College administrators have a responsibility to review and consider emerging data

Guest post by Dr. Joseph Marine*

A recent article by Dr. Kevin Bardosh and colleagues  published last month in the Journal of Medical Ethics, a subsidiary publication of the esteemed British Medical Journal provides a new analysis which argues against COVID-19 vaccine booster mandates for college students. The article entitled “COVID-19 vaccine boosters for young adults: a risk benefit assessment and ethical analysis of mandate policies at universities” can be accessed here.

Below are 10 key takeaway points:

1.     The authors estimates suggest a net harm from boosters in young adults, whereby the negative outcomes of all serious adverse events (SAEs) and hospitalizations may exceed benefit of hospitalizations from COVID-19 averted.

2.      “It is increasingly clear that current vaccines provide, at most, partial and transient protection against infection, which decreases precipitously after a few months, with limited effects on secondary transmission.”

3.     “By September 2022, the majority of young adults, both vaccinated and unvaccinated, are estimated to have been previously infected with COVID-19.” [In fact, current estimates in December 2022 are that >90% of all Americans have had COVID-19 at least once.]

4.     Several European countries, including UK and Denmark, are no longer recommending  COVID-19 boosters to healthy young people. No European countries mandate the boosters to this population.

5.     The authors “provide an Omicron-specific risk-benefit assessment of booster vaccination for young adults aged 18–29 years for both Pfizer (BNT162b2) and Moderna (mRNA-1273) vaccines.”

6.     For males aged 18-29 years, the authors estimate risk of myopericarditis to be 1 in 7000 based on CDC definitions and databases.

7.     “Thus, to prevent a single hospitalization among young males aged 18–29 years, we estimate between 1.5 and 4.6 occurrences of myo/pericarditis (rates up to 1 in 7000) among males aged 18–29 years.”

8.     “Post vaccination myocarditis has been found to be equivalent to or exceed the risk of post-COVID myocarditis in males less than 40 years old despite the lack of seroprevalence-based estimates of COVID-associated myocarditis. Rare incidences of death in young males attributed to mRNA vaccine-induced myocarditis have also been reported.”

9.     The authors also “present five ethical arguments against university booster mandates informed by our risk-benefit assessment and ethical analysis of mandatory policies to date. These arguments relate to (1) the importance of transparent, peer-reviewed risk-benefit analyses in policy, (2) the potential for net individual harm, (3) the lack of a proportionate public health benefit, (4) the lack of reciprocity in terms of compensation for vaccine-related harms and (5) the wider social harms of vaccine mandates.”

10.  The authors conclude: “Our estimate shows that university COVID-19 vaccine mandates are likely to cause net expected harms to young healthy adults—for each hospitalization averted we estimate approximately 18.5 serious adverse events and 1430–4626 disruptions of daily activities—that is not outweighed by a proportionate public health benefit. Serious COVID-19 vaccine-associated harms are not adequately compensated for by current US vaccine injury systems. As such, these severe infringements of individual liberty and human rights are ethically unjustifiable.”

For a population that has a COVID-19 survivability rate of 99.9997% from 0-19 years and 99.998 % for 20-29 years as per this recent study by Pezzullo et al., and given the analysis in the aforementioned study by Bardosh et al., college administrators have a responsibility to review and consider this emerging data, which indicate that COVID-19 vaccine mandates are no longer justified for college students.

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Joseph E. Marine, MD, is a practicing cardiologist in Baltimore, Maryland, and Professor of Medicine at Johns Hopkins University School of Medicine.