When historians look back at the COVID-19 pandemic, one of many confounding details will be the enthusiasm with which colleges and universities imposed ever-expanding draconian measures on their low-risk student body. Hundreds of U.S. colleges required all faculty, staff, and students to be vaccinated upon Emergency Use Authorization of COVID vaccines. Yet students remain masked indoors (and sometimes out), subject to random asymptomatic testing and limited in their social life.
When weighing policy options with regards to the pandemic, it seems that universities have abandoned rigorous evidence appraisal in favor of memetic signaling to political peers, regardless of how the illness itself manifests among its highly vaccinated student body.
Onto this backdrop, the omicron variant appeared in early winter. The extreme contagiousness of this new variant makes uncertain whether any measure will truly “stop the spread.” One reaction to the highly contagious variant (even among the vaccinated) might have been to focus less on extreme measures to tamp down cases, and instead focus on empowering students to take action to avoid severe outcomes based on their individual risk factors and risk tolerance.
Given lower risk of severe outcomes compared to prior variants, particularly among vaccinated young people, the situation on campus could take the shape of a bad respiratory virus season. The way forward could be as simple as: if you’re sick, get tested and stay home. If you’re well, go about your business. If you’re high risk or otherwise worried, discuss a booster or other means of protecting yourself with your health care provider, and consider wearing a properly fitted N95 mask. By messaging confidence in vaccines, a college may weather the surge with outcomes indistinguishable from schools that took more restrictive measures, without the collateral damage to community cohesion, trust in public health or institutional credibility.
But this evenhanded approach bumps up against unfashionable values concerned with civil liberties. And it doesn’t relieve the anxieties of adults who are persuaded less by the efficacy of interventions than by the moral imperative of imposing any restriction deemed virtuous by the chattering class. In fact, on Jan. 7, our state’s flagship academic institution announced that all students, faculty and staff were required to receive a COVID booster shot by Jan. 24. This measure goes beyond the University System of Maryland’s mandate by including off campus students and employees.
After nearly two years of restrictions intended to reduce the toll of this intractable disease, many may dismiss this mandate as one more inevitable imperative. But we — society and institutions of higher learning, in particular — must look critically at the necessity of such a heavy-handed intervention, and carefully evaluate the evidence supporting it.
The Centers for Disease Control and Prevention still consider an individual who has received the primary vaccine series to be fully vaccinated. Yet the university employed a new turn of phrase, requiring a booster to be “up-to-date,” indicating the initial vaccines are somehow deficient. Yet abundant evidence indicates that the primary vaccine series continues to prevent severe illness and death — an outcome worth celebrating.
Boosters are available to all, including those who are high risk or otherwise eager to take any measure to avoid infection. Emerging evidence indicates that reduction in infection due to boosters is uncertain and likely short-lived. As the efficacy of boosters in preventing infection is not clear, many are satisfied with their reduced risk of severe disease without additional shots.
Many experts reject the idea that boosting young and healthy individuals is an appropriate strategy at this stage of the pandemic. In September, the FDA’s external vaccine review panel voted 16 to 2 against blanket approval of boosters. The FDA decided internally to ignore these recommendations and approve boosters for all. Amid this process, two senior members of the vaccine review committee resigned. Both contributed to a Lancet opinion piece arguing against universal boosting. Among other points, they argue that unnecessary boosting impedes global vaccine equity, and may broadly reduce vaccine acceptance.
The available vaccines are based on the original strain of SARS-CoV-2. Many members of the campus community recently recovered from COVID, and now have immunity to the currently circulating strains. They will gain no benefit from a booster, meaning the risk, however minuscule, of an adverse event outweighs the benefit. It is widely accepted that myocarditis is an adverse event related to mRNA vaccines administered to young men. While these events are rare and typically mild, some are severe, and even mild cases may require limiting activity for an extended period. One may argue that this risk is justified before the initial vaccine series based on the risk of severe outcomes from COVID infection. However, vaccinated young men required to get yet another dose are being subjected to this risk with no evidence of benefit, particularly if they are recovered from COVID.
Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, and a vaccine developer, recently went on record to say that the benefit of boosting is not worth the risk to the average, healthy young adult male. He advised his own 20-something son against getting a booster.
Students want and deserve a normal, in-person spring semester. However, the university’s will to reassure students, parents, and faculty that the university is taking measures to reduce the burden of the disease on campus must not overpower the will to appraise whether the chosen intervention is effective, necessary, and without harm. The booster mandate does not meet these criteria.
I made the choice to be vaccinated as soon as I was eligible. I strongly encourage all adults to be vaccinated, and to discuss boosters with their physician. I am unlikely to suffer ill effects from a booster, and I may achieve some minor benefit in a temporary delay of infection. I am concerned, however, that the University is engaged in a dishonest exchange with its community by issuing a heavy-handed mandate whose necessity is not sufficiently supported by science. As an alum and a current faculty member, I wish to uphold the credibility of the university by insisting the booster mandate be suspended.
Chrissa Carlson (email@example.com) is a senior faculty specialist at the University of Maryland Extension.