The plaintiffs had religious objections to the vaccine, but the university determined their objections weren’t legitimate and fired them, according to the , which represented the former CU employees and .

CU’s in Aurora considered whether employees’ religions had an established doctrine prohibiting them from receiving any vaccines; if not, the school asked whether the employee had received other shots, and what made this one different.

The 10th U.S. Circuit Court of Appeals that CU’s process was an unconstitutional religious test by a government entity.

The university could have appealed to the U.S. Supreme Court, whose current justices have generally favored plaintiffs alleging religious discrimination.

When the vaccines first became available in December 2020, they were more than 90% effective in preventing infection, meaning they could stop further transmission of the virus to health care workers’ patients or colleagues. Since then, COVID-19 variants have become increasingly good at evading the immune system, so that vaccination primarily benefits individuals by reducing the risk of severe illness.

Michael McHale, senior counsel for the Chicago-based Thomas More Society, said nothing could compensate the plaintiffs for career damage from having to choose whether to go against their convictions.

“At great, and sometimes career-ending, costs, our heroic clients fought for the First Amendment freedoms of all Americans who were put to the unconscionable choice of their livelihoods or their faith during what (Supreme Court) Justice (Neil) Gorsuch has rightly declared one of ‘the greatest intrusions on civil liberties in the peacetime history of this country,'” McHale said in a statement. “We are confident our clients’ long-overdue victory indeed confirms, despite the tyrannical efforts of many, that our shared constitutional right to religious liberty endures.”

Julia Milzer, a spokeswoman for CU’s Anschutz Medical Campus, said federal agencies required health care facilities to have a vaccine mandate at the time. The policy is no longer in force, but was right during that stage of the pandemic, she said.

A separate state mandate required health care workers to get the shot or receive a medical or religious exemption is also no longer in place.

“While some chose to challenge the policy, the evidence remains clear: Vaccination was essential to protecting the vulnerable, keeping hospitals open and sustaining education and research,” she said in a statement. “We stand by the decisions made in that moment and remain deeply grateful to the health care professionals, faculty, staff and students whose courage and commitment protected our community and advanced our mission when it mattered most.”

Initially, pharmacies couldn’t administer the updated shots in Colorado unless a patient had a prescription. The state allows pharmacists to administer vaccines recommended by the Centers for Disease Control and Prevention’s advisory committee, but not other shots.

Dr. Ned Calonge, chief medical officer for the state health department, responded by issuing a standing order — essentially, a prescription for every resident – allowing them to get vaccinated at retail pharmacies.

But that order doesn’t guarantee insurance will cover the shots or that pharmacies will choose to stock them. Last year, fewer than half of people over 65 nationwide received an updated COVID-19 shot, with uptake dropping further in younger age groups, raising questions about whether health care providers will believe demand is high enough to justify buying the vaccine.

“The standing order provides accessibility. It doesn’t necessarily provide availability,” Calonge said Tuesday.

The last week that would require state-regulated plans to cover COVID-19 vaccines without out-of-pocket costs for people of any age, assuming the division passes it as written. Insurance cards from state-regulated plans typically have CO-DOI printed in the lower left corner.

The state’s rule doesn’t apply to federally regulated plans, which account for about 30% of employer-sponsored insurance plans in Colorado, Calonge said. Typically, however, those plans try to offer competitive benefits, since they mostly serve large employers, he said.

“My hope would be they would want to keep up with other insurers,” he said.

This isn’t the first time that people on state-regulated plans have had benefits not guaranteed for people with federally regulated insurance.

Colorado capped the cost of insulin and epinephrine shots to treat severe allergic reactions in state plans, but couldn’t require the same for plans the state doesn’t oversee. In those cases, it offered an “affordability program” requiring manufacturers to supply the medication at a lower cost for people who aren’t covered by the state caps, Medicare or Medicaid.

At least two Colorado insurers surveyed by The Denver Post said all of their plans will cover COVID-19 vaccines, while others hedged.

Select Health, which sells Medicare and individual marketplace plans in Colorado, said its plans currently cover COVID-19 vaccines without out-of-pocket costs for everyone. Kaiser Permanente Colorado said in a message to members that it will pay for the shot for anyone 6 months or older.

Donna Lynne, CEO of Denver Health, said the health system’s insurance arm is waiting on clarification about when it should cover the vaccines. Denver Health Medical Plan offers multiple plan types, some state-regulated and some under federal rules, she said.

“It’s less of a decision on our part than understanding what the health department and the insurance department are saying,” she said. “You can’t have one insurance company saying they are doing it and one saying they aren’t doing it.”

Anthem said it considers immunizations “medically necessary” if the American Academy of Pediatrics, American Academy of Family Physicians or the CDC’s vaccine advisory committee has recommended them, but didn’t specify whether it would charge out-of-pocket costs for medically necessary vaccines.

If those bodies stated that certain people could get a particular vaccine — but not that they should — Anthem would decide about coverage “on an individual basis,” . The other groups have recommended the shots for people over 18 or under 2, with the option for healthy children in between to get a booster if their parents wish.

The state’s Medicaid program is still waiting for guidance from federal authorities about whose vaccines it can cover, according to the Colorado Department of Health Care Policy and Financing, and .

For most of the COVID-19 vaccines’ relatively brief existence, they were free and recommended for everyone 6 months and older. In 2024, the federal government stopped paying for them, which meant uninsured people no longer could be sure they could get the shot without paying.

Almost all insurance plans still were required to pay for the shots, though, because the CDC’s Advisory Committee on Immunization Practices recommended them.

In previous years, the committee recommended updated shots within days of the U.S. Food and Drug Administration approving them. In late August, the increasing their risk of severe disease, including asthma, obesity and diabetes.

Doctors still could prescribe the vaccine “off-label” to healthy people, in the same way that they prescribe adult medications for children when an alternative specifically approved for kids isn’t available.

This year, however, , and may not recommend the shots when it does. Secretary of Health and Human Services Robert F. Kennedy Jr. dismissed all of the committee’s members earlier this year and replaced them with new appointees, most of whom oppose COVID-19 vaccines.

