or territory: the only people who really know that are the Ukrainians themselves.
Although Ukraine isn’t about to publicly advertise it. These are complex, multilayered operations, and surprise, actually, does tend to be pretty advantageous in war. As Ukraine’s Deputy Defense Minister Hanna Maliar said this week, Ukraine is already conducting various counteroffensive “actions.”
None of that changes the stakes around Ukraine’s counteroffensive. The pressure is on for Ukraine to reclaim and liberate territory from Russian control, and prove it can put advanced Western military assistance to effective and successful use. Kyiv must demonstrate this attritional, exhausting conflict is not turning into a stalemate.
“It has to be a campaign in which even if Ukraine suffers some losses, or has to abandon some territories — for example, the city of Bakhmut — it still has to demonstrate unprecedented skill and strategic ingenuity that will be inspirational for the Western partners and Ukrainian society to keep supporting Ukraine in this war,” said Polina Beliakova, postdoctoral fellow at the John Sloan Dickey Center for International Understanding at Dartmouth College.
The demand for drama might not quite match reality. Any counteroffensive could involve multiple operations, spanning weeks and months. The dynamics of the war are different than they were even last year, when Ukraine liberated the Kharkiv region in late summer, and forced a Russian retreat in the south, near Kherson, in November.
Ukraine has new advanced Western tanks, but also newly trained and untested troops. Russia’s winter offensive, so far, seems lackluster and ill-conceived, but its military is not defeated. Moscow garnered small gains, but at big costs: The battle for Bakhmut is still ongoing, months later. Both Russia and Ukraine are exhausting manpower and firepower in the fight for every inch of that city, and it’s not yet clear how that might affect Ukraine’s ability to launch an attack — or Russia’s ability to defend against it.
These, and other big questions, are — you know it — looming over Ukraine’s also-looming offensive. And then perhaps the biggest question is what comes after the counteroffensive, and what it will reveal about the future course of the war.
But wait, why is everyone so focused on this Ukrainian counteroffensive?
Ukraine’s objectives have not changed: to end Russian occupation within the country’s internationally recognized borders, including areas Moscow has controlled since 2014, like Crimea. To do that, pretty simply, you have to recapture occupied territory and expel the Russians. And to do that, you have to go on the offensive.
The expectation is that Ukraine would launch these offensive operations this spring, after receiving new military equipment and support from Western backers, after replenishing and training new troops, probably after mud season, and after Russia exhausted itself in its own offensive operations.
Russia mounted a winter offensive in the east, pouring troops into the Donbas. Moscow made territorial gains but failed to retake huge swaths of the region, instead settling for a few minor towns. After months, full Russian control of Bakhmut remains contested, even if documents from the recent US leak show that US officials for months have questioned Ukraine’s decision to keep fighting for what is essentially a lost, and not super strategic, city.
Both Ukraine and Russia are burning through resources in Bakhmut. Ukraine used this strategy effectively last year, exhausting Russia and leaving its forces vulnerable and weakened for its successful counteroffensive in Kharkiv. Ukraine appears to be trying to repeat this tactic, though Western officials are clearly skeptical that the costs — expending ammunition and troops — for Ukraine might outweigh the advantages.
But Ukraine can’t stay on the defensive indefinitely, otherwise the entire conflict starts to look like a stalemate — and that bangs up against political realities, especially in the West. Western partners like the US may be dubious about Ukraine retaking all of its territory (particularly Crimea), but they want to see some movement. Which may be the real reason everyone is talking about the counteroffensive: There is an external urgency and pressure on Ukraine to prove that it can repeat past successes, deploy Western equipment, and keep defeating Russia on the battlefield.
The longer that doesn’t happen, the greater the risk that skepticism of robust Ukraine support will grow in Western capitals, whether or not it’s completely warranted. (As the leaks showed, and as Ukraine has been saying for months, the West has been late and a step behind in delivering materials.) Congressional Republicans sent a letter to President Joe Biden this week to stop sending “unrestrained aid” to Ukraine.
But especially when it comes to military equipment — ammunition, artillery, armored vehicles — that physical aid does have some constraints; the West doesn’t have unlimited stockpiles, and it will take time to ramp up production to get Ukraine more of what it needs. It will also take policy shifts and resources, and doubts about Ukraine’s capabilities could complicate that.
The downside of the counteroffensive hype is, even after Ukraine launches it and we all agree it’s happening, it is unlikely to lead to a decisive victory overnight. Russia controls too much territory, and it has shored up its defenses in many places where Ukraine is likely to attack. It could be very slow: Ukraine retaking terrain, consolidating control, then pushing forward; a “take the bite of the apple approach,” said retired Lt. Gen. Stephen Twitty, the deputy commander of US European Command from 2018 to 2020 and distinguished fellow at the Center for European Policy Analysis.
