Study: University Booster Mandates May Reduce One Hospitalization with a Few Thousand Adverse Events

A pre-print study posted on 12 September 2022 titled “COVID-19 Vaccine Boosters for Young Adults: A Risk-Benefit Assessment and Five Ethical Arguments against Mandates at Universities” by K. Bardosh et al concludes that vaccines boosters for young adults are simply not worth it.

The main text is approximately 32 pages long with 18 pages of references. As suggested in the title, much of it is a discussion of “ethics” (if one likes the term) triggered by the booster mandates currently in place at North American universities.

It is commonsense that justice is a matter of proportion and consistency which the authors thankfully recognize:

Proportionality is a key principle in public health ethics. To be proportionate, a policy must be expected to produce public health benefits that outweigh relevant harms, including harms related to coercion, undue pressure, and other forms of liberty restriction.

The gist of the five arguments is as follows:

First, we argue that there has been a lack of transparent risk-benefit assessment; second, that vaccine mandates may result in a net expected harm to individual young adults; third, that vaccine mandates are not proportionate; fourth, that US mandates violate the reciprocity principle because of current gaps in vaccine injury compensation schemes; fifth, that mandates are even less proportionate than the foregoing analyses suggest because current high levels of coercion or pressure create wider societal harms.

The paper is not purely qualitative but also quantitative, looking at existing statistics and studies.

In short, the entire campus of 22,000 to 30,000 students would need to be boosted to prevent merely one COVID-19 hospitalization over six months.

To estimate the benefits of hospitalizations prevented by boosters, we updated the CDC’s estimated number needed to vaccinate (NNV) for a strain such as Omicron which was found to be approximately 59% less virulent than Delta. Scaling the CDC’s NNV estimates of 9,000 for BNT162b2 and 12,000 for mRNA-1273 by this reduced severity, we estimate that 22,000 (9000/0.41) to 30,000 (12,000/0.41) young adults would need to be boosted with BNT162b2 or mRNA-1273, respectively, to prevent one Covid-19 hospitalisation over six months.

As for severe adverse events (SAEs) and reactogenicity:

…a hypothetical campus with 30,000 young adults receiving the BNT162b2 booster could expect more SAEs (18 to 98) than Covid-19 hospitalizations averted (1.0-1.4). Our hypothetical campus may also expect 1373 to 3234 young adults (rate of 1 in 9-22) to experience Grade ≥3 reactogenicity disrupting daily activities or requiring medical care when vaccinated with BNT162b2 or mRNA-1273, respectively. Given that prior SARS-CoV-2 infection increases the rate of systemic reactions by two- to three-fold the number of young adults expected to experience disruptions in their school and daily activities is likely to exceed 1839 with BNT162b2 and 4333 with mRNA-1273.

As for myocarditis:

If the 15,000 males and 15,000 females ages 18-29 years on the hypothetical campus were all boosted under a universal mandate, we estimate between 1.7 to 3.0 occurrences of myocarditis (rates of 1 in 7,000 to 1 in 5000) among males and 0.7 cases among females. Boosting the entire campus could thus cause approximately 3-4 myo/pericarditis cases, among males 315 predominantly, per single hospitalisation averted.

In other words, to avert one hospitalization, these booster mandates may cause just a few thousand adverse events and up to 98 severe adverse events, including a few cases of myocarditis.

Well, that’s alright then. I feel safer already.

Figure 2: Expected Myopericarditis Cases per Single Hospitalisation Prevented with Universal Booster Vaccination on a Large University Campus with 30,000 Students (15,000 Males)
Figure 2: Expected Myopericarditis Cases per Single Hospitalisation Prevented with Universal Booster Vaccination on a Large University Campus with 30,000 Students (15,000 Males)

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