The committee’s decision also will determine whether the Vaccines for Children program can supply the shots for children who are uninsured, covered by Medicaid or are members of American Indian tribes, Calonge said. If the committee decides not to recommend the vaccines, those children likely won’t have another option to get the shots, he said.

When states and the federal government passed laws linking coverage to the committee’s recommendations, they did so expecting that it would also remain an apolitical arbiter of the evidence for vaccinating the population or specific subgroups, said Cathy Bradley, dean of the Colorado School of Public Health.

Now, that premise is in doubt, and states are looking for other ways to ensure access, she said.

Allowing anyone who wants a COVID-19 vaccine to get one from the provider of their choice is an important first step for Colorado, because the vaccines remain effective in preventing severe illness, Bradley said. As the situation develops, the state will likely need to come up with other partial solutions to preserve access, she said.

“It’s a different path for everyone, depending on what your coverage is,” she said.

Dr. Ned Calonge, chief medical officer for the Colorado Department of Public Health and Environment, issued a allowing anyone 6 months or older to receive the updated COVID-19 vaccines at a pharmacy starting Friday.

A standing order essentially is a prescription to the entire area under a public health department����ap jurisdiction; cities and counties used them to before it became available over the counter.

The Colorado State Board of Pharmacy will meet Friday for an emergency rulemaking session to ensure pharmacies and their employees are protected as they administer shots under the standing order. The order doesn’t require pharmacies to offer the vaccines.

CVS and Walgreens announced last week that their Colorado locations would only provide COVID-19 vaccines to people who presented a prescription. The state allows pharmacists to give vaccines only when the Centers for Disease Control and Prevention’s immunization advisory committee recommends them. Fifteen other states .

In previous years, the Advisory Committee on Immunization Practices recommended the updated COVID-19 shots within days of the U.S. Food and Drug Administration approving them.

The FDA approved updated vaccines last week, but the committee hasn’t taken action and isn’t scheduled to meet until mid-September — and even then, may not vote to recommend them, since multiple new members have publicly stated their opposition to COVID-19 vaccines or, in some cases, to all vaccines.

“Colorado is committed to empowering individuals to make choices to protect their own health and safety, and I will not allow ridiculous and costly red tape or decisions made far away in Washington to keep Coloradans from accessing vaccines,” Gov. Jared Polis said in a statement.

This year, the FDA approved the COVID-19 vaccines for anyone 65 or older, and for younger people with . Before, anyone who was 6 months or older could get the shot annually, assuming they hadn’t had the virus in the previous two months.

Doctors can prescribe the vaccine “off-label” to healthy people who want extra protection before the fall respiratory season, though . Off-label prescribing is relatively common; for example, women undergoing fertility treatment sometimes take a repurposed breast cancer drug.

Most health insurance companies in Colorado didn’t immediately respond Wednesday to questions about whether they would cover the updated shot without out-of-pocket costs for all their members.

Kaiser Permanente said it would review the CDC’s guidance when it arrives, but is “committed to making the 2025-26 COVID vaccine available at no cost to children and adults for protection from severe illness.”

Jill Hunsaker Ryan, executive director of the state health department, directing it to work with the state agencies overseeing Medicaid, private insurance plans and the regulation of pharmacies to remove barriers to vaccines for anyone who wants one.

“Since October 1, 2024, more than 4,500 Coloradans have been hospitalized due to COVID-19,” she said in a news release. “This order ensures that Colorado takes every step possible to prevent hospitalizations, protect frontline health care workers and preserve critical health care resources. Equitable vaccine access is a cornerstone of protecting the public’s health.”

State law allows pharmacists to administer vaccines recommended by the , a group that counsels the director of the about who will benefit from which shots.

In previous years, the committee recommended updated COVID-19 vaccines within days of the approving them. This year, the committee doesn’t have any meetings scheduled until late September, and may not recommend the shot when it does meet, since Secretary of Health and Human Services Robert F. Kennedy Jr. appointed multiple members with anti-vaccine views after removing all prior appointees in June.

The lack of a recommendation also means that insurance companies aren’t legally required to pay for the COVID-19 vaccine without out-of-pocket costs. Most private insurers will cover the updated shots this year, though that could change in 2026, .

Initially, CVS said it couldn’t give the COVID-19 vaccine to anyone in Colorado or 15 other states, because of their ACIP-approval requirement. As of Friday morning, its pharmacies can offer the shots to eligible people who have a prescription, spokeswoman Amy Thibault said.

As of about 10 a.m. Friday, CVS’s website wouldn’t allow visitors to schedule COVID-19 shots in Colorado.

Walgreens didn’t respond to questions about its COVID-19 vaccine policy, but its website said patients need a prescription in Colorado. A New York Times reporter .

The FDA this week recommended the updated shots that puts them at risk for severe disease.

The listed conditions include:

• Asthma and other lung diseases
• Cancer
• History of stroke or disease in the brain’s blood vessels
• Chronic kidney disease
• Liver disease
• Cystic fibrosis
• Diabetes (all types)
• Developmental disabilities, such as Down syndrome
• Heart problems
• Mental health conditions, including depression and schizophrenia
• Dementia
• Parkinson’s disease
• Obesity
• Physical inactivity
• Current or recent pregnancy
• Diseases or medications that impair the immune system
• Smoking

Healthy people technically still can get the vaccine, but would have to ask a health care provider to prescribe it off-label. An off-label prescription refers to one given for a condition the drug isn’t approved to treat, such as a blood-pressure drug prescribed to prevent migraines.

Not everyone has a regular health care provider or the inclination to take time out of their day for an office visit, though. Insurers also vary in their willingness to cover off-label prescriptions.

U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr., a former anti-vaccine activist, has rocked the normally staid world of vaccine policy since January, including by firing all 17 members of an advisory committee, no longer recommending COVID-19 shots for healthy children or pregnant women and declining to full-throatedly endorse the measles vaccine in the midst of the .

The effect has been to confuse parents about whether vaccines are safe, said Northe Saunders, president of American Families for Vaccines. For now, the federal government hasn’t directly made it harder to get routine shots, though pharmacies and providers may be less likely to stock them if they think patients don’t want them, he said.

“If there’s no demand for a product because of misinformation, it’s harder to get,” he said.

