Category: English

Source: The Conversation – USA – By Charli Carpenter, Professor of Political Science, UMass Amherst

As the Trump administration carries out what many observers say are illegal military strikes against vessels in the Caribbean allegedly smuggling drugs, six Democratic members of Congress issued a video on Nov. 18, 2025, telling the military “You can refuse illegal orders” and “You must refuse illegal orders.”

The lawmakers have all served either in the military or the intelligence community. Their message sparked a furious response on social media from President Donald Trump, who called the legislators’ action “seditious behavior, punishable by death.”

One of the lawmakers, Sen. Elissa Slotkin, told The New York Times that she had heard from troops currently serving that they were worried about their own liability in actions such as the ones in the Caribbean.

This is not the first time Trump has put members of the military in situations whose legality has been questioned. But a large percentage of service members understand their duty to follow the law in such a difficult moment.

We are scholars of international relations and international law. We conducted survey research at the University of Massachusetts Amherst’s Human Security Lab and discovered that many service members do understand the distinction between legal and illegal orders, the duty to disobey certain orders, and when they should do so.

The ethical dilemma

With his Aug. 11, 2025, announcement that he was sending the National Guard – along with federal law enforcement – into Washington, D.C. to fight crime, Trump edged U.S. troops closer to the kind of military-civilian confrontations that can cross ethical and legal lines.

Indeed, since Trump returned to office, many of his actions have alarmed international human rights observers. His administration has deported immigrants without due process, held detainees in inhumane conditions, threatened the forcible removal of Palestinians from the Gaza Strip and deployed both the National Guard and federal military troops to Los Angeles, Portland, Oregon, Chicago and other cities to quell largely peaceful protests or enforce immigration laws.

When a sitting commander in chief authorizes acts like these, which many assert are clear violations of the law, men and women in uniform face an ethical dilemma: How should they respond to an order they believe is illegal?

The question may already be affecting troop morale. “The moral injuries of this operation, I think, will be enduring,” a National Guard member who had been deployed to quell public unrest over immigration arrests in Los Angeles told The New York Times. “This is not what the military of our country was designed to do, at all.”

Troops who are ordered to do something illegal are put in a bind – so much so that some argue that troops themselves are harmed when given such orders. They are not trained in legal nuances, and they are conditioned to obey. Yet if they obey “manifestly unlawful” orders, they can be prosecuted. Some analysts fear that U.S. troops are ill-equipped to recognize this threshold.

Compelled to disobey

U.S. service members take an oath to uphold the Constitution. In addition, under Article 92 of the Uniform Code of Military Justice and the U.S. Manual for Courts-Martial, service members must obey lawful orders and disobey unlawful orders. Unlawful orders are those that clearly violate the U.S. Constitution, international human rights standards or the Geneva Conventions.

Service members who follow an illegal order can be held liable and court-martialed or subject to prosecution by international tribunals. Following orders from a superior is no defense.

Our poll, fielded between June 13 and June 30, 2025, shows that service members understand these rules. Of the 818 active-duty troops we surveyed, just 9% stated that they would “obey any order.” Only 9% “didn’t know,” and only 2% had “no comment.”

When asked to describe unlawful orders in their own words, about 25% of respondents wrote about their duty to disobey orders that were “obviously wrong,” “obviously criminal” or “obviously unconstitutional.”

Another 8% spoke of immoral orders. One respondent wrote that “orders that clearly break international law, such as targeting non-combatants, are not just illegal — they’re immoral. As military personnel, we have a duty to uphold the law and refuse commands that betray that duty.”

Just over 40% of respondents listed specific examples of orders they would feel compelled to disobey.

The most common unprompted response, cited by 26% of those surveyed, was “harming civilians,” while another 15% of respondents gave a variety of other examples of violations of duty and law, such as “torturing prisoners” and “harming U.S. troops.”

One wrote that “an order would be obviously unlawful if it involved harming civilians, using torture, targeting people based on identity, or punishing others without legal process.”

Soldiers, not lawyers

But the open-ended answers pointed to another struggle troops face: Some no longer trust U.S. law as useful guidance.

Writing in their own words about how they would know an illegal order when they saw it, more troops emphasized international law as a standard of illegality than emphasized U.S. law.

Others implied that acts that are illegal under international law might become legal in the U.S.

“Trump will issue illegal orders,” wrote one respondent. “The new laws will allow it,” wrote another. A third wrote, “We are not required to obey such laws.”

Several emphasized the U.S. political situation directly in their remarks, stating they’d disobey “oppression or harming U.S. civilians that clearly goes against the Constitution” or an order for “use of the military to carry out deportations.”

