James Woods calling it on Disease X
(twitter.com)
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Specifically it looks like the Advisory Committee on Immunization Practices (ACIP) defines the requirements. The salesmen are in charge of defining who must buy their products.
Oh sooo true. But, and also, the State Department Yale-ies are so, so superior to you. And some (read: all) even want you dead! So that's nice. And they could change the policy if they cared for the health of America. But they don't so they don't.