LAST MONTH, in a commentary piece in CommonWealth, Tufts Medical Center physician and epidemiologist Shira Doron and Monica Gandhi, a professor medicine at the University of California – San Francisco, issued a call for a “campaign of honesty” when it comes to the state of knowledge around COVID vaccines, including making clear the uncertainty of whether all population groups should be getting follow-up booster shots.
A study published yesterday tries to shed more light on that issue – and its authors conclude that vaccine booster mandates for young people at universities, a policy most major universities in the Boston area have adopted, are causing net harm to young people.
In their earlier essay, Doron and Gandhi expressed concern that overall vaccination rates in the country remain too low, but said the public health messaging around vaccines has been poor, with some claims of vaccine benefits overstated beyond what evidence shows.
Appearing on the current episode of the Codcast, Doron expanded on their thinking. She said much has changed since the early days when vaccinations were highly protective against COVID infection and, therefore, transmission to others. Now, with the vast majority of young people having a prior COVID infection, and with vaccines effective against serious illness for higher risk individuals, but not very protective against infection, Doron said the picture has changed significantly. When it comes to booster shots, including the new bivalent vaccines, she said, “a transparent approach would be to say we’re not sure everyone would benefit.”
One particular concern has been the risk the vaccine carries of myocarditis, an inflammation of the heart muscle that has been seen in young people, particularly males, following vaccination. Doron said she agreed with the assessment of the Centers for Disease Control and Prevention early in the pandemic that “having a bad outcome from COVID in that age group is worse than the risk from that initial series of vaccinations.” Now, she said, it’s much less clear that the weight of the benefit-risk evidence favors vaccination in that population.
A paper published yesterday takes that point further, arguing that vaccine booster mandates for young people at colleges and universities are “likely to cause net expected harms to young healthy adults” and should be lifted. Researchers at the University of Oxford, as well as at other universities in the UK and North America, tapped available data sources on vaccinations and adverse events to evaluate the ethics of vaccine booster mandates for students at North American universities – an issue of obvious relevance to the college-rich Boston area.
In their paper, appearing in the Journal of Medical of Ethics, a publication of the British Medical Journal, the researchers estimated that to prevent one COVID-19 hospitalization over a six-month period, 31,207 to 42,836 young adults, aged 18–29, must receive a third mRNA vaccine. Moreover, for every COVID-19 hospitalization prevented, they estimated there are “at least 18.5 serious adverse events from mRNA vaccines,” including 1.5 to 4.6 cases of myocarditis in males, typically requiring hospitalization. They further estimated that preventing one COVID-19 hospitalization is associated with 1,430 to 4,626 cases of vaccine side-effects serious enough to interfere with daily activities, though typically not requiring hospitalization.
“Policymakers should repeal COVID-19 vaccine mandates for young adults immediately,” the researchers conclude.
Most Boston-area universities required students arriving on campuses this fall to have the two initial COVID vaccines plus at least one booster shot. Harvard is requiring students to get the newer, bivalent booster.
No immediate reply was received following requests for comment on the report from Harvard, Boston University, Northeastern University, and Tufts University, all of which have booster requirements for students.
Doron, the Tufts physician and epidemiologist, said the research published yesterday is exactly the kind of nuanced evaluation that’s needed. “An analysis of who stands to benefit from boosters, focusing on low-risk populations, is precisely what I wish CDC would provide so the public could see them as transparent and trustworthy. Other countries have made very different recommendations about boosters, based on age and risk factors, which tells me that the science is not fully settled on this.” Doron said the current CDC messaging “conveys a certainty that doesn’t exist and remains broad rather than targeted to those most at risk, diluting their effectiveness. The result, I believe, is the poor vaccine uptake we are seeing.”
On the Codcast released earlier this week, Doron said US officials seem to be favoring simplicity in their messaging, but at a cost that’s not being acknowledged. “You have to balance simplicity against transparency, and a complex message is really hard to put out there,” she said. “But the fact of the matter is that the science on this is really complex, and to try to oversimplify it comes at the expense of full transparency and honesty.”