Still, the percentage of respondents who said they would disobey specific orders – such as torture – is lower than the percentage of respondents who recognized the responsibility to disobey in general.

This is not surprising: Troops are trained to obey and face numerous social, psychological and institutional pressures to do so. By contrast, most troops receive relatively little training in the laws of war or human rights law.

Political scientists have found, however, that having information on international law affects attitudes about the use of force among the general public. It can also affect decision-making by military personnel.

This finding was also borne out in our survey.

When we explicitly reminded troops that shooting civilians was a violation of international law, their willingness to disobey increased 8 percentage points.

Drawing the line

As my research with another scholar showed in 2020, even thinking about law and morality can make a difference in opposition to certain war crimes.

The preliminary results from our survey led to a similar conclusion. Troops who answered questions on “manifestly unlawful orders” before they were asked questions on specific scenarios were much more likely to say they would refuse those specific illegal orders.

When asked if they would follow an order to drop a nuclear bomb on a civilian city, for example, 69% of troops who received that question first said they would obey the order.

But when the respondents were asked to think about and comment on the duty to disobey unlawful orders before being asked if they would follow the order to bomb, the percentage who would obey the order dropped 13 points to 56%.

While many troops said they might obey questionable orders, the large number who would not is remarkable.

Military culture makes disobedience difficult: Soldiers can be court-martialed for obeying an unlawful order, or for disobeying a lawful one.

Yet between one-third to half of the U.S. troops we surveyed would be willing to disobey if ordered to shoot or starve civilians, torture prisoners or drop a nuclear bomb on a city.

The service members described the methods they would use. Some would confront their superiors directly. Others imagined indirect methods: asking questions, creating diversions, going AWOL, “becoming violently ill.”

Criminologist Eva Whitehead researched actual cases of troop disobedience of illegal orders and found that when some troops disobey – even indirectly – others can more easily find the courage to do the same.

Whitehead’s research showed that those who refuse to follow illegal or immoral orders are most effective when they stand up for their actions openly.

The initial results of our survey – coupled with a recent spike in calls to the GI Rights Hotline – suggest American men and women in uniform don’t want to obey unlawful orders.

Some are standing up loudly. Many are thinking ahead to what they might do if confronted with unlawful orders. And those we surveyed are looking for guidance from the Constitution and international law to determine where they may have to draw that line.

This story, initially published on Aug. 13, 2025, has been updated to include a reference to a video issued by Democratic members of Congress.

Zahra Marashi, an undergraduate research assistant at the University of Massachusetts Amherst, contributed to the research for this article.

Charli Carpenter directs Human Security Lab which has received funding from University of Massachusetts College of Social and Behavioral Sciences, the National Science Foundation, and the Lex International Fund of the Swiss Philanthropy Foundation.

Geraldine Santoso does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Just follow orders or obey the law? What US troops told us about refusing illegal commands – https://theconversation.com/just-follow-orders-or-obey-the-law-what-us-troops-told-us-about-refusing-illegal-commands-270401

Source: The Conversation – USA (2) – By João Marinotti, Associate Professor of Law, Indiana University

In late October 2025, as much as US$2 billion vanished from a digital marketplace. This wasn’t a hack or a bubble bursting. It happened because one company, Valve, changed the rules for its video game Counter-Strike 2, a popular first-person shooter with a global player base of nearly 30 million monthly users.

For years, its players have bought, sold and traded digital cosmetic items, known as “skins.” Some rare items, particularly knives and gloves, commanded high prices in real-world money – up to $1.5 million – leading some gamers to treat the market like an investment portfolio. As a result, many investment-style analytics websites charge monthly fees for financial insight, trends and transaction data from this digital marketplace.

In one fell swoop, Valve unilaterally changed the game. It expanded the “trade up contract,” allowing players to exchange – or “trade up” – a number of their common assets into knives or gloves.

By flipping this switch, Valve instantly upended digital scarcity. The market was flooded with new supply, and the value of existing high-end items collapsed. Prices plummeted, initially erasing half the market’s total value, which exceeded $6 billion before the recent crash. Although a partial recovery brought the net loss to roughly 25%, significant volatility continues, leaving investors unsure whether the bottom has truly fallen out.

Many of those who saw their digital fortunes evaporate immediately wondered whether there was anything they could do to get their money back. Speaking as a law professor and a gamer myself, the answer isn’t what they want to hear: no. In fact, the existing legal structure largely protects Valve’s ability to engage in this sort of digital market manipulation. Players and investors were simply out of luck.