Multiple medical groups, including the American Academy of Pediatrics, over changes to COVID-19 vaccine recommendations for children and during pregnancy. They also challenged his decision to dismiss all members of the Advisory Committee on Immunization Practices and to appoint new ones who haven’t undergone the usual vetting process. Of the eight members Kennedy appointed, one has bowed out, and at least three have anti-vaccine views.

The committee’s composition matters because it has a role in determining what vaccines insurance will cover. Almost all plans legally have to cover vaccines without out-of-pocket costs if they’re recommended by the director of the Centers for Disease Control and Prevention, who usually follows the committee’s advice. If the committee and the director opted to no longer recommend a particular vaccine, about whether to cover it.

The federally funded Vaccines for Children program also relies on the committee’s recommendations to determine which shots it will provide free to low-income and uninsured kids. If the committee decided to remove a particular shot from its list, uninsured parents would have to pay for the shots out of pocket, said Dr. Judith Shlay, associate director of the Public Health Institute at Denver Health.

In May, Kennedy announced the health department would no longer recommend COVID-19 vaccines for healthy children or during pregnancy, though it isn’t clear if that announcement frees insurers from paying because .

For now, Vaccines for Children still covers the COVID-19 shot under the “shared decision making” paradigm, said Dana Von Schaumburg, interim clinic services director at Jefferson County Public Health.

With fully recommended shots, providers start from the presumption that getting those vaccines is a good idea, unless a child has a health condition that would make certain shots unsafe. With shared decision making, the provider and the patient, or parent, determine if a shot is right for them. For example, if someone well into adulthood wanted the human papillomavirus shot, the provider would explain that it might not benefit them if they’ve already encountered HPV, then help them decide, Von Schaumburg said.

“There’s more of a conversation about the risks versus benefits,” she said.

While healthy kids will still be able to get the COVID-19 vaccine, providers won’t be able to offer it at school vaccination events, because parents typically aren’t there to have an in-depth conversation, Shlay said. Those who want their kids to get the vaccine will need to bring them to a clinic, she said.

“Anybody who wants it, we will give it to” with the proper consent, she said.

Jefferson County Public Health is still trying to clarify if it can give COVID-19 shots to pregnant patients, Von Schaumburg said. The data shows that the virus is more dangerous during pregnancy and that vaccination also protects the baby in the months after birth, but insurers may not cover the shot now, she said. A dose costs about $200 without insurance coverage.

“Vaccinating that population is important to protect the parent and the child,” she said.

Denver Health determined that pregnant patients can still get the shot, and Shlay, a family physician, said she would recommend it.

“I look at pregnancy as being a risk” for severe COVID-19, she said.

Changes at the federal level also affect flu shots, though most people won’t notice. The new members of the Advisory Committee on Immunization Practices to require vaccine manufacturers to remove the preservative thimerosal, which is , even though studies have shown no link between the ingredient and autism or health problems. (Autistic people who can speak for themselves often push back on the idea that people should attempt to prevent autism, arguing that seeing the world differently can have benefits.)

Multi-dose flu shots aren’t especially important to most practices during a normal season, but they would matter if avian flu or another novel strain started spreading among humans, requiring quick efforts to vaccinate as many people as possible, Saunders said.

“While it’s a small part of the overall vaccine supply, those multi-dose vials would be crucial” in a pandemic, he said.

Saunders said he worries about the upcoming respiratory season. Flu and COVID-19 shots aren’t top of mind for most people, and the federal government has clawed back pandemic-era grants that states could use to promote immunization, he said. Last year’s flu season was relatively severe, with more pediatric deaths than is typical, .

“If they continue to take away parts (of the vaccine infrastructure), it’s all going to crumble,” he said.

“Only sky and boat and water,” recalled the Rev. Dang, now a Catholic priest. “It was scary.”

Decades later, Dang, 50, resides in Denver and is a leader in its Vietnamese community. He is a chaplain for the Denver Police Department and serves as a community liaison for Denver Health. Dang promoted vaccinations during the COVID-19 pandemic to support public health outreach, and he’s encouraged people to vote in elections.

Now, as the 50th anniversary approaches this week for the fall of Saigon, which marked the end of the Vietnam War, he is ready to lend his support to his countrymen once more. Wednesday will be a heavy day of remembrance about what Vietnamese immigrants sacrificed in their native land to reach safety in the United States and beyond.

“Every time I see the Vietnamese, I see what we went through — and that we become successful,” Dang said. “This is our second home.”

Nearly 34,000 Vietnamese people live in Colorado, according to 2021 census data cited by the . They count as the fifth-largest population among Asian American, Native Hawaiian and other Pacific Islander communities throughout the state.

Much of the initial Vietnamese resettlement in the Rocky Mountain West was spurred by the siege of Saigon — the former capital city of South Vietnam — by communist forces on April 30, 1975, bringing a bitter end to decades of war.

Around left their homeland, with the majority risking their lives at sea after the nation’s borders were closed, according to estimates by the Canadian Red Cross. In the early years,  were resettled in Denver, History Colorado says.

The state’s Vietnamese community has expanded since then. Today, its impact can be seen firsthand at restaurants and shops in Denver’s on South Federal Boulevard, at annual events including the Mid-Autumn Festival and even in an official state holiday, the Lunar New Year.

Gov. Jared Polis recently declared Wednesday’s anniversary as Vietnamese Remembrance and Resilience Day. He met a dozen community members and advocates, including Dang, at the state Capitol on April 15 to present the proclamation to Nga Vương-Sandoval, a Vietnamese refugee and the executive director of .

The difficulties of Vương-Sandoval’s journey to the U.S. as a child shaped her in ways similarly felt by many other members of Colorado’s Vietnamese community, leaving impressions not only on those directly impacted by the war but also on the increasingly Americanized generations that have followed.

“We’re really recognizing the challenges that Vietnamese refugees faced in the wake of the Vietnam War,” Polis told The Denver Post after the ceremony.

Dang had stood behind Vương-Sandoval as she accepted the document from the governor. Both Vietnamese community leaders wore pattered áo dài — formalwear from Vietnam — and Dang raised the yellow and red flag of the former South Vietnam.