A lot of experts I spoke to think some of the urgency is manufactured (including by us journalists), and that Western governments understand and trust Ukraine to execute these operations when they’re ready. Ukraine, too, doesn’t have any incentive to launch a counteroffensive before it’s fully prepared. Kyiv needs to train troops, including new recruits, and it needs to shore up its logistical and supply capabilities. Moving before it’s ready could prove disastrous.
But still, the bargain remains: Ukraine has to end up in a better position than it started this spring.
“The Ukrainians are going to have to continue showing gains,” said Evelyn Farkas, a senior Pentagon official for Russia, Ukraine, and Eurasia during the Obama administration and executive director of the McCain Institute. “As long as they’re not showing significant loss of territory, we’re not going to get impatient. If they start looking like they’re losing tactically, then I would imagine that people might get nervous in Washington and other capitals.”
Speaking of Western capitals, Ukraine got the tanks! How might it affect the counteroffensive?
Earlier this year, after months of debate, Western governments agreed to send Ukraine advanced main battle tanks. Germany pledged to provide Leopard 2s, and to allow other countries to send their stocks of the German-made tanks. The United Kingdom is sending Challenger 2 tanks. The United States said it would send 31 M1 Abrams tanks, though they would take months to get there — but the commitment at least helped convince Berlin to offer up the Leopards, which would get to Ukraine much faster. (According to Friday’s meeting of the Ukraine Defense Contact Group, Abrams tanks will arrive in Germany in a few weeks, with training beginning after that.) In total, Western partners have delivered about 230 tanks to Kyiv.
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Oscar Del Pozo/AFP via Getty Images
Ukraine had tanks, but they were mostly old Soviet models, and after a year of war a lot of those are mostly spent, and difficult to find parts to repair. Western equipment will be easier to service — Western officials said Friday they are establishing a Leopard servicing center in Poland — and fix.
In addition to these tanks, Western governments delivered infantry fighting vehicles and armored personnel carriers. All of these are pretty crucial in a counteroffensive. They deliver troops to where they need to be on the front lines, and if you’re facing heavy artillery from, say, Russian forces, walking on foot or with regular trucks is very perilous.
On paper, that all seems great: equipment has been delivered, and Ukrainian soldiers have been trained on these tanks.
But Kyiv has a lot of different types of tanks and armored vehicles from a lot of different countries, all of which have their own specifications. When you’re talking about, say, Germany’s Leopard 2 versus the UK’s Challenger 2, they each use a different size rifle, and the ammunition isn’t compatible between the two.
“Keeping all of this equipment supplied and sustained long term is really going to be a big challenge,” said Sonny Butterworth, a senior analyst for land platforms at Janes, the defense intelligence firm. Ukraine might be able to find enough rounds for each type of gun, with personnel assigned to the right units right now. “But when things get underway, you start losing vehicles, you start needing to be resupplied in the fields, things are getting a bit more muddled up. Logistically it’s a bit more difficult,” he added.
In other words, the question is less about the tanks and more about all the supplies and logistical capabilities to support and deploy these vehicles successfully in combat. That is already a challenge in a war zone, even more so when you have a hodgepodge of different models. For example, bridging equipment helps tanks cross rivers, but it also depends on the weight of the tanks. If you’re in battle, and you’ve got the wrong equipment for your tank, you may need to bring in another, and little things like that can slow maneuvers and make forces vulnerable. Ukraine will also need support for mine-clearing and breaching, real-time combat engineering, and more.
“These are essential for offensive operations,” said Michael Kofman, director of the Russia Studies program at CNA. “Much of the discourse tends to focus on things like tanks, right? The reality is that this was probably a much lower priority compared to other capabilities.”
How prepared are Ukrainian troops, and how prepared are Russian forces for them?
Ukraine has suffered heavy losses in the past year; recently leaked intel documents suggest somewhere between 124,000 and 131,000 casualties, with about 17,500 killed in action. It is still less than estimates for Russia (as many as 220,000 casualties, with about 43,000 killed in action), but the toll is significant.
Ukraine’s forces have generally been much more motivated and willing to fight; the battle is existential for them. But after a year of fighting and a substantial expansion of the military, Ukraine had to mobilize more personnel, and new troops are filling out the ranks alongside seasoned, highly trained, and highly motivated forces. That has created an unevenness in the Ukrainian military.
“The vulnerability there is unit cohesion,” Beliakova said. “We don’t know whether they can fight together; they have not fought together.”
That feeds into questions about Ukraine’s force quality. Replenished troops, trained and armed with Western equipment, should have the advantage. “It is difficult to say how much of that force will really be ready,” Kofman said of Ukrainian troops. “Of course, that depends on the actual timing of this offensive.”