The Counter-Strike 2 crash reveals a troubling reality that extends far beyond video games: Corporations have built exchange-scale investment markets governed primarily by private terms-of-service agreements, rather than the robust set of public regulations that oversee traditional financial and consumer markets. These digital economies occupy a legal blind spot, lacking the fundamental guardrails of property rights, meaningful consumer protection or even securities regulation.

Your digital ‘property’ isn’t really yours

If you spend real money on a digital item, it may feel like you should own it. Legally, you don’t.

The digital economy is built on a crucial distinction between ownership and licensing. When users sign up for Steam, Valve’s platform, they agree to the Steam subscriber agreement. Buried in that contract is a critical piece of legalese stating that all digital assets and services provided by Valve, including the Counter-Strike 2 skins, are merely “licensed, not sold.” The license granted to users “confers no title or ownership” at all. This isn’t meaningless corporate jargon; it’s a legal standard routinely affirmed by U.S. courts.

The legal implication is clear: Because players only license their skins, they have no property rights over them. When Valve changed the game’s mechanics in a way that collapsed the items’ market value, it didn’t steal, damage or destroy anyone’s “property.” In the eyes of the law, Valve simply altered the conditions of a license, something that its terms-of-service agreement allows it to do unilaterally, at any time, for any reason.

Consumer protection laws don’t apply

While the Counter-Strike 2 crash may seem like a violation of consumer rights, current laws are ill-equipped to handle this type of corporate behavior.

Lawmakers have begun addressing concerns about digital goods, primarily focusing on instances where purchased movies or games disappear entirely from user libraries. For example, California recently enacted AB 2426. This law requires transparency, prohibiting terms like “buy” or “purchase” unless the consumer confirms that they understand they will receive only a revocable license.

As commendable as this law is, it protects only against confusion and loss of access, not loss of market value when platforms rebalance virtual economies. Valve can comply with consumer transparency laws and still adjust the supply of digital items, rendering them valueless overnight. Ultimately, current consumer protection laws are designed to ensure users know what they are licensing. They do not, however, create ownership interests or protect the speculative value of those digital items.

Game items are treated like unregulated stocks

Perhaps the most significant legal vacuum is the absence of financial regulation. The Counter-Strike 2 economy, a multibillion-dollar ecosystem with dedicated investors and third-party cash markets, looks and behaves like a traditional financial market. Yet, it remains outside the purview of any financial regulator, such as the U.S. Securities and Exchange Commission.

Under U.S. law, the primary standard for determining whether an asset should be governed as a security is the Howey test. According to this Supreme Court precedent, an asset is a security if it meets four criteria. Securities involve an “investment of money” in a “common enterprise” with a reasonable expectation of “profits” derived from the “efforts of others.”

Counter-Strike 2 skins arguably meet all of these criteria. Participants invest real money in a common enterprise – Valve’s platform – with an expectation of profit. Crucially, that profit depends on the “efforts of others.” The SEC notes this prong is met when a promoter provides “essential managerial efforts” that affect the enterprise’s success. Valve controls the game’s development, manages the platform and – as the recent update proves – dictates item supply and scarcity.

If a publicly traded company unilaterally changed its rules in a way that predictably tanked the price of its own shares, regulators would immediately investigate for market manipulation. So how can Valve get away with this? Three things cut against the skins’ status as securities.

First is their “consumptive intent” – skins are primarily game cosmetics. Second, there’s no way to convert the skins into dollars within Valve’s own ecosystem. In other words, third-party markets allow users to cash out, but these markets operate outside Valve’s own immediate control. And finally, the Howey test generally governs assets, such as stocks and bonds, that grant investors enforceable rights. Valve’s licensing scheme attempts to circumvent this by ensuring players hold nothing but a revocable license.

In my view, the $2 billion crash is a wake-up call. As digital economies grow in financial significance, society must decide: Will these markets continue to be governed solely by private corporate contracts? Or will they require integration into more robust legal frameworks, such as securities regulation, consumer protection and property law?

João Marinotti does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. $2B Counter-Strike 2 crash exposes a legal black hole: Your digital investments aren’t really yours – https://theconversation.com/2b-counter-strike-2-crash-exposes-a-legal-black-hole-your-digital-investments-arent-really-yours-268749

Source: The Conversation – USA (3) – By Julia Meszaros, Associate Professor of Sociology, Texas A&M University-Commerce

Fifteen years ago, when I started studying the international dating industry, few people took the subject seriously. The term “mail-order bride” was treated as a punch line – something outdated, associated with lonely men and poor women who migrated from Eastern Europe, Asia or other places to meet their new husbands in the United States.

But I’ve seen firsthand how ideas about gender, intimacy and global mobility have shifted. In 2025, a man going abroad to look for love might call himself a “passport bro” – and celebrate his lifestyle on TikTok.