An exodus after the war

Dang was born a month before the war ended in 1975. Vietnam had been plagued by bloodshed for decades following the August Revolution in 1945, with 1954 marking the country’s separation into the communist Democratic Republic of Viet Nam in the north and the Republic of Viet Nam in the south.

Other global powers had become involved in the fight by 1960. The U.S. backed the south, while China and the Soviet Union supported communism in the north. The American military sprayed millions of gallons of herbicides like Agent Orange from 1962 to 1971, which killed crops and other vegetation, according to a report in the . But exposure also caused cancers, birth defects and other diseases in civilians and service members. U.S. troops were deployed to Vietnam in 1965.

Despite a hiatus in 1973 with the striking of a peace agreement, the conflict restarted in 1975.

In South Vietnam, Saigon fell on April 30. Since then, the country has operated under a communist dictatorship.

As hundreds of thousands of Vietnamese people left their country by boat, certain nations hosting refugees — Indonesia, Malaysia, the Philippines, Singapore and Thailand among them — began to turn people away, according to .

“When Vietnamese boat arrivals escalated dramatically in 1979, with more than 54,000 arrivals in June alone, boat ‘pushbacks’ became routine and thousands of Vietnamese may have perished at sea as a result,” says a chapter on the exodus from Southeast Asian countries in that period from a 2000 report by the UN refugee agency.

It details that other countries, including the U.S., Australia, France and Canada, resettled refugees between 1979 and 1982, although foreign enthusiasm to help was strained by the late 1980s.

After the North Vietnamese took power, Dang’s father was held as a prisoner of war for a decade. He recalled growing up without him until his dad’s skinny frame showed up at the door of their home. Soon after, Dang said, his parents lied to him — saying they were going to go to a wedding.

Instead, in 1986, the trio left Vietnam on a boat.

After Dang struggled with seasickness for two nights, his group was picked up by a French battleship that took them to — a humanitarian ship that was one of three vessels sharing that name that sailed from 1979 to 1989 to rescue Vietnamese refugees at sea. They were brought to the Philippines, where Dang’s family lived in a refugee camp for more than two years.

In 1989, a teenage Dang and his family arrived in California. At age 15, Dang left for a Vietnamese monastery in Missouri, with the goal of becoming a priest. He served as a pastor for five years at the University of Kansas before a yearlong sabbatical brought him to Denver.

Today, Dang has come to terms with the likelihood that he cannot return to visit Vietnam. He’s applied for a visa twice, but its government rejected both attempts. Dang believes it’s because he was labeled as anti-communist.

By escaping, Dang said, “I paid the price.” Tears welled in his eyes. “I’m not able to go back to Vietnam freely.”

‘We don’t want this day to be forgotten’

Vương-Sandoval’s parents also made the decision to flee Vietnam by boat. She was 3 when her family left their motherland on a cargo ship.

“While it’s a unique situation for my family and I, it’s not so unique for millions of us who had to flee,” she said, referring to the collective experience of the Vietnamese diaspora.

Decades of upheaval in the Southeast Asian country had led up to the war, which is known as the American War in Vietnam.

“The ongoing, looming anxiety and apprehension had been going on for quite some time,” said Vương-Sandoval.

After the fall of Saigon, refugees left Vietnam in waves from 1975 to 1995, Vương-Sandoval said. For some, to remain in the country would mean persecution, torture, exile or death.

At refugee camps in the Philippines and Guam, she recalls waiting in lengthy lines for food on hot days. “Just that daily monotonous routine,” Vương-Sandoval said.

As refugees scattered across the globe, “we were one of the lucky ones where my immediate family was intact,” Vương-Sandoval said. “There were many families that were not able to do that because of family separation, as well as other decisions.”

Once in the United States, her family landed in Arkansas in the late 1970s, spending one year there.

“That was quite the culture shock,” Vương-Sandoval said, “and I think it was a culture shock for the people who saw us as well. There had never been such a large influx of refugees in (the) modern day during that time.”

After another year in Alabama, the family finally arrived in Colorado. In adulthood, Vương-Sandoval has grown into an outspoken advocate for marginalized communities and served as a refugee representative at the UNHCR.

Her nonprofit group, Refugees + Immigrants United Colorado, is partnering with the Denver Vietnamese restaurant Sắp Sửa to host a in honor of the 50th anniversary of the fall of Saigon from 3 to 5:30 p.m. Sunday at the Sie FilmCenter, 2510 E. Colfax Ave.

Her goal: “Reclaiming that day for what it is, which is a huge day of mourning and loss.”

Vương-Sandoval wants to honor those who didn’t survive the journey from Vietnam. The Canadian Red Cross says an estimated 250,000 refugees died at sea.

But she also aims to uplift the stories of survivors and educate the public.

“We don’t want this day to be forgotten,” Vương-Sandoval said. “Healing is absolutely possible.”

The community’s epicenter in Denver

The advocacy work done by Vương-Sandoval and Dang is part of the fabric of Colorado’s Vietnamese community, which largely resides in metro Denver. The state capital is home to almost 7,000 people of Vietnamese descent, according to 2020 census data, while the seven-county metro claims about 28,000 people.

The drive along West Alameda Avenue toward the Little Saigon Business District signals the diversity of west Denver, with messaging by local businesses alternating between English, Spanish, Chinese and Vietnamese. A green street sign on South Federal Boulevard welcomes passersby to the official business district near the pagoda-style entrance of the .

On an afternoon last week, the shopping center at 333 S. Federal Blvd. was bustling. Wind chimes clanged against the door of the Little Saigon Supermarket as customers left the store with cardboard boxes of groceries, and a trio chatted in Vietnamese in the parking lot outside Viet’s Restaurant.

Inside Truong An Gifts, goods were displayed in every nook and cranny of the shop: Pokémon keychains and giant jade frogs, incense and skincare products, golden dragons and bamboo plants.

The center is part of Thanh Luong’s family legacy in Denver. But it’s a long way — over 8,000 miles — from where his life began.

Luong, 74, was raised in Saigon. Before its fall in 1975, he worked as a high school teacher. His father owned a bank, and his aunt was an English translator at the U.S. embassy. She married an American general.

Just before Saigon was captured, Luong said his father received a call from the embassy, instructing their family to stay at home and prepare to leave the country.

