New York's department of public health released a series of odd guidances to pharmacists and physicians on Friday to promote COVID vaccines to children and adults for "off label" use, meaning in conflict with FDA's official label. Signed by Governor Kathy Hochul, New York's executive order 52 declares a "disaster in the state of New York due to federal actions related to vaccine access."

"A friend of mine said they're contacting the nurse's union," a New York City nurse texted me, shortly after New York released their new COVID vaccine guidance. "They don't know wtf to do with that!"

A New York physician sent me documents the state's health department sent to physicians and pharmacists, called "providers" in healthcare lingo. She and the majority of her colleagues no longer get COVID boosters, and she's worried that the new guidance for "off label" use makes no sense, does not fully inform patients, and might be illegal.

Pfizer pled guilty to criminal charges and paid a record $2.3 billion fine for illegal, off label promotion of multiple drugs in 2009. As previously reported here, Biden's FDA Commissioner and CDC Director both promoted COVID vaccines for uses that the FDA admitted were off label. No evidence exists that pharmaceutical companies helped to shape New York's off label policy, but CNBC reported in 2021 that Governor Hochul's daughter-in-law is a top lobbyist at a pharma firm that has sought to influence NY lawmakers.

According to a recent biography at BIO, Christina Hochul is now a lobbyist at Alexion, a subsidiary of AstraZeneca.

In one unsettling example of New York's emergency guidance, officials allege that "physical activity" places people at risk of COVID.

Because she works in both New Jersey and New York, this physician requested to go by the name "Michelle" to protect her license and possible job reprisals. "The states that I practice in are particularly regressive and hostile," Michelle said. "They have pursued suspending and revoking licenses for providers that asked questions that in any other situation would be normal to ask."

Over the weekend, I spoke at length with Michelle, probing her to explain what is going on in healthcare right now and what she and other physicians plan to do about New York's emergency declaration. At times, the conversation veered into the horrors she's experienced in modern American healthcare. When a wave of illegal immigrant children came to New York a couple years back, many of them she treated had been sexually abused and trafficked during their migration from places as far away as Honduras. She also consulted for a hospital where boys who identified as "trans girls" were placed in a female psychiatric ward and then sexually abused the girls, crimes which were likely never reported to police, and handled internally by staff.