This new generation of young men may have rebranded international dating, but they reflect an age-old theme. Social and economic changes shape how people negotiate love and labor across borders, as I explore in my 2025 book, “Economies of Gender.” In a chaotic world, some men and women turn to traditional gender roles as a source of seeming stability – and that often leads them abroad.

Old industry, new look

The term “mail-order bride” dates back to the 19th century, when so-called frontier brides advertised themselves in newspapers to single men in the American West. After the Civil War, when large numbers of men had died on the East Coast, some women saw migrating to the frontier to marry someone sight unseen as a way to secure stability. That narrative still lingers today in Western novels and films.

The modern international matchmaking industry, however, took shape in the 1970s, when catalogs of mostly Filipino women’s photos and addresses were sold to American men. After being pen pals, men would travel to the Philippines to meet and decide whether they wanted to get married. Some scholars consider this a form of human trafficking, but that has been challenged by other scholarship.

These catalogs emerged as more U.S. women were entering the workforce and earning their own money. Some men sought wives abroad who they believed would embody more traditional values – prioritizing domestic work and devoting themselves to men and children.

Over the next few decades, large numbers of stable, well-paying factory jobs disappeared, further challenging some men’s view of themselves as breadwinners.

By 2010, the catalog system had moved online and expanded into a global industry that generated US$2 billion dollars per year. Today, it takes many forms. Most of the industry is online, with email and chat correspondence that charges men but not women. Some agencies provide in-person tours for male clients, and there are higher-end, more personalized matchmaking services as well.

From taboo to televised

What was once stigmatized has become more normalized through reality TV. TLC’s hit series “90 Day Fiance,” which came on air in 2014, has transformed international dating into a lucrative entertainment franchise.

The show and its numerous spin-offs show couples navigating the K-1 visa process, which gives 90 days to marry after a partner enters the country. If the wedding is called off, the foreign fiance or fiancee must return to their country of origin.

Many of the featured couples met randomly, in person. A significant number, however, connected through online dating or language-learning sites. Numerous couples’ storylines highlight family and friends of the American partner who question the girlfriend’s or boyfriend’s motives, accusing them of faking love for financial gain and access to a green card.

Audiences might watch the show for drama or love stories, but the underlying themes mirror what I’ve seen in the field: relationships shaped by economic inequality and migration, with women often exchanging emotional, domestic and sexual labor in return for financial stability.

Rise of the ‘passport bros’

In recent years, the mail-order bride industry has gotten a cultural revamp, with younger and more diverse men who identify as “passport bros.” This crowd is typically younger than men participating in the commercial international dating industry and more likely to identify as men of color.

These men are less likely to pay for formal dating and introduction services. They travel on their own, using free dating apps such as Tinder to meet local women – mostly in Colombia, Brazil and the Dominican Republic.

Passport bros say they travel abroad to meet women who are more traditional than the ones they meet at home. Many of the American men I interviewed between 2010 and 2022 talked about Western women as too focused on career, which challenged their idea of themselves as financial providers.

Similarly, my research in Ukraine, Colombia and the Philippines shows that many men using international dating services are motivated by more than just love or cultural curiosity. They are responding to a changing world in which women’s financial independence has challenged traditional male roles. For some, traveling abroad is a way to reassert control and to find relationships that reaffirm a sense of masculine identity.

In my interviews, American men looking abroad talked about feeling empowered and having choices, while being ignored in the U.S. dating market. Some recognized that their relative wealth is the cause of this. As one man on a romance tour in Ukraine told me in 2012, “I am here to exchange my financial stability for some Ukrainian woman’s youth and beauty, and I am OK with that.”

Appeal of ‘tradition’

Together, many of these daters illustrate the global pattern I’ve seen across my years of fieldwork: anxiety fuels a longing for traditionalism.

What appears to be a return to the past is, in reality, an adaptation to the present. The romance tours, the “90 Day Fiance” phenomenon and the passport bros speak to how people use relationships to navigate the economic instability of the modern world. Gender roles become a way to reestablish order and identity.

In the past two decades, rising inflation, stagnant wages and housing shortages have left many people, especially younger generations, feeling economically trapped. The COVID-19 pandemic deepened these inequalities, forcing millions out of the workforce and amplifying the strain of unpaid caregiving, particularly for women.

In times of uncertainty, societies often retreat to familiar narratives. Traditional gender roles offer an illusion of stability and order, even if they reinforce inequality. The fantasy of the dependable male provider and the nurturing homemaker resurfaces because it seems to resolve anxieties that the modern economy has made harder to bear.

