University Covid-19 Vaccine Mandates Should Be Rescinded
Updated
How many university students are dispensable?
What criteria are university officials using to mandate Covid-19 vaccines[i] and boosters? If Covid-19 vaccines cause harm, surely higher education institutions must determine the aggregate acceptable harm to students when making vaccination policies. Over 1,000 universities and colleges require the original vaccine sets and over 300 require the boosters to attend school (“Colleges Require Covid-19 Vaccine,” 2022). The authors (Bardosh et al., 2022) of an analysis published in BMJ’s Journal of Medical Ethics discuss the ethicality of mandating Covid-19 boosters for university students: they find in order to avoid one hospitalization in the college cohort, 31,207 to 42,836 young males must be boosted, resulting in 1.5 to 6.3 cases of myopericarditis, harming up to sixfold more than it saves, and precipitating an estimated 18.5 serious adverse events (SAEs).
Frightening as these estimates are, this calculated harm is likely a gross undercount as the hospitalization numbers come from clinical trial data reported by the Centers for Disease Control (CDC), V-Safe Data and peer-reviewed data from large health systems that include incidental covid positive patients. According to one of the authors of the analysis, Allison Krug (2022) explains on Twitter: “The CDC’s hospitalization numbers include 40-60% incidental findings of COVID. We did not exclude these hosp estimates in the baseline NNV we used, erring on the conservative side. CDC also did not include prior inf. The net harm we estimate is likely an *under*estimate.”
This under-estimate of net harm may also be complicated by whether the long-term consequences of covid hospitalizations in this cohort are as life-defining and damaging as myopericarditis or other SAEs from the vaccine. If the potential for harm is this blatant, are U.S. universities weighing risk-benefit ratios when making Covid-19 vaccine policy or are they accepting the “safe and effective” robot speak without doing their due diligence?
What is the ethical argument for vaccine mandates?
The problem here is that there is a real risk of injury, even using the CDC’s own conservative data. If there are any dangers to this medical procedure, one would think that ethically the benefits must outweigh the harm. Bardosh et al. (2022) explain that the strongest argument for vaccine mandates is when “vaccines prevent transmission and thereby reduce harm to others, [and] restrictions on individual freedom are [then]viewed as more ethically justifiable.” The authors assert that even preventing transmission alone is not enough for mandates, and explore four conditions (Savulescu, 2021) that must be met in order for vaccines to be considered ethically compulsory:
1. There is a grave threat to the public health
2. The vaccine is safe and effective
3. Mandatory vaccination has a superior cost/benefit profile compared with other
alternatives
4. The level of coercion is appropriate.
What threat does covid pose to college students?
Bardosh et al. (2022) state there is a lack of evidence that young adults need a vaccine to prevent hospitalization as their cohort suffers minimally from covid. A recent study published in Environmental Research (Pezzullo et al., 2022) finds the Infection Fatality Rate (IFR) for 0-19 year olds is 0.0003% and 20-29 year olds is 0.002%, which is somewhere between 1 in 330,000 and 1 in 50,000, much less risk than the National Safety Council estimates of dying from electrocution at 1 in 14,705 or opioid overdose at 1 in 67 or heart disease at 1 in 6 (Injury facts, 2020).[ii] It was clear from the beginning that SARS-CoV-2 was an illness that would mostly affect at-risk populations like the elderly and the immune-compromised, not college students, but the push to get the jab to avoid long Covid and “save grandma” was ubiquitous on mainstream news and social media.
The threat of long Covid
The authors (Bardosh et al., 2022) conclude that college students are not at risk for SARS-CoV-2 complications and that vaccination is not an effective tool to prevent long Covid. They cite a study in Nature Medicine (Al-Aly Z., Bowe B., & Xie Y., 2022) that emphasizes vaccinations should not be “a sole mitigation strategy” for preventing post-acute sequelae of SARS-CoV-2 infection (PASC), or long Covid complications, because the data do not support a huge difference between breakthrough infections and acquiring Covid-19 without vaccination. Because this age group is not at risk from infection, the vaccines do not reduce potential for long Covid and can cause measurable harm, the ethical criteria for compulsory vaccination is not met.
Does the vaccine “save grandma” aka diminish the public health threat?
But what about doing our part, for grandma? While the need for a vaccine is negligible for the college population, Bardosh et al. (2022) discuss the ineffectiveness of the vaccines to stop transmission, citing the CDC statement that “anyone with Omicron infection, regardless of vaccination status or whether or not they have symptoms, can spread the virus to others,” and several studies showing “limited effects on secondary transmission,” which effectively refutes any grounds for mandates. And Grandma will not be saved by her college-aged grandkid getting a covid vaccine or booster. The authors also reason that these policies ignore immunity from prior infection as most young adults have already been infected with SARS-CoV-2 and have antibodies, and therefore wouldn’t need to be vaccinated to decrease the “threat.”
