COVID-19 Vaccine Boosters for Young Adults

COVID-19 Vaccine Boosters for Young Adults: A Risk-Benefit Assessment and Five Ethical Arguments against Mandates at Universities

50 Pages Posted: 12 Sep 2022
Kevin Bardosh

University of Washington; University of Edinburgh - Edinburgh Medical School
Allison Krug

Artemis Biomedical Communications LLC
Euzebiusz Jamrozik

University of Oxford
Trudo Lemmens

University of Toronto - Faculty of Law
Salmaan Keshavjee

Harvard University - Harvard Medical School
Vinay Prasad

University of California, San Francisco (UCSF)
Martin A. Makary

Johns Hopkins University - Department of Surgery
Stefan Baral

John Hopkins University
Tracy Beth Høeg

Florida Department of Health; Sierra Nevada Memorial Hospital

Date Written: August 31, 2022
Abstract

Students at North American universities risk disenrollment due to third dose COVID-19 vaccine mandates. We present a risk-benefit assessment of boosters in this age group and provide five ethical arguments against mandates. We estimate that 22,000 - 30,000 previously uninfected adults aged 18-29 must be boosted with an mRNA vaccine to prevent one COVID-19 hospitalisation. Using CDC and sponsor-reported adverse event data, we find that booster mandates may cause a net expected harm: per COVID-19 hospitalisation prevented in previously uninfected young adults, we anticipate 18 to 98 serious adverse events, including 1.7 to 3.0 booster-associated myocarditis cases in males, and 1,373 to 3,234 cases of grade =3 reactogenicity which interferes with daily activities. Given the high prevalence of post-infection immunity, this risk-benefit profile is even less favourable. University booster mandates are unethical because: 1) no formal risk-benefit assessment exists for this age group; 2) vaccine mandates may result in a net expected harm to individual young people; 3) mandates are not proportionate: expected harms are not outweighed by public health benefits given the modest and transient effectiveness of vaccines against transmission; 4) US mandates violate the reciprocity principle because rare serious vaccine-related harms will not be reliably compensated due to gaps in current vaccine injury schemes; and 5) mandates create wider social harms. We consider counter-arguments such as a desire for socialisation and safety and show that such arguments lack scientific and/or ethical support. Finally, we discuss the relevance of our analysis for current 2-dose CCOVIDovid-19 vaccine mandates in North America.

Note: Funding: This paper was partially supported by a Wellcome Trust Society and Ethics fellowship awarded to KB (10892/B/15/ZE) and Wellcome Trust grants to EJ (216355, 221719, 203132).
Competing Interest Statement: We do not have any competing interests to declare.

Keywords: COVID-19 vaccines, mandates, ethics, young adults, risk-benefit analysis

Source and full paper:
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4206070

cooler

6 Likes

Coupla comments—

First, the post should be tagged OT.

Also, a point about the content.
The abstract notes “we find that booster mandates may cause a net expected harm”.
To which group? To the group whose vaccinations are being considered, or including the wider population of those that would be incrementally infected in the absence of the mandate in question?
The point of a vaccine is not wholly to prevent disease in the person being vaccinated, after all.

I’m not saying what I think the right answer is in terms of mandates, just pointing out that it seems like they’re not thinking clearly.

After all, ALL vaccines with wide deployment have a net expected harm to the marginal person.
That’s because wide deployment means there isn’t a pandemic level disease burden on the population.
Without a material disease exposure risk, the marginal person gets no benefit while bearing the (very small) vaccine downside risk.
However, the program as a whole, rather than at the level of the marginal person, has a huge net benefit.
The calculus for the individual is the reverse of the calculus for the set of all individuals.

One person burning their garbage in then back yard isn’t really a big deal for air pollution death rates.
But it’s a big deal if everyone does it. That’s presumably why it’s prohibited.

Similarly, one person skipping a vaccination (rubella, say) the impact isn’t a big deal.
But it’s a big deal if everyone does it.
Remembering the latter makes it clear that the former amounts to statistical attempted manslaughter.
And advocating skipping vaccines based on self interest reasoning is just a larger scale version of the same crime.
Less statistical as the incremental deaths become countable.

If we all pay a penny, we all gain a pound.
But if a bunch of people don’t chip in, lots of people lose everything.
I’m willing to chip in. Who wouldn’t?

Jim

51 Likes

The abstract notes “we find that booster mandates may cause a net expected harm”.
To which group? To the group whose vaccinations are being considered, or including the wider population of those that would be incrementally infected in the absence of the mandate in question?
The point of a vaccine is not wholly to prevent disease in the person being vaccinated, after all.

They do acknowledge that a certain amount of harm to the vaccinated students (point 2) might be justifiable if the ‘public health benefits’ (they mean, benefits to others) were present:

From the abstract:
2) vaccine mandates may result in a net expected harm to individual young people; 3) mandates are not proportionate: expected harms are not outweighed by public health benefits given the modest and transient effectiveness of vaccines against transmission;

From the text of the article:
To be ethically acceptable, such severe restrictions of individual liberty need to be justified not only by an individual benefit but by the expectation that vaccination reduces harm to others. Booster doses of Covid-19 vaccines provide no lasting reduction in the probability of infection or transmission (references 27-29)

What they are basically saying is that vaccinating college students provides little to no benefit to the rest of society. If you are pretty sure to get infected by COVID anyways, even if college students and others are all vaccinated, then vaccination against COVID becomes a matter of protecting one’s own health, not the health of others, and people should be allowed to make their own choices.

If we all pay a penny, we all gain a pound.
But if a bunch of people don’t chip in, lots of people lose everything.
I’m willing to chip in. Who wouldn’t?