As a sociologist, I study these dynamics not just to understand dating trends but to trace how societies reproduce inequality through intimacy. Until our society addresses stagnant wages, rising costs and the erosion of social safety nets, I believe nostalgia for a clear, gendered hierarchy will continue. In this hierarchy, men are guaranteed women’s labor, and women hold out hope for economic security – which is often seen as romance.

Julia Meszaros receives funding from East Texas A&M and Florida International University to support her research. She volunteers for the nonprofit organization RISE Travel Institute.

– ref. From ‘mail-order brides’ to ‘passport bros,’ the international dating industry often sells traditional gender roles – https://theconversation.com/from-mail-order-brides-to-passport-bros-the-international-dating-industry-often-sells-traditional-gender-roles-268616

Source: The Conversation – USA (3) – By David B. Sarwer, Professor of Social and Behavioral Sciences, Temple University

The Trump administration is making a significant effort to reduce the cost of weight loss drugs. Its agreement with pharmaceutical giants, announced Nov. 6, 2025, will reduce the monthly prices of these medications by hundreds of dollars.

For the past 25 years, I have treated people with obesity and have developed and studied treatments for the condition in both adults and adolescents. One major frustration of my work is the fact that evidenced-based treatments for obesity are woefully underused

These drugs, originally approved to treat Type 2 diabetes, mimic a natural hormone called glucagon-like peptide-1 that regulates blood sugar and reduce appetite.

In my view, by making GLP-1 drugs more accessible to patients, this agreement represents one of the most significant advances the federal government has made to address obesity, one of the country’s most pressing public health issues. However, this reduced price tag alone may not make a meaningful dent in rates of obesity in American adults without additional policy changes.

Treating obesity

The Centers for Disease Control and Prevention estimates that about 40% of adults in the U.S. – more than 70 million people – have obesity. Researchers and clinicians generally define obesity based on a measure called body mass index, or BMI, which is the ratio of a person’s weight in kilograms to their height in meters, squared.

BMI is an imperfect measure, to be sure, but most medical organizations consider a person with a BMI greater than 30 to have obesity.

Between television commercials, advertisements on social media and suggestions from family and friends, Americans are bombarded by approaches to losing weight. For many of these approaches, there’s little to no evidence showing they successfully help people lose weight. However, extensive and rigorous research supports the use of GLP-1s for treating obesity. Studies show that these medications can reliably help people lose about 15% of their body weight in six to 12 months.

There are two other evidence based-approaches. Lifestyle changes, such as consuming fewer calories and increasing physical activity, can help people lose about 5% of their weight in the same period of time. With surgical treatment, now referred to as metabolic and bariatric surgery, patients can achieve a loss of about 30% of their body weight after about 18 months.

Which of these treatment approaches is appropriate for a given person depends on their circumstances and is best discussed with their health care provider. But in my experience, too few health care professionals refer their patients to any of these therapies.

Addressing the cost barrier

According to a November 2025 poll from the Kaiser Family Foundation, 1 in 8 adults in the U.S. have tried a GLP-1 medication. That may sound like a lot, but given that more than 40% of American adults have obesity, it may not be enough.

In clinical trials, people taking GLP-1 drugs to treat obesity generally maintained their weight loss for a year if they stayed on the medication. However, participants in the trials did not have to pay for the medications. Research suggests that more than half of people using the drugs stop taking them after six months, most often because they can’t afford them.

The federal government’s deal with Eli Lilly and Novo Nordisk aims to address this barrier.

GLP-1 drugs currently cost more than US$1,000 per month for people unable to get them covered by health insurance – and many insurance plans do not.

According to the Nov. 6 White House announcement, starting in early 2026, certain GLP-1 drugs covered by the agreement will be available for $350 per month or less through an online marketplace the government plans to launch.

Some drugs will be as cheap as $150, according to the announcement. Companies will also drop the amount that Medicare and Medicaid pay for them, and certain Medicare patients would be able to access them with a $50 co-pay.

These prices are still in flux, news reports suggest. However, for most Americans, paying even $150 a month for a single medication remains a budget buster. That’s especially true given that people from lower socioeconomic groups experience higher rates of obesity and often have other related health conditions that require costly medications.

These costs are not temporary. Most patients with obesity and related health problems will likely need to use these medications indefinitely. According to emerging research, people who stop taking them typically regain the weight they lost. Realistically, very few people who take GLP-1 drugs can maintain their weight loss with lifestyle changes alone.

Beyond cost

The reduced pricing for GLP-1 drugs is an important first step in increasing affordability and access to these treatments. Given that the food environments people live in make it difficult to make healthy choices, I believe that this move will only meaningfully benefit the health of all Americans if it is combined with other policy changes.

