I got a Pfizer COVID vaccine last night from Walgreens. And no, RFK Jr, I didn’t die. I didn’t feel a thing, and I feel fine now. No magnetic particles are letting extraterrestrials control my thoughts from space, at least not as far as I can tell. We are in the late summer COVID spike, so likely 10-15 percent of us will get COVID this summer, but few of us are at much risk from it. As we expected, the severity of Covid is trending down over the years, as more of us get more and more immune to it, and our herd immunity strengthens. COVID-19 is in the process of turning into just one more cause of what we call the common cold, but COVID-19 will always be an unusual cause because of the pandemic, a cause we have a test for, which makes it stand out a little from the zillions of respiratory viruses and coronaviruses that cause colds.
There’s no hurry to get the COVID vaccine right now for most people, and likely only people with severe chronic disease, people over 65, and particularly over 80 should get revaccinated yearly, because this group is at some risk of hospitalization and death – but few people have a significant risk. For me, vaccination was a convenience choice. I am over 65, I’m flying in three weeks, and I’m going to be officiating at a wedding (believe it or not) so I’m going to get exposed in the airport, I promise, because airports are places that spread infectious diseases. It would be inconvenient for me to get sick the day of the wedding of my oldest friend (who is getting married for the first time, at 73!). So I got the shot.
What was crazy about it? Two things. First, the process of getting immunized is crazy in 2026 and is further evidence of how much we need a health care system in Rhode Island and the US, instead of a mess. And second, what the vaccine costs is completely nuts.
My primary care office (I use a community health center) doesn’t do vaccinations for adults anymore, so they sent me to a nearby pharmacy. When I called the pharmacy to book the appointment, I talked to someone in some foreign country, who asked me a zillion questions on the phone before they would book the appointment, a process that took nearly ten minutes, just for the appointment. Then, when I got to the pharmacy at the appointed time, it took a half hour for the pharmacist to figure out what and how to bill me. I have great but unusual insurance (a Health Savings Account for Medicare) which meant the pharmacist had to really puzzle things out on her computer. She couldn’t believe that the shot wasn’t free because I have Medicare, even though I told her from jump street that I had a Health Savings Account with a high deductible, which means I have to pay for the shot. It hurt my heart to see a pharmacist, who likely has a doctorate degree, struggle with a computer to figure out how to bill for a routine shot, but that’s how low we’ve fallen. We have turned pharmacists, doctors, and nurses into billing clerks, at least until health professionals organize and revolt, and return to caring for patients, which was what they were trained for and want to do.
The second thing that was crazy about the COVID shot was what it actually cost. $250. For a shot. I kid you not. The amazing and overworked pharmacist found a discount card or code, which dropped the price to $144. (So it was good for me that said pharmacist wrestled with her computer. But not that good for her, I fear) $144! For a drug that costs Pfizer no more than two dollars to make. Yikes!
Whew, you might say. At least I don’t have to pay that kind of money when I get a shot, because I have good insurance. If you think that way, however, you’d be sadly mistaken. You do have to pay for all this, and you do so many times over, but the insurance process in the US has hidden the cost from you, so you keep getting taken of. (There are other words I’d like to use instead of ‘taken advantage of’ but this is a family news outlet.)
Here’s how the hustle works: Walgreens bills Medicare or your insurer. You don’t see the bill, so you think the shot was free because you didn’t get charged. The bill gets passed on as insurance or Medicare premiums, which, if you are over 65, get taken out of your monthly Social Security check, so you really never see it. This way, you also don’t see the cost increases, which will be 11 percent for commercial insurance, or about $500 in 2027, and 3.5 percent or $72 a year for Medicare — and you’ll also pay more with copays and deductibles. What is disappearing is YOUR money that should be in YOUR pocket but got diverted to someone else’s profit.
How much profit? It’s estimated that Pfizer made $80-90 billion on the COVID vaccine alone, after investing $2 billion up front, but about $ 4 billion was covered upfront by a US government contract for the vaccine in 2020 and 2021(at $19.50 a dose!)
Here’s the rub. If health care were a normal market, COVID vaccines should cost $5-10 per dose now, because there are two competing vaccines, both manufactured at a cost of about $2 per dose. If the government and insurance companies weren’t involved, competition would have driven the cost way lower than it is. Instead, hidden prices and profits drive prices up, and make health care unaffordable.
One more weird thing that happened as I got my COVID shot: they pushed me to get a flu shot and about 10 other vaccines, all of which I’ve already had. What’s weird about that? It’s a business, right? Well, they didn’t have my medical record so they didn’t know what I’ve had and not had. But I bet lots of people just go along and get other shots while they are there, because someone is telling them it’s all free. If we had a health care system, on the other hand, your primary care practice would be giving shots because you need them, not to make a profit, and would be reminding you when and what you need.
And one more technical problem. No one should be offering or giving flu shots in August. The peak incidence of the flu is from late February to March. The flu shot is only effective for about 3 months, particularly in older people, who are at the highest risk of the flu. So a flu shot in August will be ineffective by the time the flu is spreading widely.
SO. Get a COVID shot if your doctor tells you to, or if you want to keep from getting sick for a specific upcoming event. And get a flu shot. But in the middle to the end of November. Any other choice is crazy.
And please ask all those political candidates out there if they understand anything at all about how this works and how they plan to change it.
You can find Michael Fine’s commentaries and short stories on
https://michaelfinemd.
