The National Institutes of Health Clinical Centre hosted a one hour presentation at their Ethics Grand Rounds: The Ethics of Vaccine Mandates. Dr Matthew Memoli, Director at the Clinical Studies Unit, National Institutes of Allergies and Infectious Diseases Laboratory of Infectious Diseases, kicked off as the first of three presenters, best viewed in the video but I’ve summarised his 12 minute presentation below.
Dr Memoli is followed by Julie Ledgerwood, Chief Medical Officer and Deputy Director of the NIAID Vaccine Research Centre speaking on Safety and Effectiveness of Covid-19 Vaccines; and Dorit Reiss, Professor of Law at UCSF who discusses ethical considerations relating to vaccine mandates.
All three presenters appear to me, to be influenced by their connection with NIAID, headed up by Dr Anthony Fauci who is clearly someone to be feared and who noone working in this arena, needing shares of his $6 billion annual research funding grants, would speak against. Dr Memoli mentions new early treatments, ignoring the well known effectiveness of repurposed existing and cheap early treatments. Dr Ledgerwood only discusses relative risk reduction to promote vaccine efficacy, with no mention of the absolute risk reduction which is closer to 1%. Professor Reiss is very clear in her support of mandates with any exemption requiring that people “jump through hoops”.
Does pursuing very high or universal vaccination rates address the Covid-19 pandemic?
Dr Matthew Memoli.
Can the vaccines prevent infection and symptomatic Covid disease?
Whilst initial trials showed very good efficacy, real world data has since shown that efficacy begins to wane after 2 months post-vaccination and declines rapidly so that there is no vaccine efficacy at all after 7 months.
Can the vaccines prevent transmission / spread of SARS-CoV-2 virus?
Studies suggest any protection against transmission is limited and very short term. Once a vaccinated person is infected, they are just as likely to transmit to others, including other vaccinated people, as an unvaccinated person is. A study in the European Journal of Epidemiology, published on 30 September 2021, states “increases in cases of Covid-19 were unrelated to levels of vaccination across 68 countries and 2947 counties in the United States“. In other words, going after a high percentage of vaccination does not prevent spread of disease. Recent data from Singapore, with 83% vaccination rate, shows they have the biggest spike of Covid cases since the pandemic began. Vermont in the USA are now experiencing record numbers of disease and death despite 73% of the population fully vaccinated and 99% of people aged 65 and older, fully vaccinated.
Can the vaccines reduce severe disease and death caused by Covid-19?
There is reduction in disease and death, which is prominent in locations with high case rates. However this protection wanes after 3-4 months. Presence of anti-spike protein antibodies in the blood (conferred via vaccination) do not correlate with protection against severe disease. In many data sets, including those available through CDC, once people are infected, the rate of vaccination has no impact on the rate of hospitalisation and death.
When you separate the risk of death by age, the benefit from vaccination is completely driven by vaccinating the elderly and the sick. The risk of death is highest in the elderly unvaccinated, at about 0.065% risk of death, and the highest risk occurs during the season when case rates are highest. If you are under 65 years old, your risk of death is extremely low at 0.02% for those in the 50-60yo age group, to 0.001% for everyone else, regardless of vaccination status. All vaccine benefit is seen in the elderly, and mostly driven by the sick.
Risk reduction is driven by vaccinating those at risk, and this efficacy is independent of the vaccination status of others. Vaccinating the workforce, people under 65yo, clearly has diminishing returns. The risk-benefit analysis of this must be questioned. Is it really beneficial for these people to take the risk of the vaccines?
The real world mass vaccination experience has shown various adverse events with many countries restricting vaccine use due to safety concerns. Much more study on long term safety is required. The data in Vaccine Adverse Events Reporting System (VAERS) is concerning and includes serious adverse events and death. Further investigations are required.
The perception of vaccines and the loss of public trust when people are coerced into getting vaccinated is a matter for consideration.
Are vaccine mandates justified? Who should the mandates target and what exemptions should be permitted? What are the ethics related to the acceptance or rejection of exemptions? Who is qualified to determine whose personal or religious beliefs are valid? What are the appropriate consequences people should suffer for not wanting to get vaccinated? Is career loss truly acceptable?