All the risks and no benefits
Part of the ethical argument Bardosh et al. (2022) explores is proportionality, which “requires that the benefits of a public health policy must be expected to outweigh harms, including harms arising from the restriction of individual liberty and basic human rights such as access to education and employment.” The boosters do not have clear benefits for students and carry real risk of injury with “no transparent legal rout to adequate compensation,” which means the mandates are not proportionate when the consequences are far worse than what they are attempting to prevent (Bardosh et al., 2022). Tufts University recently dropped their bivalent mandate (Covid-19 Vaccine Information), but their policy still requires both the original sets and the boosters and prohibits any noncompliers to “study in person on any Tufts University campus. [And] Remote options may be limited” (Tufts COVID-19 Booster, 2023). While most higher ed institutions, including Tufts University, allow for accommodations to vaccine requirements, these medical and religious exemptions have to be approved, and may be denied based on the school’s willingness to accommodate the exemption.
Beyond the “cause and effect” coercion of banning onsite education for noncompliance, many institutions parrot language about vaccination “benefits” with no discussion of potential risk. In the Tufts vaccine FAQs, the answer to “are Covid-19 vaccines safe?” includes vaccines having “met rigorous safety and efficacy standards” by the FDA, and that “neither the Pfizer nor Moderna vaccines have reported any widespread or permanent serious adverse events.” Neither of these statements are givens. And most of the answers in the FAQs do not have citations or attributions to sources, so it would appear that the university itself is acting as an authority on these questions rather than referring students to their doctors for informed consent. And as a resource on the same page, the university includes an outdated document titled “Covid-19 vaccines: What are your concerns?” (2021) written by the Infectious Diseases Society of America (IDSA) to guide frontline staff on how to respond to covid vaccine hesitation. The document includes statements such as: vaccines “prevent almost all people who get them from getting sick with COVID-19. In studies of the people who received the vaccine and got sick, few needed to go in the hospital, and no one died from COVID-19” and “the vaccines do not cause infertility. This is misinformation or information that is not true that is spread on the internet.” These statements also do not include studies or sources to back up their claims. This coercive propaganda is especially damaging for fresh college students getting their footing into adulthood.
Bardosh et al. (2022) shows that mandating covid boosters for university students is unethical because even at the base of the argument—that they prevent transmission—it falls flat. Beyond that, the vaccines and boosters have little, if any, benefit to the individual and can cause events like myopericarditis and death. These mandates must be rescinded. In the best case scenario, higher ed institutions are negligent in doing their due diligence in researching their own medical policies and at worst, they knowingly put their students at risk of serious harm or death.
References
Al-Aly, Z., Bowe, B. & Xie, Y. Long COVID after breakthrough SARS-CoV-2 infection. Nat
Med 28, 1461–1467 (2022). https://doi.org/10.1038/s41591-022-01840-0
Bardosh, K., Krug, A., Jamrozik, E., et al. Covid-19 vaccine boosters for young adults: a risk
benefit assessment and ethical analysis of mandate policies at universities. Journal of
Medical Ethics (2022, December 5). doi: 10.1136/jme-2022-108449
Covid-19 immunization record requirement for students. 10.3.14 (2021, November 2). Rutgers.
https://policies.rutgers.edu/view-policies/academic-%E2%80%93-section-10#3
Covid-19 vaccines: What are your concerns? (2021) IDA & HIVMA. Tufts University.https://www.idsociety.org/globalassets/idsa/public-health/covid-19/covid-19-talking-points-for-frontline-staff-final2.pdf
Krug, A. [@KrugAlli]. (2022, December 8). The CDC’s hospitalization numbers include 40-
60% incidental findings of COVID [Image attached] [Tweet]. Twitter. https://twitter.com/KrugAlli/status/1601076054881234944?ref_src=twsrc%5Etfw
Odds of Dying. (2020) National Safety Council: Injury Facts. https://injuryfacts.nsc.org/all-
injuries/preventable-death-overview/odds-of-dying/
Pezzullo, A., Axfors, C., Contopoulos-Ioannidis, D., Apostolatos, A., & Ioannidis, J. Age-
stratified infection fatality rate of COVID-19 in the non-elderly population. Environmental Research 2023; 216(3): 114655. https://doi.org/10.1016/j.envres.2022.114655.
Tufts University Covid-19 Booster Policy for Students (2023). University Infection Control
Health Director, Office of the Executive Vice President. Tufts University. https://tufts.app.box.com/s/w6kh8r5k42c1by5loy5wk0wz73s44e9s
What colleges require the COVID-19 vaccine? (2022, Sept. 9) Best Colleges.
https://www.bestcolleges.com/news/2021/10/11/list-of-colleges-that-require-covid-19-vaccine/#colorado
[i] Even though these injections cannot technically be termed vaccines as they don’t prevent transmission, this discussion will refer to them as such for congruent public terminology.
[ii] Please note that the National Security Council gets its data from the National Center for Health Statistics, using ICD codes
