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The Challenge
It has been an unprecedented challenge for governments worldwide to try and steer their populations through the Covid-19 pandemic. In recent months, public policy has taken a significant shift. From vaccinating the vulnerable at the start of 2021, there is now a drive for mandating the vaccine for everyone and preventing them from accessing everyday life until they do so: whether that is travel, school, shopping, or socialising.
In this post, we want to help answer a core question that many of our athletes, executives and corporate clients have asked us: Does the weight of research from evidence-based medicine support the efficacy of vaccine mandates? The answer is no. This research does not mean vaccines are not crucial in protecting specific populations. It simply means that forcing the entire population to get vaccinated will not stop SARS-CoV-2.
In the fantastic book “The Beginning of Infinity”, David Deutsch wrote:
The real key to science is that our explanatory theories – which include those interpretations – can be improved, through conjecture, criticism and testing.
He went on to say:
Testability is now generally accepted as the defining characteristic of the scientific method. Popper called it the ‘criterion of demarcation’ between science and non-science.
Human progress relies on debate, criticism and scientific testing. When you test the efficacy of vaccine mandates through the lens of evidence-based medicine, it fails. It should therefore be rejected as a policy.
Fallibilism teaches us there are no authoritative sources of knowledge. The scientific test is essential. We made tremendous progress in the western world in the Age of the Enlightenment by rejecting authority as the source of truth and embracing science.
To move forward as a society, we must do that again now. Evidence-based medicine helps us to ensure objective, peer-reviewed, high-quality data guides us along.
"Testability is now generally accepted as the defining characteristic of the scientific method. Popper called it the ‘criterion of demarcation’ between science and non-science."
David Deutsch, The Beginning of Infinity
What Studies Can Tell Us About The Efficacy of Vaccine Mandates
Let’s begin by looking at the hypothesis.
Those bringing in vaccine mandates propose that stopping citizens from accessing regular services in their day-to-day lives will increase vaccine uptake. Let’s leave any ethical or moral debate out of this for a moment and view it through the lens of scientific integrity.
The underlying assumption for vaccine mandates appears to be that by coercing everyone to get vaccinated, we will stop SARS-CoV-2 and therefore protect human life. What does the research show in this respect?
Does Covid-19 vaccination prevent transmission of SARS-CoV-2?
In early 2021 we all had a lot of hope that vaccines could halt the pandemic in its tracks by protecting people and preventing transmission. Pfizer issued a press release on 1 April 2021 stating that the “vaccine was 100% effective in preventing Covid-19 cases in South Africa.”
It would have been amazing if this had turned out to be the reality. You only have to look at real-world data comparing countries and states with vaccine mandates to those who do not use vaccine mandates to understand that vaccination does not prevent the spread of SARS-CoV-2. However, let’s use peer-reviewed studies as a guide.
A recent study published in the prestigious New England Journal of Medicine investigated the effect of Covid-19 vaccination on transmission of Alpha and Delta Variants. This study was published on 5 January 2022 but looked at data pre-Omicron. Here is what the authors concluded:
Vaccination was associated with a smaller reduction in transmission of the delta variant than of the alpha variant, and the effects of vaccination decreased over time.
There are a few points worth mentioning here:
- The median time from the second dose of Covid-19 vaccination to positive PCR infection was 27 days with the AstraZeneca vaccine and 42 days with Pfizer. This timeline is not very long!
- 66% of transmission of SARS-CoV-2 happened in the home versus 11% at events and 11% at work. So most people do not get Covid in shops, cafes and sporting events.
- Regardless of vaccination status, for each doubling of weeks since 14 days after the second vaccination, the percentage of persons with positive PCR tests increased by a factor of 1.08 among contacts of patients vaccinated with AstraZeneca and by a factor of 1.13 among contacts of those vaccinated with Pfizer. In other words, within a few weeks, the transmission went up week on week, regardless of vaccination.
You can see the results of this below:
To describe it simply, the graphs above show the effect of vaccination on the transmission of SARS-CoV-2 over time. If you look at the graphs, transmission rates go up every week – especially with Delta.
Take a moment to reflect on this data solely through the lens of vaccine mandates. Would double vaccination for all (even against the original variant for which the vaccines were designed) stop transmission? No. Very quickly, the chances of getting infected and infecting others go up. We could be in a football stadium with absolutely everyone vaccinated and having shown their vaccine pass, and you could still get Covid.
As the authors concluded:
The delta variant has spread globally and caused resurgences of infection even in areas with high vaccination coverage. Increased onward transmission from persons who become infected despite vaccination is probably an important reason for this spread.
This data does not mean that vaccination cannot save lives. It can confer a level of protection to specific groups, such as the elderly, who are particularly vulnerable to Covid-19 and naturally experience immunosenescence with age.
