By Eli Vieira
A new article published in the Journal of Medical Ethics concludes that requiring a Covid-19 booster dose in universities is “unethical”.
The nine authors, who are physicians and bioethicists affiliated with 11 institutions in three countries—Canada, the United States, and the United Kingdom—performed a cost-benefit analysis of the dose and concluded that the harms outweigh the benefits.
In addition, the authors believe that compulsory enrollment vaccination, a current requirement in many Brazilian universities, violates the principle of reciprocity and causes widespread social harm.
For every hospitalization prevented by the booster dose, they concluded, 18.5 adverse events are generated by mRNA vaccines.
These events will include up to 4.6 inflammations of the heart and its lining in young men, which usually lead to hospital admissions.
In addition to adverse events, any benefit from avoiding a hospitalization with the dose would also be offset by up to 4,626 side effects that interfere with daily activities, such as body aches.
Mandatory vaccines “have harmful social consequences and are eroding trust in scientific and governmental institutions,” the authors say.
In May of this year, they report that at least 1,000 US higher education institutions requested the Covid-19 vaccination and 300 required the booster dose.
The controversy is particularly with booster doses, which there is a “lack of evidence” that they significantly reduce hospitalizations among healthy adolescents and young adults, in addition to “growing evidence that prior generalized infection confers significant protection against hospitalization due to (re)infection”. .
That is, natural immunity can make these doses excessive.
LIQUID DAMAGES
Researchers acknowledge that the risks of Covid vary by age, co-morbidities and gender. Their analysis focuses on young people who make up the majority of those affected by university requirements and “vaccination passports”.
They note that most countries outside of North America have not implemented mandatory booster doses for university students. In the United States, the main government agencies dealing with this topic are the CDC (Center for Disease Control and Prevention) and the FDA (Food and Drug Administration).
In July 2021, both said booster shots were not necessary. Two months later, a committee of FDA advisors ruled, by a vote of 16 to 2, that it was against promoting healthy youth. But that recommendation was overruled by the White House and the CDC, prompting two senior experts to step down from their FDA posts.
There is a lack, the study says, of cost-benefit analyzes that respect minimum rigor criteria.
Those available lack sufficient safety data and, from the data used by the CDC, lack an update that takes into account natural immunity and the new framework established a year ago by the omicron variant, less lethal than the previous ones.
Sometimes, natural immunity is considered only to be excluded as a confounder in the analysis of the effectiveness of the booster dose, as was done by the CDC in a June publication. In short, there is a lack of data for young people, and – the researchers warn – for children as well.
The CDC has been careless in producing useful numbers, such as the “number needed to harm”—an epidemiological measure of how many people must be exposed to a risk before someone is harmed.
For adolescent males, a Hong Kong analysis calculated this number to be 2,563 for two doses of the mRNA vaccine. Based on the risks, the United Kingdom, Norway, Taiwan and Hong Kong changed their policy to a single dose for the group. The United States and the CDC continued to insist on a booster dose.
The study authors did their cost-benefit analysis of mRNA vaccines for youth ages 12-17 and adults ages 18-29.
In summary, these vaccines are 18 times more likely to cause a serious adverse event (such as myocarditis) than to prevent hospitalization as a group. In young people between the ages of 18 and 24, the third dose of Pfizer was almost four times more likely to inflame the heart and its lining than to prevent hospitalization. In another sample of men aged 18 to 39, it is 4.6 times more likely.
As for other complications that are less serious than myocarditis but still affect daily life, the third dose of mRNA is 1,429 times more likely to cause them than to prevent hospitalizations. For people who have had Covid and recovered, it’s even higher: 2,340 times.
THE ETHICAL ARGUMENT
Liberal philosopher John Stuart Mill argues, in his classic essay on liberty, that authorities can only impose duty on an individual in the name of preventing harm to others, never to compel the individual to do something “for his own good.” .
The argument is known as the harm principle. Translated into the context of vaccines, this means that mandatory vaccines would be justified in the name of protecting the population by preventing transmission to the individual.
However, on a large scale, Covid vaccines have already been shown to be ineffective against the infection.
According to IHME (Institute for Health Metrics and Evaluation at the University of Washington), the effectiveness against omicron infection is 24% for Coronavac, 36% for AstraZeneca and Janssen, 44% for Pfizer and Sputnik and 48% for Moderna. Against serious diseases, their efficacy is all close to or greater than 60%, with the exception of Coronavac, at only 37%.
In this case, there is the individual’s “good for himself,” but the low efficacy against infection and transmission suggests that the principle of harm should not be used to justify mandatory doses.
A factor always ignored by sanitary authoritarianism is the effectiveness of natural immunity acquired from previous infection. In February of this year, the CDC estimated that 64% of adults aged 18 to 49 had antibodies acquired with the infection.
Five months ago, it was 30%. Now it should be an absolute majority. The researchers say that “evidence increasingly shows that previous infection with [the virus] SARS-CoV-2 provides clinical protection at least similar (and possibly more durable) than current vaccines.”
In the valid Qatar studies, vaccination alone and infection alone were equally effective against severe disease: over 70%. In one sample, previous infection was better against severe disease: 91% for natural immunity versus 66% for two doses and 83% for three doses.
However, university vaccination passports ignore protection from previous infection. An exception was Denmark, whose passport accepted natural immunity.
Now, the country has decided that vaccinating children against Covid-19 is not an effective policy and no longer recommends such vaccination for most children. Similarly, the UK now recommends that booster shots be offered, not mandated, only to risk groups.
Furthermore, the protection gained from a booster dose wears off quickly. Effectiveness against hospitalization drops to less than 50% after three or four months.
Against symptomatic disease, it breaks down after ten weeks. In people who have had a previous infection, protection becomes indistinguishable from natural immunity within a few months.
The first author of the analysis is Kevin Bardosh, affiliated with the University of Washington School of Public Health (USA) and the University of Edinburgh School of Medicine (UK).
The leader of the study was Beth Høeg, who works at the clinical data research company Acumen and Sierra Nevada Memorial Hospital in California.
The authors close the article by expanding their ethical case against mandatory booster shots in universities into five points:
- transparency, emphasizing the lack of reviews like theirs to let the public make up their own minds;
- the potential net expected harm to each individual, which is the summation of cost-benefit analysis and should provide ammunition for individuals to defend themselves against sanitary authoritarianism;
- lack of proportion to the public health benefit of the obligation;
- failure of reciprocity, since individuals harmed by the obligation are not adequately compensated for it, when the responsibility falls on those who have obliged them;
- and broader societal harm that includes a loss of faith in science and institutions as authoritarianism is enforced in their name.
With information from Gazeta do Povo