MICHAEL JONAS
NEW STORIES FROM COMMONWEALTH MAGAZINE
Low value: The Lown Institute of Needham criticizes local hospitals for performing “low value” medical procedures, even during the height of COVID. “You couldn’t go into your local coffee shop [during the pandemic], but hospitals brought people in for all kinds of unnecessary procedures,” said Vikas Saini, the president of the Lown Institute and a physician.
– Lown examined Medicare data for three types of procedures – coronary stenting, hysterectomy, and spinal fusion/laminectomy – and concluded 1,721 were performed from June to December 2020.
– Hospital officials and trade groups criticized the Lown analysis, pointing out that it is nearly impossible to assess the validity of a diagnosis and treatment using only billing information. They say the key factor is a physician’s judgment based on the circumstances of each individual case. Read more.
Topless on Nantucket: After some delay, Attorney General Maura Healey’s office approves Nantucket’s topless beach bylaw. Read more.
OPINION
Recycling plastic: Claire Galkowski of the South Shore Recycling Cooperative has some straight talk about recycling plastics. Read more.
STORIES FROM ELSEWHERE AROUND THE WEB
BEACON HILL
Gov.-elect Maura Healey and Boston Mayor Michelle Wu held their first sit-down meeting since Healey’s election a month ago, but emerged from the session to share only “cheerful platitudes but few particulars.” (Boston Globe)
HEALTH/HEALTH CARE
The FDA pulls its approval for the last remaining COVID-19 monoclonal antibody treatment, saying it is no longer effective against current variants. (Reuters)
Massachusetts primary care and behavioral health workers can now apply for loan repayment awards ranging from $12,500 to $300,000. (MassLive)
A settlement ends seven years of litigation between specialty pharmacy company Shields Healthcare Solutions and the founder’s former friend, which included allegations of kickbacks and using company time for personal gain. (MassLive)
Attorney General Maura Healey is suing a Salem company that she alleges took more than $3 million in taxpayer money and diverted hundreds of thousands of dollars of it to the company owners and their families rather than delivering N95 masks in exchange for the payments, as it was supposed to. (Boston Herald)
ELECTIONS
Sen. Raphael Warnock defeats Herschel Walker in Georgia’s closely-watched runoff election, giving Democrats a 51-49 edge in control of the Senate. (Washington Post) Why Warnock’s reelection victory is so important to Democrats. (NPR)
More than 11,000 mail-in ballots were rejected by city or town clerks in the November election because they arrived too late or contained errors. (Salem News)
A man charged with voting twice in the same election, in both Massachusetts and New Hampshire, regularly since 1996 claims his identity was stolen. (MassLive)
BUSINESS/ECONOMY
As they prepare for sports betting, members of the Massachusetts Gaming Commission raise concerns about Penn National’s move to acquire Barstool Sports. Penn National owns Plainridge Park Casino in Plainville. (GBH)
The Globe profiles Caroline Ellison, the 28-year-old Newton North High School grad who ran Alameda Research, the crypto trading firm founded by Sam Bankman-Fried, the head of the FTX currency exchange that collapsed last month.
EDUCATION
The Greater New Bedford voc-tech high school settles a lawsuit over staff’s failure to protect a female student from harassment when a male student disseminated nude pictures of her. (Standard-Times)
A poll commissioned by the Pioneer Institute finds that 62 percent of state residents favor adding a US history component to the state MCAS exam, something that was called for in the 1993 Education Reform Act, but has been continually deferred by state officials. (Boston Herald)
TRANSPORTATION
A project is on track to double the capacity of Worcester’s Union Station. (Telegram & Gazette)
ENERGY/ENVIRONMENT
Gov. Charlie Baker gets a briefing on Lynn Harbor Park, a proposed park and open space on land owned by MassDevelopment on the water. (Daily Item)
CRIMINAL JUSTICE/COURTS
The Trump Organization, the multi-pronged real estate business that Donald Trump rode to fame and the presidency, was convicted on all 17 counts of tax fraud and other charges brought by prosecutors in New York. (New York Times)
Worcester is the only diocese in Massachusetts not to release a list of priests credibly accused of sexual abuse. (MassLive)
MEDIA
Buzzfeed is laying off 12 percent of its staff. (CNN)