The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good, published in BMJ Global Health. (See: https://gh.bmj.com/content/7/5/e008684?fbclid=IwAR2Vl1lPUozvc_bEAiR1uAt GDR0L_3JVeqB9-_LIgMX0kpe4TsuulnAuP48).
COVID-19 vaccine boosters for young adults: a risk benefit assessment and ethical analysis of mandate policies at universities. Journal of medical ethics. (See: https://jme.bmj.com/content/early/2022/12/05/jme-2022-108449.abstract). In the first paper, written in late 2021, I and a group of scholars from Johns Hopkins, Oxford, Harvard and elsewhere outlined a set of 12 reasons why the coercive approach to Covid vaccination policy would ultimately be both counterproductive and damaging to public health and society. We based these ideas on the existing literature at the time, with nearly 150 citations. We divided these 12 reasons into 4 categories:
Behavioural psychology: reactance and entrenchment; cognitive dissonance; stigma and scapegoating; distrust and conspiracy theories.
Politics and law: erosion of civil liberties; social polarization, global governance.
Socio-economics: disparities and inequalities; reduced health system capacity; exclusion from work and social life.
The integrity of science and public health: erosion of key principles of public health ethics; and the erosion of trust in regulatory vaccine oversight. I would like to quote directly from our abstract: “Our analysis strongly suggests that mandatory COVID-19 vaccine policies have had damaging effects on public trust, vaccine confidence, political polarization, human rights, inequities and social wellbeing. We question the effectiveness and consequences of coercive vaccination policy in pandemic response and urge the public health community and policymakers to return to non-discriminatory, trustbased public health approaches.” We started the result section of this paper with the following statement: “Although studies suggest that current policies are likely to increase populationlevel vaccination rates to some degree, gains were largest in those under 30 years old (a very low-risk group) and in countries with below average uptake.” The totality of actual data on increases in vaccination uptake from mandates and passports does not suggest an overwhelming positive impact. For example, a recent study found that indoor vaccine passports had no significant impact on COVID-19 vaccine uptake, cases, or deaths across all nine US cities that implemented the policy (See: https://www.mercatus.org/research/working-papers/indoor-vaccine-mandates-and-covid19). The second paper focused on booster mandates at American universities. Let me digress for a moment. We received a lot of emails from people after this first paper, including concerned students and parents. At first, I was reluctant to write this second paper on boosters (this work was conducted voluntarily; it was all free time) and was skeptical of our findings, based on publically available data from CDC and Pfizer. I thought, “Surely the CDC and other professional bodies have crunched the numbers. The adults are in the room.” But we have seen the stifling of debate in our institutions of higher education, a lack of transparency and a worrying groupthink in the liberal class. This has been alarming to witness first-hand. It was surprising to see just how widespread vaccine mandates were at universities in North America. This was not the case in Europe, where the vast majority did not have mandates. In our paper, we combined empirical risk-benefit assessment and ethical analysis.
We estimated that to prevent one COVID-19 hospitalisation over a 6-month period, between 31,000–42,000 young adults aged 18–29 years would have to receive a third mRNA vaccine.
But this would mean that for each hospitalization prevented with these booster mandates, at least 18.5 serious adverse events from mRNA vaccines would occur, including 1-5 booster-associated myopericarditis cases in males (typically requiring hospitalisation).
Our ethical analysis argued that university booster mandates are unethical because:
Are not based on an updated (Omicron era) stratified risk-benefit assessment for this age group;
May result in a net harm to healthy young adults;
Are not proportionate: expected harms do not outweigh their public health benefits given modest and transient effectiveness of vaccines against transmission;
Violate the reciprocity principle because serious vaccine-related harms are not reliably compensated due to gaps in vaccine injury schemes; and
May result in wider social harms, such as losing educational opportunities for those who do not comply. Let me finish with my own personal opinion. May I remind everyone here about the higher law, inspired by God, on which this country defines liberty. We consider a deprivation of bodily autonomy to be fundamentally humiliating and associated with a form of mental and physical enslavement. Inherent to human nature is the desire to have self-determination over ones own body and mind. Notice that many American chose to suffer the deprivations of losing their material income rather than be subject to the humiliations of forced medical treatments that would have denied their own medical privacy, physical agency and psychological freedom. The shock and dismay citizens of this country have expressed over these coercive mandate measures makes the situation clear for anyone willing to pay attention- that they are an affront to the God given order of freedom on which American liberty is founded. Never mind that they are scientifically inconsistent and illogical- the mandates are an insult to our American foundation of freedom and I hope we never are reduced to such humiliations again in the future- or we risk demoralizing an already demoralized people further.
