On August 15, 2022, Secretary of Defense Lloyd Austin sent a press release stating that he had just tested positive for covid (2nd time this year) and commented on his “fully vaccinated status, including two booster shots.” He further reminded the Department of Defense (DOD) that “vaccination remains a medical requirement for our workforce.”1
The DOD mandated the covid vaccine for servicemembers in 2021 with a suspense of 21 November 2021. Since then, research has shown that the vaccine booster rapidly wanes in effectiveness. In April 2022, authors in the New England Journal of Medicine showed that effectiveness fell to 73% at 2-4 weeks and 64% at 5-9 weeks.2 Even more telling, in July 2022, researchers published results of a study concerning vaccinations and boosters in NBA players and rates of infection. The article, published in the Journal of the American Medical Association (JAMA), followed a cohort of NBA players and staff from 1 Dec 2021 to 15 Jan 2022 during the height of the omicron surge. Median age was 34 years (older than the average age of DOD servicemembers). Of the players followed, 608 of 2,164 (28%) of fully boosted players contracted covid compared to 127 of 715 (17%) vaccinated (not boosted) players. No players/staff were hospitalized or died. 93% of infections were determined to be omicron variant using advanced testing techniques.3 This trial showed that despite vaccines and boosters and one of the most intensive screening processes available, covid transmission was unavoidable even if vaccinated and boosted.
The US military has separated over 3,000 servicemembers for failure to become ‘fully vaccinated’ against covid. Many more separations are pending. Many servicemembers described harassment and unprofessional behavior from their chain of command regarding the vaccine issue. Many who were separated were combat veterans with a wealth of leadership and real-world deployment experience, now lost to the military.
As of 18 AUG 2022, the DOD reports 95 cumulative covid deaths4, up from 81 in December 2021, so averaging less than 2 per month for 2022. During the time of the covid pandemic, the DOD Database reported a drastic increase in new disease processes in the military in 2021 over the past 5 years (2016-2020). Interestingly, the report was quickly disputed by the DOD claiming a database error that was apparently was unrecognized for 5 years.
DOD members have much larger threats to their health. A 2013 paper showed over 8% of servicemembers autopsied for all causes of death had advanced atherosclerotic heart disease, even though the average age at autopsy was 25 yrs for the 10 year period studied.5 Drug use and deaths among active duty members and veterans is increasing commensurate with the civilian population. 2021 had a record number of opiate and other drug related deaths.
In the past, the DOD has usually listened to the science and legal discussions on vaccines. Mandatory anthrax vaccination was halted in 2003. Inhalational anthrax had a projected kill rate of over 80% so for a time in the early war it’s administration could be justified for force protection. However, vaccine safety and legalities of FDA approval halted its use. Covid’s kill rate is under 1%. The author, who has treated covid patients for nearly 3 years believes the rate to be much lower due to the numbers of covid patients who declined testing and/or treatment so that the denonimator is likely much higher.
The bottom line is that the threat of covid to the DOD’s population is extremely low. The questions of the covid vaccine’s safety and the loss of experienced servicemembers due to vaccine noncompliance took a far greater toll than the disease itself. DOD should end the mandate. It is not following the threat assessment. It is not following the ‘science.’ At this point, with deaths plummeting in the population at large, it appears vindictive.
Covid vaccine mandates around the world are relaxing as reality and reason are resuming their rightful place. And yet DOD remains steadfast in its conviction. The vaccine is a tool, not THE tool. For certain populations, it is effective and should be used to prevent severe covid disease. For overweight people like the SECDEF and the Chairman of the Joint Chiefs, and for those with multiple co-morbidities, it should be considered. For the vast majority of healthy, young DOD servicemembers, it should be optional, not mandated as the relative benefit is not there.
As the SECDEF muddles through his second covid diagnosis in 2022 despite being vaccinated and double boosted, he should ponder the mandate. He should know that obesity increases the risk of covid death (if he is concerned about deaths) and decreases the covid vaccine effectiveness (if he is concerned about effectiveness). If he truly want to be a covid ‘leader’ he should lose weight as an example for others in DOD to follow. If he sincerely wants to improve the health of the military, perhaps he should look to prevention of perennial issues – obesity, drugs, etc and pivot away from the covid mandate.
John Hughes, MD
USMA Class of 1996 (#1 graduate)
3rd Generation West Pointer
4 combat tours of duty in Iraq and Afghanistan
3Tai, Caroline, et al. “Association Between COVID Booster Vaccination and Omicron Infection in a Highly Vaccinated Cohort of Players and Staff in the National Basketball Association.” Journal of the American Medical Association. 12 July 2022. Vol 328, No 2. Pp. 209-211.
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