While several countries have a national plan to prevent and treat obesity, the U.S. does not. Instead, American public health policies are largely set state by state. They often include strategies such as free school meals for children or more robust insurance coverage for treating obesity and related health conditions. However, most such policies are often too narrow to have significant benefits at the population level.

Broader policy shifts and legislation targeting obesity prevention could move the needle.

For example, research is increasingly showing that ultraprocessed foods play a role in promoting weight gain and potentially other diseases, such as colorectal cancer. Legislators could draw on that research to better regulate these foods – for example, to limit the use of certain especially harmful ingredients, to restrict marketing of ultraprocessed products, or to limit their inclusion in school meals.

Another policy change that may help would be to build more extensive nutrition education into the training that medical students and other health care providers receive. This may better position the next generation of clinicians to help their patients make the healthiest choices to maintain their weight and health.

These and other policy changes will be critically important in efforts to reduce the rate of obesity among Americans in the future.

David B. Sarwer’s program of research has been funded by grants from the National Institutes of Health for over the past 20 years. He also serves as Editor-in-Chief of the journal Obesity Science and Practice.

– ref. Making GLP-1 weight loss drugs cheaper isn’t enough to address America’s obesity problem – here’s why – https://theconversation.com/making-glp-1-weight-loss-drugs-cheaper-isnt-enough-to-address-americas-obesity-problem-heres-why-269361

Source: The Conversation – USA (3) – By Shannon Fyfe, Assistant Professor of Law and Assistant Professor of Philosophy, Washington and Lee University

Following the federal government’s changes to COVID-19 vaccine eligibility and recommendations in 2025, many people are wondering whether they can get COVID-19 vaccines for themselves or their children.

In May 2025, the U.S. Food and Drug Administration limited eligibility for updated COVID-19 vaccines to people ages 65 years and up and to those under 65 with a “high-risk” condition. In September, the Centers for Disease Control and Prevention adopted an “individualized decision-making” approach to COVID-19 vaccination instead of broadly recommending the vaccines.

It’s not just the public that is confused. Many physicians and pharmacists also have questions about whether and how they can administer COVID-19 vaccines.

As philosophers with expertise in bioethics and legal philosophy, we have been following the ethical and regulatory landscape for COVID-19 vaccines since they first became available in late 2020.

In the fall of 2025 that landscape looks a bit different in light of the new guidelines. While it is causing understandable confusion, most people who want to get a COVID-19 vaccine can do so. Broad access is possible, in part, through what in health care is called “off-label use.”

“Off-label” refers to using an FDA-approved product for a different purpose, or with a different population, than that for which it received approval. Off-label prescriptions are common in health care, particularly in pediatrics.

COVID-19 vaccines from 2020-2025

People likely recall that COVID-19 vaccines were developed faster than any vaccine had been previously, thanks to efforts such as the U.S. government’s Operation Warp Speed. Initially limited in supply, the vaccines first became available through “emergency use authorization” in December 2020, with health care workers among the first prioritized by the government to receive them.

In August 2021, the FDA fully approved the first COVID-19 vaccine for people ages 16 and up. Following this, younger children started to become eligible for COVID-19 vaccines. From 2022 through summer 2025, COVID-19 vaccines were available to everyone 6 months and older in doctors’ offices or pharmacies, mostly free of charge, albeit with disparities in access due to an individual’s age, geographic location or vaccine costs.

But in May 2025, the new FDA and CDC leadership appointed by the Trump administration started to change their agencies’ positions on COVID-19 vaccines. Such regulatory changes affect who is considered eligible for the vaccines and whether public and private insurers must provide coverage. Meanwhile, state laws influence the ability of pharmacists, who frequently provide routine vaccinations, to administer COVID-19 vaccines.

Understanding the role of federal agencies such as the FDA and the CDC, as well as medical professional organizations and guidelines, can help untangle the complicated picture for access to COVID-19 vaccines.

2025 changes to FDA and CDC guidance

It’s helpful to understand the process through which vaccines become approved and endorsed by government agencies in the U.S.

First, the FDA approves drugs and other biologic products such as vaccines for specific uses, in specific age groups – in this case, to prevent people from getting COVID-19 or, if they do get it, to reduce the severity of their symptoms.

Next, the CDC recommends products that the FDA has approved or authorized. These recommendations have a different regulatory function than the initial FDA decisions. The CDC issues public health guidelines for which vaccines people should receive and which ones public and private insurance must cover. In some states, the CDC’s recommendations also affect whether pharmacies can administer vaccines.

