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 (typically requiring hospitalisation).
We also anticipate 1430–4626 cases of grade ≥3 reactogenicity interfering with daily activities (although typically not requiring hospitalisation). University booster mandates are unethical because they:
- 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 are not outweighed by 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.