University-age vaccine mandates: reply to Lam and Nichols

• Published in: Journal of medical ethics 2024-02, Vol.50 (2), p.143-145
• Main Authors: Høeg, Tracy Beth, Krug, Allison, Baral, Stefan, Jamrozik, Euzebiusz, Keshavjee, Salmaan, Lemmens, Trudo, Prasad, Vinay, Makary, Martin A, Bardosh, Kevin
• Format: Article
• Language: English
• Subjects: Age groups; Colleges & universities; Coronaviruses; COVID-19 vaccines; Disease transmission; Ethics; Ethics- Medical; Hospitalization; Humans; Infections; Males; Mandatory Vaccination; Medical ethics; Myocarditis; Public Health; Public Policy; Response; Severe acute respiratory syndrome coronavirus 2; Universities; Vaccination; Young adults
• ISSN: 0306-6800; 1473-4257
• DOI: 10.1136/jme-2023-109163

Furthermore, myocarditis is associated with an increased risk of sudden cardiac death later in life14 and this should not be trivialised especially when benefits of this booster are questionable and poorly defined owing to increased infection-derived immunity and lack of randomised data of booster effectiveness against severe disease in this age group. [...]contrary to the statements by Lam and Nichols, we did not use booster myocarditis rates from the Vaccine Adverse Event Reporting System (VAERS), which has consistently underestimated the true rate of postvaccination myocarditis, as noted by Witberg et al.15 Our highest estimated rates of postbooster myocarditis among males in this age group were from the Centers for Disease Control and Prevention (CDC)’s Vaccine Safety Datalink16 and from the Israeli Military.17 Finally, the respondents state: ‘The referenced studies,6 8 9 14 especially those on myocarditis, all concluded that the benefit of vaccination outweighs the risk of a COVID infection, let alone ones that require hospitalisation’. [...]none of the articles conducted a risk–benefit analysis, with the exception of one18 comparing postinfectious to postvaccination myocarditis rates, and thus could not and did not attempt to make generalisations about overall risks versus benefits. Conclusion In conclusion, we have given a fair representation of the expected harms of the booster dose for young people and provided a conservative overestimate of the benefits of the booster dose against severe COVID-19 in this age group. [...]far vaccination has not been shown to prevent future severe disease in those with infection-derived immunity and this is currently estimated to be over 93% of first-year college-aged people in the USA.25 The benefits of the booster in this age group, even to those not previously infected, have not been demonstrated using randomised data.