Until September 2025, when the CDC shifted its stance, the agency broadly recommended COVID-19 vaccines for everyone 6 months of age and older, regardless of their underlying conditions. These recommendations supported public health and ensured that public and private insurance covered 100% of the cost of these vaccines as preventive health care.

Medical and CDC recommendations

Despite the FDA’s updated eligibility criteria and the CDC’s revised guidance, medical professional organizations have continued to broadly recommend COVID-19 vaccines.

In August, the American Academy of Pediatrics issued its own vaccine schedule. In addition to kids who meet FDA eligibility due to heightened risk, the organization recommends that all children between 6 months and 2 years old be vaccinated against COVID-19, as well as any child whose parent or guardian wants them to be vaccinated.

When the Advisory Committee on Immunization Practices, or ACIP – the committee that advises the CDC on vaccine policy – met in mid-September, it voted to recommend that anyone 6 months and older can get a COVID-19 vaccine according to “individual-based decision-making.” The committee also voted to require continued funding of COVID-19 vaccines through private and public health insurance and the Vaccines for Children program that provides free vaccines to children who are Medicaid eligible, uninsured or underinsured. In October, the interim CDC director adopted the ACIP recommendations as the formal guidance from the CDC for the 2025-2026 COVID-19 vaccines.

These recommendations from the CDC and medical professional organizations are difficult to square with the FDA labeling changes for COVID-19 vaccines. The CDC is recommending that people make individual decisions with their medical providers about COVID-19 vaccination, regardless of their eligibility through FDA approval.

This is possible because anyone who doesn’t meet FDA eligibility can get a COVID-19 vaccine through off-label use.

Off-label use of COVID-19 vaccines

Using COVID-19 vaccines off-label means administering them for the same purpose but to a wider population than those who are FDA-eligible. In 2021 the CDC prohibited the off-label use of COVID-19 vaccines purchased by the federal government. This was an unusual move and is no longer the case.

While uncommon, off-label vaccination is sometimes recommended. One example is off-label vaccination against measles, mumps and rubella, or MMR, for children under 12 months old who plan to travel to areas where measles is not eradicated, or are exposed to a disease outbreak.

Moreover, the CDC’s 2025-2026 COVID-19 vaccine recommendations remove certain barriers that typically accompany off-label use.

For example, products used off-label are not always covered by insurance. Many private insurers already committed to covering COVID-19 vaccines as preventive care for the 2025-2026 vaccine season. The recommendations from ACIP and the CDC subsequently guaranteed that private and public health insurance plans would continue to cover COVID-19 vaccines in full. This includes COVID-19 vaccines under the Vaccines for Children program that purchases vaccines for approximately half of U.S. children.

Off-label use of a product is ethically and legally permissible if a physician believes its benefits outweigh its risks for their patient. But the CDC’s recommendation for individual decision-making may also lessen clinicians’ worries about liability. So might the guidance from the American Academy of Pediatrics, as well as the American College of Obstetricians and Gynecologists’ vaccine recommendations that anyone who is pregnant should get an updated COVID-19 vaccine during pregnancy.

Off-label use is typically done via a doctor’s prescription. Yet many COVID-19 vaccines are administered in pharmacies. Getting vaccinated in a pharmacy is especially helpful for people without primary care doctors or the time or money for a clinic visit. Many states have taken steps to remove barriers to obtaining off-label COVID-19 vaccines at pharmacies. The CDC’s October 2025 recommendations for individual decision-making also enable COVID-19 vaccination by pharmacists.

For people who would like to be vaccinated against COVID-19, knowing how off-label use fits into current regulations may be helpful for understanding their access to vaccines this respiratory virus season, and medical treatment in general.

The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. Off-label use of COVID-19 vaccines was once discouraged but has become common amid new guidelines – https://theconversation.com/off-label-use-of-covid-19-vaccines-was-once-discouraged-but-has-become-common-amid-new-guidelines-268345

Source: The Conversation – USA – By Stefani Langehennig, Assistant Professor of Practice, Daniels College of Business, University of Denver

When the Colorado Artificial Intelligence Act passed in May 2024, it made national headlines. The law was the first of its kind in the U.S. It was a comprehensive attempt to govern “high-risk” artificial intelligence systems across various industries before they could cause real-world harm.

Gov. Jared Polis signed it reluctantly – but now, less than a year later, the governor is supporting a federal pause on state-level AI laws. Colorado lawmakers have delayed the law’s enactment to June 2026 and are seeking to repeal and replace portions of it.

Lawmakers face pressure from the tech industry, lobbyists and the practicalities related to the cost of implementation.

