ArticleJournal of medical ethics2024
COVID-19 vaccine boosters for young adults: a risk benefit assessment and ethical analysis of mandate policies at universities.
Article in Journal of medical ethics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Quantitative Benefit-Risk Assessment of Vaccination Against COVID-19: A Systematic Review.Pharmacoepidemiology and drug safety · 2025Pooled it
- Neurobiological Determinism versus Human Freedom: Competing Explanatory Models and the Hope for Moral Enhancement.The Journal of medicine and philosophy · 2026Article
- Refining the role of behavioural and social sciences in pandemic response post-COVID-19.Nature human behaviour · 2026Review
- Quantitative benefit-risk analysis for prophylactic vaccines in the context of FDAs benefit-risk framework.NPJ vaccines · 2026Review
- Coercion in public health: a scoping review of definitions.BMJ public health · 2026Article
- From mRNA stabilisation to mirror life: Biological orthogonality, incremental risk, and anticipatory governance.Frontiers in bioengineering and biotechnology · 2026Article
- Scope and Spatio-Temporal Patterns of Workplace Vaccination Mandates During the COVID-19 Pandemic.International journal of environmental research and public health · 2025Article
- Commentary: Without Values, Complexity is Reduced to Mathematics.Journal of evaluation in clinical practice · 2025Article
- What Lessons can Be Learned From the Management of the COVID-19 Pandemic?International journal of public health · 2025Review
- Article
- Is Covid-19 "vaccine uptake" in postsecondary education a "problem"? A critical policy inquiry.Health (London, England : 1997) · 2024Article
- University Students' Vaccination Intention after the Fifth Wave of the COVID-19 Outbreak in Hong Kong: Inspiration from a Health Belief Model.Healthcare (Basel, Switzerland) · 2024Article
- Wearing masks is easy but taking them off is difficult - A situation in Japan during COVID-19 pandemic and after.Dialogues in health · 2024Article
- Factors affecting motivation for receiving a booster dose of the COVID-19 vaccine among Japanese university students and staff: a cross-sectional questionnaire survey.Scientific reports · 2024Article
- The Ethical Obligation for Research During Public Health Emergencies: Insights From the COVID-19 Pandemic.Medicine, health care, and philosophy · 2024Article
- COVID-19 mRNA Vaccines: Lessons Learned from the Registrational Trials and Global Vaccination Campaign.Cureus · 2024Review
- Self-reported side effects of COVID-19 vaccines among health professions students in India.PeerJ · 2024Article
- Subjective Well-Being, Health and Socio-Demographic Factors Related to COVID-19 Vaccination: A Repeated Cross-Sectional Sample Survey Study from 2021-2022 in Urban Pakistan.International journal of environmental research and public health · 2023Article
- COVID-19 vaccination requirements for Ireland's healthcare students.Critical social policy · 2023Article
- Rational harm-benefit assessments by age group are required for continued COVID-19 vaccination.Scandinavian journal of immunology · 2023Article
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Authors and funding
9 authors at 8 institutions in 3 countries.
Funding
Abstract
In 2022, students at North American universities with third-dose COVID-19 vaccine mandates risk disenrolment if unvaccinated. To assess the appropriateness of booster mandates in this age group, we combine empirical risk-benefit assessment and ethical analysis. To prevent one COVID-19 hospitalisation over a 6-month period, we estimate that 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 (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: (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; (4) violate the reciprocity principle because serious vaccine-related harms are not reliably compensated due to gaps in vaccine injury schemes; and (5) may result in wider social harms. 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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.