“At that time, it was really dangerous because everybody panicked,” Luong said. “Everybody tried to run away.”

In the early morning hours, U.S. embassy officials brought the family to a military base and loaded them onto a cargo plane flying to a refugee camp in Guam. From there, they were brought to Arkansas, then Oklahoma.

“Technically, my family is the first (Vietnamese refugee) family that came to Oklahoma,” Luong said.

With relatives already residing in Denver, they headed for Colorado next.

Luong’s first job was as a bus boy at the now-shuttered Top of the Rockies restaurant downtown. Then, he and his brother worked night shifts at King Soopers, stocking shelves. But at the store, they could find only short-grain rice — not the long-grain variety they ate back in Vietnam.

It helped spark the decision of Luong, his brother and his cousin to open a small Asian grocer, Thai Binh Oriental Foods, in 1977 near Dayton Street and East Colfax Avenue to cater to the local Vietnamese population. “They get homesick,” Luong remembered of community members then.

Two years later, the entrepreneurs opened a second location near West Alameda Avenue and South Federal Boulevard — the site of his shopping center today.

Luong’s future wife, Phung, arrived in the U.S. in 1980. Her family was stuck in Vietnam for several years and escaped by boat in 1979. They made it to Hong Kong first, but they needed a sponsor to travel to the U.S.

Phung’s brother knew Luong’s cousin, and Luong agreed to sponsor the family. Once he met Phung, it wasn’t long before they wed.

In Denver, Phung Luong opened a video store, Truong An Video, which catered to an Asian customer base. It eventually evolved into Truong An Gifts — one of several shops that make up the Far East Center, which opened in 1988.

Today, Thanh Luong has lived in Colorado twice as long as he lived in Vietnam.

Although the Vietnamese community is “a little bit bigger” than it once was, Luong said, Denver’s sprawling growth has kept the population from being as concentrated as communities in Texas and California.

He wants his children and grandchildren to remember where their elders came from. Luong taught his kids the Vietnamese language, but he says not everyone is able to do so: “My family is lucky,” he said.

Because many parents in their community often work long hours to support their families, they have less time to teach their children Vietnamese, Luong said. Instead, the younger generation predominantly learns English through the American education system.

“They lost their language,” Luong said. “They lost their root. That’s a sad story.”

His daughter, Mimi Luong, was born and raised in Denver.

“I saw the struggle,” she said. “I always wondered why my parents had to work so hard.”

It’s been almost 50 years since the end of the war — and the start of Thanh Luong’s new life outside Vietnam.

“Now, the U.S. is my country,” he said. “But sometimes, I still miss it.”

Raising the next generation

In southeast Denver, Thai Nguyen, 44, is performing an emotional balancing act: recognizing her family’s trauma from the Vietnam War and fighting against passing it down to the next generation.

“We should honor the past but also try to move forward,” Nguyen said.

Nguyen has lived in Denver for 15 years. She runs , one of the largest refugee-founded food access organizations in Colorado, as its sole full-time employee after quitting her job at a Fortune 500 company. Nguyen is also raising three multiracial children — Vietnamese, Irish and German — with her husband.

But as busy as her schedule is now, it doesn’t compare to the chaotic start of her life. In 1980, she was born in a refugee camp run by Doctors Without Borders in Thailand.

Her father was a Buddhist monk, but he and his relatives fought the north-aligned Viet Cong after Nguyen’s grandfather, great uncle and uncle were executed so that guerrilla fighters could gain possession of their 250 acres of farmland. Many of Nguyen’s paternal family members joined the rebellion army and died at the hands of the Viet Cong.

Nguyen’s dad trained with the U.S. Army and was permitted to resettle on American soil, though Nguyen’s mom and older brother had to leave Vietnam by boat. From Thailand to Malaysia to Indonesia to Singapore, they traveled “the pipeline to America,” Nguyen said, and experienced misfortunes like robbery along the way.

With Nguyen — then a toddler — in tow, her family entered the country through San Francisco. They lived in Houston for a decade, then New Orleans and Ft. Walton Beach, Florida. Finally, they settled in Southern California.

“I’m technically like a third-culture kid at this point,” Nguyen said. “I’m really Americanized, but then also I have these roots of Southeast Asia, Vietnam.”

However, for 38 years, Nguyen didn’t know she wasn’t an American citizen. Instead, she was a permanent resident with a green card because she lacked Vietnamese or Thai citizenship.

Her mother informed her during President Donald Trump’s first administration, out of a fear of deportation. Nguyen has since become a naturalized citizen.

The 50th anniversary of the fall of Saigon has stirred up emotions as Nguyen has watched it trigger her parents’ memories. The feelings tied to the upcoming commemoration include guilt for wanting to go back to Vietnam — “but that would be like a slap in the face to my parents,” she said.

She wants to see her elders heal from the trauma they’ve endured. Nguyen says both pride and a cultural fear of “losing face” — an Asian concept tied to losing social respect due to embarrassment or shame — can prevent people of the older generation from fully addressing their suffering.

“The past pain and anger and anguish is still seated there, unprocessed,” Nguyen said. “The older generations, that’s part of their core memory — whereas, for us, we’re the byproduct.”

When she was 15 years old, Nguyen returned for a visit to the island of Hon Tre in the Kien Giang province of Vietnam, where 10 acres of her family’s farmland — part of its ancestral burial site — remain.

She remembers leaving the airport and seeing beggars with missing limbs and deformities: the human cost of the Vietnam War.

“There has been no redress,” Nguyen said. “There’s still landmines. And how do you take … Agent Orange out of land?”

However, her father can never go back. There, he would be killed, Nguyen says. That’s because, in spite of his efforts to protect his family and land, he was labeled as a traitor for fighting against the Viet Cong, Nguyen said.

Today, she’s connecting her children to their maternal culture by teaching them to speak Vietnamese, celebrating holidays, and reading Vietnamese authors and poets. She depicts Denver’s Vietnamese community as small but close-knit.

One day, she wants to bring her kids to Vietnam — and is even considering the possibility of moving there at some point.