That may influence whether Ukraine can achieve a large-scale breakthrough against Russian lines. That also depends a bit on, well, the state of the Russian lines. Russian defenses have been largely untested against new advanced Western weapons. But Moscow has been ramping up its defenses ahead of the counteroffensive, potentially learning some lessons from last year. Those preparations could make any operation for Ukraine costly and challenging.
Russia’s winter counteroffensive showed continued vulnerabilities in training and equipment among Moscow’s forces; it also exhausted some of those numbers. Russia mobilized thousands of troops last fall, but Western intelligence officials are skeptical of Russia’s ability to man and put personnel along a massive front line. It will still likely be easier for Russia to defend than attack at this moment, but the question is whether, and how effectively, Ukraine can exploit any Russian weaknesses along those defenses.
A year has taken a toll on both Ukrainian and Russian troops. Beyond manpower, there are also real questions about equipment — specifically ammunition. Both Russia and Ukraine are facing ammunition constraints, likely a mix of trying to conserve for an operation, but also because they may not have enough.
Western governments are racing to ramp up supplies, as earlier this year, Ukraine was burning through ammunition faster than the US and NATO allies could replace it. Even if Ukraine is prepared and fully equipped as it launches these offensive operations, the big question is whether the US and its allies can continue to supply Ukraine with what it needs to consolidate any gains and launch subsequent attacks.
What happens after the counteroffensive?
This, experts said, is really the biggest question about the counteroffensive. Everyone knows it will happen, and most experts I spoke to were naturally reluctant to make predictions, but the general consensus seems to be that yes, Ukraine will have some degree of success in taking back some territory — just the scope and scale and pace are impossible to say. A lot is going to depend on how success is defined: by Ukraine, by the West, and by Russia, too.
Ukraine, of course, wants to push Russia outside of its borders, but it seems unlikely that Kyiv will achieve that in one counteroffensive push. Russia just controls too much territory — about one-sixth of Ukraine’s land — and as much as Russian troops have struggled to achieve sweeping gains, they are still in this thing, not defeated.
Any counteroffensive is likely to be costly, too; Ukraine can expect to suffer personnel and equipment losses. If it wants to sustain operations, the West is going to have to continue assisting Kyiv with weapons and supplies.
Western supplies are not infinite. A successful spring counteroffensive could buy the West time to gather more supplies and manufacture more ammunition, but it also just isn’t going to be easy to send over major weapons systems, like those tanks.
Many Western governments turned over what they had to spare, and they don’t have many extra tanks and infantry fighting vehicles to give, without sacrificing their own force readiness. “If Ukraine comes to need more in the future, where are they going to come from?” asked Butterworth.
Ahead of the counteroffensive, Western governments have reiterated their support, both political and practical. But the longer a counteroffensive takes (and it could take a long time), and the more costly it is (and it could be costly), the greater the potential that the West starts to question whether Ukraine can really win this war.
The risk right now is not that the Ukraine war becomes a stalemate. The risk is that observers and Western backers start to perceive it as one. “If Ukraine does not succeed, it will amplify the voices abroad that call for negotiations with Russia, basically saying that the conflict cannot be solved militarily,” Beliakova said.
“It means less aid, less support, less training, less money, and it would be losing the war — but not on the battlefield, but actually politically,” she added.
The justices hand down the first decision in the mifepristone litigation saga that is not completely unhinged.
The Supreme Court handed down a brief order on Friday in Danco Laboratories v. Alliance for Hippocratic Medicine, a lawsuit asking the federal judiciary to effectively ban mifepristone, a drug used in more than half of all abortions in the United States.
The most immediate impact of the Court’s new order is that the justices voted to stay lower court decisions that would have cut off access to mifepristone, at least for the time being. That means that mifepristone remains available, and that patients who live in states where abortion is legal may still obtain the drug in the same way they would have obtained it if this lawsuit had never been filed.
The Court did not disclose how each justice voted, but only two justices, Clarence Thomas and Samuel Alito, publicly noted their dissents.
This stay, however, is only temporary. The case will still need to be litigated in the conservative United States Court of Appeals for the Fifth Circuit, and it may need to be heard by the Supreme Court again. Nevertheless, Friday’s order means that mifepristone will remain available until the last court to hear this case issues its final decision.
The plaintiffs’ arguments in this case are laughably weak. They ask the Court to defy longstanding legal principles establishing that judges may not second-guess the FDA’s scientific judgments about which drugs are safe enough to be prescribed in the United States. Moreover, no federal court has jurisdiction to even hear this case in the first place.
As attorney Adam Unikowsky, a former law clerk to Justice Antonin Scalia, has written, “if the subject matter of this case were anything other than abortion, the plaintiffs would have no chance of succeeding in the Supreme Court.”