I don’t think anyone seriously believes that, even with 100% vaccination rates, we can stop SARS-CoV-2 from circulating, so this argument falls flat. It works for other vaccinations, like against measles or polio, where high rates of vaccination DO practically eliminate these viral infections as threats to others, but it doesn’t work for COVID.

dtb

8 Likes

“If we all pay a penny, we all gain a pound.
But if a bunch of people don’t chip in, lots of people lose everything.
I’m willing to chip in. Who wouldn’t?”

How true.
And yet, it is also how I can slip into pessimism over our collective future. Coercion won’t work.

CDC Director Admits Agency Gave False Information on COVID-19 Vaccine Safety Monitoring

The director of the Centers for Disease Control and Prevention (CDC) has acknowledged publicly for the first time …

https://www.theepochtimes.com/cdc-director-admits-agency-gav…

3 Likes

DetroitBadBoy: CDC Director Admits Agency Gave False Information on COVID-19 Vaccine Safety Monitoring

The director of the Centers for Disease Control and Prevention (CDC) has acknowledged publicly for the first time …

https://www.theepochtimes.com/cdc-director-admits-agency-gav…

Did she?

Her letter seems to say that rather than using proportional reporting ratio analysis, the CDC used Empirical Bayesian data mining, “a more robust technique used to analyze disproportionate reporting” to mitigate false signals.

The CDC “Vaccine Adverse Event Reporting System Standard Operating Procedures for COVID-19” referenced in your link states that: CDC will perform PRR data mining on a weekly basis or as needed.

But also that the… FDA will perform data mining at least biweekly (with stratified data mining monthly) using empirical Bayesian data mining to identify AEs reported more frequently than expected following vaccination with COVID-19 vaccines, using published criteria.

Perhaps I’m wrong but it seems as though The Epoch Times and senator Johnson are trying to make something out of nothing.

Finally, here’s what Media Bias Fact Check has to say about The Epoch Times: “Overall, we rate The Epoch Times Right Biased and Questionable based on the publication of pseudoscience and the promotion of propaganda and conspiracy theories, as well as numerous failed fact checks.”

https://mediabiasfactcheck.com/the-epoch-times/

42 Likes

https://www.theepochtimes.com/unethical-and-up-to-98-times-w…

The "ol fact checker trick

3 Likes

https://twitter.com/P_McCulloughMD/status/156982030967450828…

Dr Peter McCullough. NOT a lightweight.

7 Likes

Is there perhaps a better board to post crackpot conspiracy theories?

Asking for a friend.

37 Likes

Is there perhaps a better board to post crackpot conspiracy theories?

Is there perhaps a better way to convince intelligent people of your viewpoint than ad hominem attacks?

8 Likes

Not a light weight at what? BS?

Lawsuit: Doc Using Old Baylor Affiliation While Dishing COVID Vax Falsehoods
— Baylor Scott & White Health says Peter McCullough, MD, used former title during media interviews

“McCullough has also come under fire for promoting the use of hydroxychloroquine to treat COVID-19. A group of clinicians from Doctors for America, a nonprofit physician organization, wrote in the Dallas Morning News last December that they were “deeply concerned after hearing the baseless, misleading commentary” from McCullough, in which he promoted the use of the antimalarial drug for early outpatient COVID-19 care. Randomized controlled trials have repeatedly shown that hydroxychloroquine is not effective to treat or prevent COVID-19, the physicians said.”
–MedPage Today

Joe Rogan interview with Peter McCullough contains multiple false and unsubstantiated claims about the COVID-19 pandemic and vaccines
–Health Feedback
Help us create a more trustworthy Internet!

2 Likes

Is there perhaps a better way to convince intelligent people of your viewpoint than ad hominem attacks?

I didn’t attack anyone personally. Roll the tape if you don’t believe me. The only point I made is that some other board would be better for these types of discussions than this one. I’m not trying to convince anyone of my viewpoint. I’m not saying don’t talk about it. I’m simply saying this is the wrong venue.

13 Likes

I didn’t attack anyone personally.
You really think that? My simple logic tells me that saying “to post crackpot conspiracy theories” means someone "post"ed something you call “crackpot conspiracy theories”. And this is no personal attack on that someone?

5 Likes

https://expose-news.com/2022/09/04/real-reason-moderna-suing…

“Official Documents confirm real reason Moderna is suing Pfizer: Moderna created & patented COVID Virus in 2013 following Gain of Function Research which allowed Moderna to develop COVID Vaccine before World knew COVID-19 existed.”

1 Like

DetroitBadBoy exhibited a serious lack of vetting of his news sources as he posted a conspiracy theory claiming that research ‘proved’ Moderna created the Covid-19 virus.

‘The Expose’ is not a serious news organization and have been banned from a lot of social media for spreading falsehoods on important topics.

The Agence France Presse (AFP) debunked the current conspiracy theory here:

https://factcheck.afp.com/doc.afp.com.326Q8PG

They spoke to Yale School of Medicine immunobiology professor Craig Wilen.

"
Given that the SARS-CoV-2 genome is about 30,000 nucleotides long, Wilen said that “the idea that a 19-nucleotide sequence overlap proves anything is complete nonsense.”

Scott Kenney, a virology professor at the Ohio State University College of Veterinary Medicine, said the odds of Moderna having created the virus are “much less” than the probability that the match occurred naturally.

Referring to the genome of Covid-19 and Moderna’s patented sequence, he said: “The authors’ stretch to connect the two subjects is quite dubious.”

"

19 Likes