Over the past few decades, the country has built a powerful manufacturing industry and transformed into one of the continent’s fastest-growing economies, fighting poverty nationwide, reported last year. But rights like freedom of speech and assembly are limited by the government, which still has the 50-year-old communist regime in place.

But much has changed. In Nguyen’s view, “modern Vietnam is really progressive — and I just want to be a part of that progress.”

The Centers for Disease Control and Prevention’s forecasting center , or slightly lower, director Dr. Mandy Cohen said during a press briefing on Aug. 23.

But the projection could be off if the forecasters misjudged how many people will get vaccinated, she said. The CDC assumed vaccine uptake will be similar to last year, when and .

“The power is in our hands,” she said.

Typically, flu season in Colorado takes off in November and peaks in late December or January, which usually overlaps partially with a period of increased infections from RSV and COVID-19. Other viruses that cause common colds also circulate more widely in the fall and winter, but those three are responsible for most hospitalizations and deaths from respiratory infections.

The Southern Hemisphere’s flu season, which comes while the United States is experiencing summer, has followed the normal pattern, said Jenna Guthmiller, an assistant professor of immunology and microbiology at the University of Colorado School of Medicine. While the respiratory season can be different in the Northern Hemisphere, the data points to a relatively ordinary year for flu, she said.

One possible exception to the normal pattern is that influenza B may make a late-season appearance, as it has since the pandemic, Guthmiller said.

A and B are the two major flu subtypes that infect humans. Traditionally, flu B primarily affected children, but now it seems to be making a broader range of people sick after influenza A’s seasonal peak, she said.

“We don’t really understand why,” Guthmiller said.

Dr. Michelle Barron, senior medical director of infection prevention and control at UCHealth, agreed that the flu season is likely to be relatively normal, but cautioned that significant numbers of people still get sick even in an ordinary year. About 20,000 to 25,000 Americans, mostly older adults and young children, die during a typical flu season, she said.

“Typical is good, in that it’s probably not going to overrun our (health care) resources,” she said.

Experts were less sure what to expect from COVID-19. , and have leveled out since mid-August. As of Tuesday, 146 people were in Colorado hospitals for the virus, which was higher than at the same point last year, but lower than in early September 2022.

If a significant number of people had the virus recently, that could mean the population has some immunity heading into the fall, when it typically spreads more widely, Barron said. But since the state and federal government are no longer tracking COVID-19 as closely, no one really knows how many people had a recent infection, she said.

“COVID’s still my wild card,” she said.

Outpatient visits for COVID-19 went up over the summer, and Dr. Amy Duckro, an infectious disease specialist at Kaiser Permanente Colorado, said she wouldn’t be surprised if they continue increasing through the fall. RSV and flu typically come later, so she doesn’t know what to expect from them yet based on clinic visits. Colorado doesn’t start tracking flu and RSV until October.

“It’s really difficult to predict what any respiratory season will bring, so the best thing you can do is be prepared,” she said.

Guthmiller, with the CU School of Medicine, agreed that a continuation of the late-summer COVID-19 wave is more likely than a drop-off at this point. While predicting what the virus will do is never easy, it looks likely to peak around the end-of-year holidays, as it usually does, she said.

The CDC forecasted two possible scenarios: one where COVID-19 cases keep rising and peak in early fall, and another where the summer wave is peaking now, and a second wave follows in the winter. Right now, the second scenario looks more likely, but they likely would produce similar amounts of severe illness and death, said Beth Carlton, chair of environmental and occupational health at the Colorado School of Public Health.

“What we really care about now is peak hospital demand across the three viruses,” to ensure the health care system can care for everyone who needs a bed, she said. “And then it’s, how we prevent people from becoming acutely ill or dying, and that’s vaccination, vaccination, vaccination.”

None of the experts predict anywhere close to the level of hospitalizations and deaths in the first years of the pandemic, unless an evolutionary leap produced a radically different variant. Other possibilities that would cause trouble include extremely low vaccine uptake, or the avian influenza currently circulating in cows , Carlton said.

RSV also appears likely to have a more-normal year after two abnormal seasons. Infections with RSV spiked in 2022 when children who hadn’t had their first infection during the period of masking and social distancing got it, alongside younger kids who would have gotten it anyway during that time, said Dr. Kevin Messacar, an infectious disease specialist at Children’s Hospital Colorado. Infections also were higher than usual last year, but not as high as in 2022.

“In 2023, we started to see a slow return toward normal,” he said. “We’d expect this year is going to look like a more typical RSV year.”

Relatively new shots to prevent RSV could be a “game-changer” for infants, who are at the highest risk of severe disease, Messacar said. The shots debuted last year, but because they arrived late in the season, he said.

Women who are between 32 and 36 weeks of pregnancy and will give birth during RSV season can get vaccinated and pass the antibodies to their babies prenatally, Messacar said. When that timing doesn’t work out, or if the baby was born prematurely and the antibodies didn’t have a chance to transfer, they can get a product of , he said. Kids who are at high risk of severe illness can also get the antibody drug during their second RSV season.

The virus frequently hospitalizes babies, because their tiny airways become inflamed and they need oxygen, Messacar said. In healthy adults and older children, it typically causes colds.

RSV “tends to fill up our hospitals with children needing respiratory support… and sometimes hydration,” he said.

Overall, it appears that the viruses are settling back down after the pandemic’s peak and measures to fight COVID-19 threw off their normal cycles, UCHealth’s Barron said. But even before COVID-19, viruses and bacteria would sometimes behave in unexpected ways, so people working in infectious disease have to be prepared in case they end up facing a worse-than-expected season, she said.

“It’s kind of like horse racing,” she said. “Occasionally, the long shot shows up.”

The Centers for Disease Control and Prevention recommend that everyone 6 months and older get an annual flu shot and the vaccines for COVID-19.

The , with vaccination recommended for people over 75; those between 60 and 74 who have chronic conditions; and women between 32 and 36 weeks of pregnancy who will deliver during RSV season. Anyone who got the RSV shot last year doesn’t need another one, unless they became pregnant again and need to pass protection to a new baby.

People get the best immune response if they space out their flu and COVID-19 shots, but they need to consider if they will return to get another vaccine, or if they’re likely to forget or get busy, said Jenna Guthmiller, an assistant professor of immunology and microbiology at the University of Colorado School of Medicine. She didn’t specify how far to space them out.