But this Court’s GOP-appointed majority has a history of manipulating longstanding legal principles in order to achieve anti-abortion results. Most notably, in Whole Woman’s Health v. Jackson (2021), the Supreme Court announced a new legal rule that, if taken seriously, would allow any state to nullify any constitutional right — a result that allowed the Court to shield a Texas anti-abortion law from judicial review.
That said, the Court’s decision to temporarily keep mifepristone legal is a hopeful sign that the justices will ultimately decide not to ban mifepristone. And there are other reasons to believe that a majority of the Court might reject this entirely meritless attack on abortion rights.
Republican elites appear ambivalent about banning mifepristone
Although a supermajority of the justices were appointed by Republican presidents, not all of these justices are reliable votes for literally any outcome preferred by conservative litigants. To the contrary, the Court’s current majority tends to track the views of Republican elites in other positions of power and influence.
To be sure, the Court’s six Republican appointees frequently call for massive rightward shifts in the law. And they often do so based on legal theories rejected by most legal experts. But in recent high-profile instances, the Court has done so after a consensus emerged among Republican elites that the law should be changed.
As Yale law professor Jack Balkin has written, “law, and especially constitutional law, is grounded in judgments by legal professionals about what is reasonable.” A legal argument can “move from off the wall to on the wall because people and institutions are willing to put their reputations on the line and state that an argument formerly thought beyond the pale is not crazy at all, but is actually a pretty good legal argument.”
To see this phenomenon in action, consider two high-profile lawsuits asking the Supreme Court to repeal the Affordable Care Act: NFIB v. Sebelius (2012) and California v. Texas (2021).
When the NFIB case was filed shortly after Obamacare became law, it was widely viewed by legal experts as so absurd that few were willing to defend it. At a 2010 panel on the lawsuit hosted by the University of Washington, for example, the moderator announced that “we tried very hard to get a professor who could come and who thinks this is flat-out unconstitutional, but there are relatively few of them, and they are in great demand.”
But elected Republican leaders, GOP-aligned media outlets, and powerful legal organizations like the Federalist Society spent two years touting the NFIB plaintiffs’ arguments against Obamacare and giving prominent platforms to lawyers who supported these arguments.
The result was that four justices, all Republicans, voted in NFIB to repeal the Affordable Care Act in its entirety. And a fifth, Chief Justice John Roberts, struck a deal that severely weakened the law by permitting states to opt out of Obamacare’s Medicaid expansion.
A very different drama played out nine years later, however, in the Texas case. As that case rose through the courts, leading voices in the GOP and its allied media outlets mocked the plaintiffs’ legal theory. The Wall Street Journal’s editorial board labeled this lawsuit the “Texas Obamacare Blunder.” Yuval Levin, a prominent conservative policy wonk, wrote in the National Review that the Texas lawsuit “doesn’t even merit being called silly. It’s ridiculous.” Even Senate Republican Leader Mitch McConnell (R-KY) claimed that “no one believes the Supreme Court is going to strike down the Affordable Care Act” while the Court was considering the Texas case.
The Supreme Court ultimately voted 7-2 to dismiss the Texas case, ruling that federal courts didn’t even have jurisdiction to hear it.
So far, Republican reaction to the Hippocratic Medicine case more closely resembles the GOP reaction to Texas than NFIB. The Wall Street Journal’s editorial board conceded that this lawsuit should fail. And at least one Republican member of Congress, Rep. Nancy Mace (R-SC), even argued that the Biden administration should ignore one of the lower court decisions attacking mifepristone, telling CNN that this lawsuit “should just be thrown out quite frankly.”
This tepid reaction by many Republican elites suggests that, if the Supreme Court’s GOP-appointed majority does decide to go out on a limb and ban mifepristone, then they will do so without consistent support from their fellow Republicans in other positions of power. Historically, even the Court’s current majority has been reluctant to go this far out of a limb on their own.
If the Supreme Court does decide to attack mifepristone, that will have catastrophic consequences throughout the health care system
An amicus brief filed by many key players in the pharmaceutical industry warns that, should the Supreme Court embrace the lower courts’ attacks on mifepristone, the entire health care system is likely to suffer terribly.
That’s because the lower courts required the Food and Drug Administration to jump through so many needless hoops before it could approve mifepristone — or any drug, for that matter — that, the brief’s authors wrote, “it is unlikely that a single one” of the thousands of drugs the FDA has approved in the past “would have been approved” if those drugs had “been developed or reviewed by FDA under the lower courts’ approach.”
The Hippocratic Medicine case, in other words, doesn’t just threaten access to abortion. It could potentially toss the FDA’s entire drug approval process into turmoil, threatening access to everything from antibiotics to blood pressure medication to cancer-fighting drugs.