Analysis suggests Covid-19 boosters likely to cause a net clinical harm to young adults(18-29 yr), where total severe adverse events (SAEs) will outweigh Covid hospitalizations averted
In April, Paul Offit stated in a NEJM editorial:"It is now incumbent on CDC to determine who most benefits from booster dosing & educate the public about the limits of mucosal vaccines"
Over 300 universities & colleges were (as of Sept 2022) mandating boosters across North America (1000 with 2-dose Covid-19 mandates still in place)
Is this a science-based policy?
Is it ethically justified?
3/13
Using CDC/Pfizer data,we estimate 31,207-42,836 previously UNINFECTED adults 18-29 yrs must be boosted to prevent 1 C19 hospitalization over 6 months.But we also estimate 18.5 serious adverse events
Displayed per million boosted:
32 hospitalizations prevented = 593.5 SAEs
4/13
We also anticipate 1,430–4,626 cases of grade ≥3 reactogenicity per C19 hospitalization averted, which prevents people from conducting daily activities.
Displayed per million boosted, here👇 5/13
We anticipate 1.5 to 4.6 booster-associated myopericarditis cases in males (typically requiring hospitalisation) per Covid hospitalization averted.
Displayed per million young adults (18-29) boosted here: 👇
6/13
We then outline 5 ethical arguments against booster mandates at institutions of higher education in North America.
1) The CDC has been negligent and it is incumbent on the agency to conduct an updated Omicron risk-benefit analysis for this age group. 7/13
2) Our analysis (see above) shows the alarming possibility that mandates may result in a net expected harm to young people. This violates the 'do no harm principle.' 8/13
Our estimates assume NO ONE has been infected w Covid. So: real-world benefits likely to be less favourable.
3) Vaccine mandates are not proportionate public policy.
The benefits are unlikely to outweigh the harms by any significant degree to justify liberty restrictions.
Current vaccines do not durably stop transmission.
9/13
4) Booster mandates violate the reciprocity principle.
US vaccine injury schemes are completely inadequate and have failed to provide support for rare but severe Covid-19 vaccine injuries. 10/13
5) Booster mandates have wider social harms.
Students and faculty risk being dis-enrolled or fired.
Mandates have caused backlash, resistance & anger.
This has further damaged the trustworthiness & credibility of scientific institutions/universities. 11/13
We consider counter-arguments against our position, such as a desire to 'socialize' compliance & increase safety on campus
We find these arguments sorely lacking in a scientific or ethical basis.
European countries have more appropriate policies for boosters in young pls
12/13
Lastly, we make the point that although our risk-benefit analysis is focused on boosters in young adults, our analysis is relevant to other university, workplace & school Covid-19 vaccine mandates, esp given high prior infection rate among the US population.
End (@VPrasadMDMPH)
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Do face masks increase social conformity? Yes, based on 10 experiments from China. Masks (supposedly) make u: less likely to run red lights, park a bike in no-parking zones, cheat for money & misbehave in libraries. Wild paper in PNAS, but behind paywall
Prof. Woolhouse=1 of Scotland's most senior ID epidemiologists
🧵/25; my favourite quotes from his book: "The Year the World Went Mad"
"My main aim in writing this book is that lockdown scepticism will become the mainstream view"
"The truth is that we didn't really try to protect the vulnerable. All in all, the under-investment in protecting the vulnerable is one of the most baffling failures of the UK's pandemic response."
"There is comfort in following the crowd even while it is stampeding in the wrong direction. We wouldn't let go of lockdown even after the evidence of the harm it was causing became so compelling that the WHO itself came to reject it."
In April, Paul Offit stated in a NEJM editorial: "It is now incumbent on CDC to determine who most benefits from booster dosing & educate the public about the limits of mucosal vaccines."
"These results raise concerns that mRNA vaccines are associated with more harm than initially estimated at the time of emergency authorization."
"We conducted a simple harm-benefit comparison using the trial data comparing excess risk of serious AESI against reductions in COVID-19 hospitalization. We found excess risk of serious AESIs to exceed the reduction in COVID-19 hospitalizations in both Pfizer and Moderna trials."
@sdbaral Thought experiment: imagine the implications if this statement is true (evidence is still mixed & debated, of course): all the sacrifices, moralizing, grandstanding, harms for naught
The cultural, psychological and political forces against accepting this possibility are massive
& the options are not 'kitchen sink lockdowns' vs 'let-er ripe everyone is infected'. That fictitious dichotomy has caused so much silly harm
I see the debate more between 'aggressive mandates' vs voluntary risk reduction and efforts to address structural vulnerabilities
"The COVID-19 crisis has been one of the defining points in history for economic inequality. The wealth of the richest exploded, rising to unprecedented highs, while at the same time poverty numbers started to rise dramatically for the first time in decades."
"COVID-19 has stretched the finances of governments worldwide to the limit. The cost of the recession caused by the pandemic was immense, and the actions taken to tackle the impacts on people by many governments cost a lot of public money, and drove up levels of public debt."