The shots are safe to get together.

“If it’s convenient for you to get them all at the same time, just do it,” she said. “Some protection is better than no protection.”

Ideally, people would get their shots around late October, since the flu typically takes off in the state near the end of the year, Guthmiller said.

Not everyone agrees that waiting is the best plan.

While some people like to time their shots closer to the holidays, getting them early ensures people won’t get sick or pass the viruses to others during the early weeks of respiratory season, said Dr. Amy Duckro, an infectious disease specialist at Kaiser Permanente Colorado. She personally likes to get the flu and COVID-19 shots together, so as to only have side effects once a year.

“I’d recommend getting them as soon as you can. It does take some time for immunity to develop,” she said.

Given the high amount of COVID-19 circulating right now, the best thing is to get that shot as soon as possible, said Beth Carlton, chair of environmental and occupational health at the Colorado School of Public Health. For flu, people should get adequate protection as long as they get the shot before Halloween, she said.

Last year, , while the number of people getting COVID-19 vaccines dropped. , which typically causes colds but can be deadly in infants and older people.

So far, uptake of the new flu and COVID-19 shots has been relatively strong, said Jessica Chenoweth, who oversees 17 CVS pharmacy locations along the Front Range. She isn’t sure what changed to revitalize people’s interest.

“It feels on-pace to what I’ve seen in previous years,” she said.

People who got a COVID-19 booster during the summer wave should wait two months before getting their next dose, though they could get the flu shot earlier if they want, Chenoweth said. Generally, though, she recommends getting all seasonal vaccines at once, to avoid forgetting one.

Some people who got the COVID-19 vaccine for free last year will have to pay out of pocket this fall. The Bridge Access program, which paid for COVID-19 vaccines for uninsured people, , but the CDC said it would allocate $62 million for state and local health departments to buy vaccines they can give out for free.

Chenoweth said the shot costs about $200 if an uninsured person pays cash. Nearly all insurance plans cover them.

The flu and COVID-19 vaccines change each year, to try to match the dominant variants. RSV doesn’t evolve as quickly, so the vaccine is the same one that rolled out last year.

For the first time in a decade, the , rather than four. The influenza B Yamagata strain hasn’t shown up in testing since March 2020, and flu manufacturers dropped it from the vaccine this year. Unlike influenza A strains, flu B only circulates in people, so when respiratory virus transmission plummeted early in the pandemic, the Yamagata strain apparently couldn’t survive, said Guthmiller, the CU researcher.

“There’s a strong belief that it’s gone extinct,” she said.

The updated Pfizer and Moderna COVID-19 vaccines teach the body to make the spike protein from the KP.2 variant of the virus, which is a . When the body sees the spike, it develops antibodies against it, reducing the risk a person will get sick if they encounter the actual virus. The disembodied spike proteins produced after vaccination can’t give anyone the virus, though some people feel tired or achy because of their immune response.

The , which injects the spike protein directly, is based on the JN.1 variant, which .

In addition to getting vaccinated, people can protect themselves and others by staying home if they feel sick, washing their hands frequently, practicing general healthy habits and wearing masks in crowded spaces if they feel comfortable doing that, Duckro said.

“We certainly wouldn’t want to rely on vaccines entirely,” she said.

typically start spreading in the fall and peter out by spring. In Colorado, the worst points of the pandemic , but COVID-19 hasn’t disappeared in the warmer months, as flu does.

Four years ago, at the beginning of the pandemic, scientists expected the virus would be well on its way to settling into a seasonal pattern by now, said Talia Quandelacy, an assistant professor of epidemiology at the Colorado School of Public Health.

Now, they’re less sure whether COVID-19 will eventually do that, or if it can keep churning out new variants fast enough to remain active year-round, she said.

“That’s one of the big questions in the field,” she said.

Colorado’s most recent  showed concentrations of the virus increasing in three-quarters of the 55 utilities statewide that supplied information. The state’s wastewater data doesn’t indicate how widespread a virus is, but it can show whether that particular infection is becoming more or less common.

The number of Colorado watersheds showing an increasing pattern has gradually risen since early May, when none were.

The number of new COVID-19 cases reported to the state also has trended upward since mid-May, though since relatively few people get tested in facilities that report results, the figure isn’t a reliable indicator of how many Coloradans actually got sick.

Nationwide, the percentage of tests coming back positive, emergency department visits for the virus and COVID-19 deaths all have risen in recent weeks, Quandelacy said.

Hospitalizations ticked up nationwide, rising about 36% from their low point in May, before flattening in early June. They remain low, however, with about , compared to a rate of 7.7 per 100,000 people last winter. The Centers for Disease Control and Prevention no longer requires all hospitals to disclose how many COVID-19 patients they’re treating, and only about one-third do voluntarily, making the number of patients significantly fuzzier than it was earlier in the pandemic.

Data on the percentage of tests coming back positive, prevalence in wastewater and emergency room visits also indicate whether the virus is becoming more or less common, but don’t allow for exact comparisons to previous years.

Unlike in some previous waves, this one isn’t the result of , Quandelacy said. Rather, KP.3, KP.2 and LB.1 combined have dethroned JN.1, which dominated during the winter and early spring. All are descendants of omicron and appear to be . Some epidemiologists group the three together under the term “FLiRT” variants, based on a shortening of the technical terms for their mutations.

“I think it does have to do with these new variants,” she said. “Having all of these circulating together means we’re more likely to have infections.”

In Colorado, rates of COVID-19 remain low, with 87 people hospitalized with the virus statewide as of Tuesday, though infections have increased slightly in recent weeks, said Kayla Glad, spokeswoman for the Colorado Department of Public Health and Environment.

At the low point at the end of April, 75 people were in Colorado hospitals for the virus. The shifting variants could be a factor, but other possibilities include summer travel, people spending more time indoors as the weather heats up and waning immunity, she said.

Also, most people haven’t had a COVID-19 vaccine in a year or longer, Quandelacy said. While protection against severe illness lasts longer, immunity to infection starts to wane within months.

