January 25, 2022

Guest Room | The Ethical Implications of Cornell’s COVID-19 Booster Mandate

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A growing number of Cornell students, including myself, have grown concerned about the ethical implications of Cornell’s COVID-19 booster shot mandate. I have personally discussed this issue with numerous members of the Cornell community, and social media has been ablaze with students voicing their frustrations over this policy decision. While members of the Cornell community may differ in opinions and policy preferences regarding who should be covered under this mandate, one group has been left thoroughly disillusioned — the recently recovered. 

In December 2021, over 1,300 students, including myself, tested positive for COVID-19. My first positive test came back on Dec. 25 (as an at-home antigen test) followed by a second positive PCR test on Dec. 27. My bout with COVID-19 was fortunately mild, but for the first time in my life, I was unable to celebrate Christmas with my family. I am sure I was not the only student who had to sacrifice a normal Christmas surrounded by family and friends due to a recent COVID-19 diagnosis. 

I now struggle to grapple with how I will navigate the administration’s COVID-19 Booster Mandate. I appreciate that the University has linked preliminary studies which indicate that COVID-19 boosters offer some, albeit debatably marginal, protection for those who received their two-dose regimen of either the Pfizer or Moderna mRNA vaccines over six months ago. However, I am convinced one ever-increasing population was not given due consideration — those with two doses of an mRNA vaccine who recently recovered from the Omicron variant of COVID-19. For simplicity, I will refer to this category as “Omicron-hybrid-immunity.” 

I received the last shot of my two-dose regimen of the Pfizer COVID-19 vaccine on Apr. 10, 2021, but as I mentioned, I have also recently recovered from COVID-19. My curiosity led me to seek out confirmation of infection from the Omicron variant. The Tompkins County Health Department told me that, based on the timing of my infection, I can be all but assured that I was infected with Omicron. Given that many other students fall under the Omicron-hybrid-immunity category, we are left wondering why such a mandate to receive a COVID-19 booster would apply to us. 

From the frequently asked questions section of Cornell’s COVID-19 dashboard, the University explicitly cites concern over the Omicron variant and CDC guidelines as rationale for the booster mandate. 

“The Centers for Disease Control and Prevention encourages all Americans to receive an mRNA booster immunization once eligible, and have summarized the benefits and risks of booster inoculation,” the dashboard website states. “While no medical intervention is completely risk-free, adverse side effects such as myocarditis and pericarditis are quite rare, and the CDC states that the ‘benefits of COVID-19 vaccination outweigh the known and potential risks.’” 

From this, two things are abundantly clear. First, the purpose of the booster mandate is to offer the Cornell community enhanced protection against the Omicron variant. Second, the administration acknowledges that such a medical intervention carries the small but statistically significant risk of heart complications such as myocarditis and pericarditis, which appear to be more common in men under 40 years old. In addition, for this specific demographic, either a second or third dose of the Pfizer or Moderna vaccines carries a higher risk for these heart complications than a COVID-19 infection. 

I, a 27-year-old male, and many others fall within this under-40 demographic. Nevertheless, the tacit rationale for all of Cornell’s vaccine requirements is that the risk-benefit ratio for each student (barring medical conditions like allergies to vaccine ingredients) comes out in favor of vaccination. These risk-benefit assessments ought to be guided by robust safety and efficacy data from US governmental agencies or the broader international scientific community. 

My ultimate concern is as much medical as it is ethical. For students with Omicron-hybrid-immunity, there exists no such safety or efficacy data concerning the benefit conferred by a COVID-19 booster. Some early preprints have begun to indicate that antibodies produced by those with Omicron-hybrid-immunity offer up to 14-fold higher neutralization of Omicron viral particles and up to 4.4-fold higher neutralization of Delta viral particles two weeks after the onset of symptoms. This would indicate that those with Omicron-hybrid-immunity are highly protected against both the Omicron and the still circulating Delta variants of COVID-19. If further studies confirm this to be the case, as some have begun to do, the rationale for requiring a booster for those with Omicron-hybrid-immunity to protect them from Omicron does not hold up to scrutiny. In a recent interview, Dr. Anthony Fauci M.D. ’66 even suggested that those with Omicron-hybrid-immunity should wait up to 90 days before getting a booster shot. 

Cornell’s booster mandate forces over 1,000 students to receive a medical intervention that seems to carry little net benefit to them, the Cornell community or the broader Tompkins County region. To my knowledge, there exists no precedent for such a mandate, and the ethical implications for establishing this precedent has instilled a deep sense of malaise among those, like me, with Omicron-hybrid-immunity. 

Thus, I implore the Cornell administration to consider amending the COVID-19 booster mandate. 

Gianno Pannafino is a PhD candidate in biochemistry. Guest Room runs periodically this semester. Comments may be sent to [email protected].