Conclusion
Based on public data provided by the CDC, we estimate that approximately 22,000 to 30,000
previous uninfected young adults ages 18–29 years must be boosted with an mRNA vaccine to prevent one Covid-19 hospitalisation. Given the fact that this estimate does not take into account the protection conferred by prior infection nor a risk-adjustment for comorbidity status, this should be considered a conservative and optimistic assessment of benefit. Our estimate shows that university Covid-19 vaccine mandates are likely to cause net expected harms to young healthy adults—between 18 and 98 serious adverse events requiring hospitalisation and 1373 to 3234 disruptions of daily activities—that is not outweighed by a proportionate public health benefit. Serious Covid-19 vaccine-associated harms are not adequately compensated for by current US vaccine injury systems. As such, these severe infringements of individual liberty are ethically unjustifiable.
Worse still, mandates are associated with wider social harms. The fact that such policies were
implemented despite controversy among experts and without updating the sole publicly available risk-benefit analysis to the current Omicron variants suggests a profound lack of transparency in scientific and regulatory policy making. These findings have implications for mandates in other settings such as schools, corporations, healthcare systems and the military. Policymakers should repeal booster mandates for young adults immediately, ensure pathways to compensation to those who have suffered negative consequences from these policies, provide open access to participant-level clinical trial data to allow risk- and age-stratified harm benefit analyses of any new vaccines prior to issuing recommendations and begin what will be a long process of rebuilding trust in public health.
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