People who didn’t get boosters in the fall or winter should consider one now, particularly if they are at higher risk of severe illness, Quandelacy said. The Centers for Disease Control and Prevention recommended that everyone six months and older receive the latest COVID-19 shot when it becomes available, but that won’t be for at least another three months, she said.

“I think it’s still a good call to get the booster if it’s been a while,” she said.

Wearing masks in indoor public places also will reduce the risk of getting the virus, Quandelacy said. People who feel like they might have the flu or a cold should test for COVID-19, and if they have it, they should stay home until their symptoms resolve, she said.

While most people no longer treat COVID-19 as a threat, the virus hospitalized about 916,000 people and killed about 76,000 in 2023, including 626 people in Colorado.

While the odds of developing long COVID seem to have fallen over time, the debilitating, chronic symptoms that can follow a routine infection remain a risk, Quandelacy said.

“It’s still an infection that has longer-term consequences that we want to prevent,” she said.

U.S. Rep. Ken Buck, a Windsor Republican, is with California Democrat Ted Lieu to create a national commission focused on regulating the technology and another bill to keep AI from unilaterally .

Sen. Michael Bennet, a Democrat, has publicly urged the leader of his caucus, Majority Leader Chuck Schumer, to carefully consider the path forward on regulating AI — while warning about the lessons learned from social media’s organic development. Sen. John Hickenlooper, also a Democrat, chaired a subcommittee hearing last September on the matter, too.

“We are intimately aware that even seemingly innocuous digital products can have deeply damaging effects on mental health, civic discourse, democratic legitimacy and Americans’ economic agency,” Bennet to Schumer in late summer. “Repeating our oversight failure when it comes to more powerful technologies like AI would be disastrous.”

No proposed regulations have found footing in Congress yet — where almost nothing happens fast, even in more cooperative times — but the focus shows it may not be that way for long. Already, has reached a deal on how to regulate AI, and the has turned an eye toward the technology, too.

Inside Colorado, state lawmakers, with the backing of Secretary of State Jena Griswold, likewise have previewed legislation aimed at regulating AI’s use in election campaigning.

“Artificial intelligence represents a huge turning point in our history, and we must act to protect our elections,” Rep. Junie Joseph, a Boulder Democrat, said during a news conference Thursday in Denver.

Concerns about the future of AI run the gamut, from how it could be used to influence elections to potential economic disruptions to an apocalyptic nuclear weapons scenario.

But it also has significant potential upsides, including its usefulness in reading medical scans to identify irregularities, as an educational tool and other yet-to-come innovations.

“When the Industrial Revolution happened, there was a real change in our society,” Buck said in an interview. “When the internet came around, it was a real change in our society. And so this is something that is going to create a lot of difficulties and it’s hard to identify right now what some of those are going to be.”

Reining in Big Tech?

Buck said he turned his attention to AI as he looked into Big Tech and whether its major players needed to be reined in. Many of the companies behind everyday internet, including Facebook’s parent company, the social media platform X and Google’s parent company, are also developing AI tools.

He emphasized that he doesn’t want to stop innovation in the field, but make sure to prevent potential harm to Americans, similar to how he doesn’t want to shut down search engines but does want to make it hard for people to access information like how to build bombs or harm themselves.

Daniel Weiner, director of the Brennan Center’s Elections and Government Program, warned that “the early 2020s will likely be remembered as the beginning of the deepfake era in elections,” using the term for audio and video that����ap been manipulated with artificial intelligence.

He goes on to cite elections far and near where AI-generated fakes have made the rounds. In Slovakia, they to a pro-Western political party’s narrow loss to a pro-Russia faction; in the United States, Florida Gov. Ron DeSantis’ presidential campaign last year released a fake video in which former President Donald Trump kissed former National Institute of Allergy and Infectious Diseases Director Anthony Fauci on the nose, .

And the New Hampshire attorney general’s office announced Monday that it was investigating a robocall ahead of its first-in-the-nation primary that apparently to mimic President Joe Biden’s voice and discourage residents from voting.

“Advances in generative AI have become a real force multiplier,” Weiner said in an interview, referring to the AI used to generate media. “Photoshop and low-tech manipulation have been with us forever. Those sorts of dirty tricks are nothing new. But the way AI and synthetic content can be generated and distributed. … The potential in a very fraught political time for this technology to sow chaos is huge.”

Simply banning that use of the technology is off the table, because some of it can be used for satirical purposes, or for political commentary that����ap protected by the First Amendment, Weiner said. Other uses fall into a distinctly gray area, such as if an AI-generated video made a digital clone of Trump read tweets that were legitimately sent from the former president����ap social media accounts.

Weiner, for his part, thinks the most elegant solution is clear: prominent, mandated watermarks on AI-generated media. Bennet made a similar point in his letter to Schumer, and it’s the main thrust of he introduced last spring.

Worries about stifling innovation

But that����ap just one showy way that AI might can disrupt society.

Weiner said he was just as worried about election officials using AI for things like routine verification of voter rolls without guardrails to keep the machines from removing voters inappropriately.

While Weiner’s specialty is election law — and he notes political campaigns are already pretty heavily regulated — he also acknowledged the desire for a “light regulatory touch” broadly to not stifle innovation or put U.S. industry at a disadvantage.

He said Buck and Bennet are “among the group of members taking a leadership role” on artificial intelligence broadly. His organization hasn’t taken an official position on their efforts to put together a commission to study the matter, but he called it “generally a good idea.”

He noted that, absent congressional action, Biden has also issued to establish safety and security protocols while protecting Americans’ privacy.

“It’s urgent to start developing solutions,” Weiner said. “It’s also not smart to think you’re going to come up with one round of policy solutions and be done.”

Buck, who announced last fall that he wouldn’t seek reelection in 2024, agreed with that sentiment. As AI progresses, so will Congress’ need to revisit it and its capabilities, he said. In addition to just regulating it for security and health purposes, it’s also about keeping America economically competitive both internationally and internally.

“You’re going to have a whole lot of people in the have-not category, and some people in the have category,” Buck warned. “Some people who understand the technology, (who) have been trained and have used the technology, and a whole of people who aren’t. That is going to create a wealth disparity in this country and that really undermines one of the strengths of our society, our middle class.”

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