“Expected HARMS are NOT OUTWEIGHED by public health benefits”

… To prevent one COVID-19 hospitalisation over a 6-month period

… 31,207–42,836 young adults aged 18–29 years must receive a third mRNA vaccine

… Booster mandates in young adults are expected to cause a net harm:

— per COVID-19 hospitalisation prevented, we anticipate at least 18.5 serious adverse events from mRNA vaccines

… including 1.5–4.6 booster-associated myopericarditis cases in males 

… 1,430–4,626 cases of grade ≥3 reactogenicity interfering with daily activities

… University booster mandates are unethical because they: 

— (1) are not based on an updated (Omicron era) stratified risk-benefit assessment for this age group

— (2) may result in a net harm to healthy young adults

— (3) are not proportionate: expected harms are not outweighed by public health benefits given modest and transient effectiveness of vaccines against transmission

… We consider counterarguments including efforts to increase safety on campus but find these are fraught with limitations and little scientific support

… Finally, we discuss the policy relevance of our analysis for primary series COVID-19 vaccine mandates