But it is clear from this data that vaccine mandates are, and would be, useless in stopping the spread of Covid-19. This conclusion is even more apparent when you take into account Omicron. This new variant has over 50 mutations compared to the original strain of SARS-CoV-2 but appears milder due to factors, such as weaker binding to ACE2 receptors in the lungs. To learn more about Omicron’s milder effect, read this post in Nature.
Importantly, early research suggests that Omicron might be 10 times more contagious than the original Alpha variant, with an 88% likelihood of evading vaccination. This evasion is referred to as vaccine breakthrough or antibody resistance. Thus, by the time a new vaccine is developed and has passed trials measuring safety and efficacy, the virus will have reached billions more people, vaccinated or otherwise.
A pre-print has analysed the effectiveness of Covid-19 vaccines against Omicron or Delta infection. As the data shows, there is negative effectiveness from around three months after the second vaccination dose against Omicron. In other words, you are more likely to get and transmit Covid at this time. Boosters only marginally help. The study found that vaccine effectiveness was 37% after 7 days against Omicron after experiencing a third booster vaccine on top of double vaccination. You can see the results below:
From a practical standpoint, this data has several implications from a vaccine mandate perspective.
First, let’s say you have a family member in the hospital. Forcing staff to be vaccinated, even with boosters, will not stop the transmission of SARS-CoV-2. If the goal is to save lives, it is far more efficacious to protect the elderly and vulnerable by focusing on workforce testing than vaccination.
Second, current vaccines clearly drop in efficacy very quickly. This situation creates a dilemma: do we ask people to take boosters every 2-3 months in a bid to stop transmission, even though that will fail? We have no long-term safety data on the effect of regularly boosting the entire population and growing concerns by regulators, and thus mandating vaccines makes no sense.
Third, this data blows apart the current blame on unvaccinated individuals for the pandemic. You can be unvaccinated but, through the previous infection, have high levels of antibodies and T cells. A study from Qatar published in the New England Journal of Medicine found that the median time between first infection and reinfection with natural immunity alone was 277 days (interquartile range, 179 to 315). The odds of severe disease at reinfection were 0.12 times (95% confidence interval [CI], 0.03 to 0.31) than at primary infection. Natural immunity works. But at the moment, mandates in many countries refuse to acknowledge natural immunity, which is scientifically illiterate.
Natural immunity has been shown on a vast scale in hundreds of thousands of people to be more durable and robust than vaccine-induced immunity. For example, a study from Israel compared natural immunity to vaccine-induced immunity in the most extensive real-world observational study of its kind to date. In one analysis in the paper, comparing more than 32,000 people in the health system, the risk of developing symptomatic COVID-19 was 27x higher among the vaccinated, and the risk of hospitalization was 8x higher, compared to natural immunity.
Similarly, just because someone is vaccinated does not mean that they are fully protected and have the same robust immune response as someone else. Take this study that looked at antibody responses in those with abdominal obesity. The authors found that:
After receiving 2 doses of BNT162b2 mRNA vaccine, infection-naïve individuals with abdominal obesity reached a lower antibody peak compared to individuals without abdominal obesity. Between the first and third month after BNT162b2 mRNA vaccine dose 2, the drop in antibody levels was more remarkable in individuals with abdominal obesity compared to those without. Multivariable linear regression confirmed this result after inclusion of assessed confounders.
In other words, someone who carries more fat around their waist does not have the same level of immunity and protection against SARS-CoV-2 as someone who is leaner and gets vaccinated.
The binary split between “vaccinated” and “unvaccinated” needs to stop. This reality does not mean vaccination is unimportant. It does mean vaccine mandates are useless.
Some people ask if vaccination ensures that when someone does contract SARS-CoV-2, they have a lower viral load. The data is mixed in evidence-based medicine, and Omicron will change the picture still, but the evidence is not compelling in favour of vaccine mandates. For example, a study published in The Lancet found zero evidence of variation in peak viral load by variant or vaccination status.
Conclusion
There is no scientific case for vaccine mandates, as you have just learned. From every perspective, vaccine mandates will not guarantee your safety, nor the safety of those you love. This reality is why you can look at countries, cities and states that are using mandates and locking down the unvaccinated, and you will see that cases of SARS-CoV-2 continue to rise. Look at Australia:
- On 29 November 2021, there were just over 14,339 infections
- On 10 January 2022, there were 669,323 infections
From Rhode Island to Seattle, from Greece to Germany, from Australia to Italy, vaccine mandates are failing to stop the rise of Omicron. Getting vaccinated is a personal choice for you, and it is no one else’s business. Look after your wellbeing, enjoy 2022, and contact 360 if we can be of value! Thank you.