What Colorado does next will shape whether its early move becomes a model for other states or a lesson in the challenges of regulating emerging technologies.

I study how AI and data science are reshaping policymaking and democratic accountability. I’m interested in what Colorado’s pioneering efforts to regulate AI can teach other state and federal legislators.

The first state to act

In 2024, Colorado legislators decided not to wait for the U.S. Congress to act on nationwide AI policy. As Congress passes fewer laws due to polarization stalling the legislative process, states have increasingly taken the lead on shaping AI governance.

The Colorado AI Act defined “high-risk” AI systems as those influencing consequential decisions in employment, housing, health care and other areas of daily life. The law’s goal was straightforward but ambitious: Create preventive protections for consumers from algorithmic discrimination while encouraging innovation.

Colorado’s leadership on this is not surprising. The state has a climate that embraces technological innovation and a rapidly growing AI sector. The state positioned itself at the frontier of AI governance, drawing from international models such as the EU AI Act and from privacy frameworks such as the 2018 California Consumer Privacy Act. With an initial effective date of Feb. 1, 2026, lawmakers gave themselves ample time to refine definitions, establish oversight mechanisms and build capacity for compliance.

When the law passed in May 2024, policy analysts and advocacy groups hailed it as a breakthrough. Other states, including Georgia and Illinois, introduced bills closely modeled after Colorado’s AI bill, though those proposals did not advance to final enactment. The law was described by the Future of Privacy Forum as the “first comprehensive and risk-based approach” to AI accountability. The forum is a nonprofit research and advocacy organization that develops guidance and policy analysis on data privacy and emerging technologies.

Legal commentators, including attorneys general across the nation, noted that Colorado created robust AI legislation that other states could emulate in the absence of federal legislation.

Politics meets process, stalling progress

Praise aside, passing a bill is one thing, but putting it into action is another.

Immediately after the bill was signed, tech companies and trade associations warned that the act could create heavy administrative burdens for startups and deter innovation. Polis, in his signing statement, cautioned that “a complex compliance regime” might slow economic growth. He urged legislators to revisit portions of the bill.

Polis convened a special legislative session to reconsider portions of the law. Multiple bills were introduced to amend or delay its implementation. Industry advocates pressed for narrower definitions and longer timelines. All the while, consumer groups fought to preserve the act’s protections.

Meanwhile, other states watched closely and changed course on sweeping AI policy. Gov. Gavin Newsom slowed California’s own ambitious AI bill after facing similar concerns. Meanwhile Connecticut failed to pass its AI legislation amid a veto threat from Gov. Ned Lamont.

Colorado’s early lead turned precarious. The same boldness that made it first also made the law vulnerable – particularly because, as seen in other states, governors can veto, delay or narrow AI legislation as political dynamics shift.

From big swing to small ball

In my opinion, Colorado can remain a leader in AI policy by pivoting toward “small ball,” or incremental, policymaking, characterized by gradual improvements, monitoring and iteration.

This means focusing not just on lofty goals but on the practical architecture of implementation. That would include defining what counts as high-risk applications and clarifying compliance duties. It could also include launching pilot programs to test regulatory mechanisms before full enforcement and building impact assessments to measure the effects on innovation and equity. And finally, it could engage developers and community stakeholders in shaping norms and standards.

This incrementalism is not a retreat from the initial goal but rather realism. Most durable policy emerges from gradual refinement, not sweeping reform. For example, the EU’s AI Act is actually being implemented in stages rather than all at once, according to legal scholar Nita Farahany.

Effective governance of complex technologies requires iteration and adjustment. The same was true for data privacy, environmental regulation and social media oversight.

In the early 2010s, social media platforms grew unchecked, generating public benefits but also new harms. Only after extensive research and public pressure did governments begin regulating content and data practices.

Colorado’s AI law may represent the start of a similar trajectory: an early, imperfect step that prompts learning, revision and eventual standardization across states.

The core challenge is striking a workable balance. Regulations need to protect people from unfair or unclear AI decisions without creating such heavy burdens that businesses hesitate to build or deploy new tools. With its thriving tech sector and pragmatic policy culture, Colorado is well positioned to model that balance by embracing incremental, accountable policymaking. In doing so, the state can turn a stalled start into a blueprint for how states nationwide might govern AI responsibly.

Stefani Langehennig receives funding from the American Political Science Association’s (APSA) Centennial Center Research Center.

– ref. Colorado is pumping the brakes on first-of-its-kind AI regulation to find a practical path forward – https://theconversation.com/colorado-is-pumping-the-brakes-on-first-of-its-kind-ai-regulation-to-find-a-practical-path-forward-269065