Around 300 American colleges and universities, according to the website Best Colleges, mandate that students receive some form of a COVID vaccine booster. According to a new study from the Journal of Medical Ethics, whether thinking of the mandates as a matter of overall societal health or ethics, those particular vaccine mandates likely shouldn't exist.
Authors Kevin Bardosh, Allison Krug, Euzebiusz Jamrozik, Trudo Lemmens, Salmaan Keshavjee, Vinay Prasad, Marty A. Makary, Stefan Baral, and Tracy Beth Høeg (from a wide range of academic and medical institutions, but characterized in the paper as a "team of bioethicists, epidemiologists, legal scholars and clinicians") looked at the best available medical study data related to people ages 18 through 29—which covers the vast majority of college students—regarding the danger of COVID infection in 2022 and the dangers boosters may present to that age group.
After calculations whose specifics and citations are given in the full paper, the researchers estimate that in order to prevent one COVID hospitalization over a 6-month period, approximately 31,000 to 42,000 adults in that age group would have to get a third mRNA booster; and that if that many people from that age group get that booster, given the best available knowledge and estimates on how frequently that booster is likely to cause adverse effects, those boosters will generate over 18 "serious adverse events" (SAEs) for that single prevented hospitalization.
Those adverse events would include in that sized group 1.5–4.6 "booster-associated myopericarditis cases in males (typically requiring hospitalisation)" and 1,430 to 4,626 booster-associated health complications that would "interfer[e] with daily activities" but "typically not requir[e] hospitalisation."
The authors' analysis is rooted in propositions they insist should not be controversial any longer given actual evidence: that the latest vaccines "provide, at most, partial and transient protection against infection, which decreases precipitously after a few months" and that, quoting the Centers for Disease Control and Prevention (CDC), "anyone with Omicron infection, regardless of vaccination status or whether or not they have symptoms, can spread the virus to others." They also stress the often unnoted benefits of previous infection for immunity in COVID policy making.
That all works to minimize the "benefit" side of such vaccine booster mandates for college students. On the "cost" side, the researchers rely on many cited medical studies to conclude that "While harms from COVID-19 vaccines are uncommon, they should be factored into policy recommendations….To estimate the expected harms…specific to boosting young adults aged 18–29 years, we used data reported by CDC from phase II/ III clinical trials, peer-reviewed observational data from large integrated health systems, and postmarketing surveillance collected via V-Safe by the CDC."
Three SAEs that they think are reasonably "vaccine related" based on analysis of randomized control trials include "moderate persistent tachycardia, moderate transient elevated hepatic enzymes and mild elevated hepatic enzymes."
The full paper strings out all these points and cites them to the medical studies and sources that justify them at far greater length than this post. Their full analysis leads them to conclude—remember, this is in a journal of medical ethics, not merely medical science—that requiring people in typical college-going age groups to receive COVID boosters is "unethical" in that the mandates are "not based on an updated (Omicron era) stratified risk-benefit assessment for this age group" and "may result in a net harm to healthy young adults" and "are not proportionate: expected harms are not outweighed by public health benefits given modest and transient effectiveness of vaccines against transmission."
The researchers grant many possible gaps or complications in the available data about harms associated with vaccine boosters, including that "our estimates rely on sponsor-reported and CDC summaries of AEs" and they thus "cannot account for failures to report small sample sizes, poor quality evidence subject to serious bias or loss to follow-up during the clinical trials." The particular age groups they are concerned with weren't as highly represented in the existing data as might be optimal, and they note that many SAEs occurred in placebo patients in the original studies as well, which limits the number of such complications that might be attributed with reasonable certainty to the vaccines themselves.
Still, they feel confident that there is enough reasonable inference of net harm from booster mandates that "policymakers should repeal COVID-19 vaccine mandates for young adults immediately and ensure pathways to compensation to those who have suffered negative consequences from these policies. Regulatory agencies should facilitate independent scientific analysis through open access to participant-level clinical trial data to allow risk-stratified and age-stratified risk-benefit analyses of any new vaccines prior to issuing recommendations. This is needed to begin what will be a long process of rebuilding trust in public health."
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