About a week ago a United States Air Force Academy cadet was informed by a superior officer that upon returning from the Cadet Wing’s spring break, he would receive an ultimatum: Receive the Department of Defense (DOD) mandatory Covid vaccine or be expelled from the academy upon return.
On Tuesday the order became official, giving all the cadets involved 5 days to receive the vaccine, resign from the academy, or receive disciplinary expulsion from the Air Force for violating the Uniform Code of Military Justice. The cadets face a Faustian bargain; whether to comply with an order that violates their religious principles and remain members of the Cadet Wing or refuse the vaccine and lose their lifelong dreams of graduating from the academy and serving their country as Air Force officers.
The cadets, many of whom were raised in deeply religious homes before attending the academy, share the sincere belief that receiving the Covid mRNA-engineered vaccine conflicts with their religious beliefs. An Air Force Academy chaplain interviewed these cadets and in every case which we are aware of, determined that their religious beliefs are sincere.
They were hopeful, for earlier this year multiple federal courts on religious grounds enjoined the DOD from forcing Covid vaccinations on military personnel, most notably the Navy SEALs. However, this week the Supreme Court issued a temporary stay, allowing the Navy to reassign the SEALs at its discretion. Subsequently, a federal judge in Texas certified a lawsuit as a class action and issued a preliminary injunction protecting approximately 4,000 sailors seeking religious exemptions. Until the final opinions are rendered, it remains to be seen whether the courts will permit the DOD to enact other punishments.
All the cadets facing dismissal are in prime health and without medical comorbidities, which greatly reduces the chances of becoming severely ill. Their vaccine status has not affected their ability to perform all required duties. A number of them have been infected with Covid, suffered only mild symptoms, and achieved antibody-proven natural immunity.
They understand that the original Covid viral strain for which the current vaccine was designed has mutated over the past two years to the less virulent Omicron variant. They question the risk-to-benefit profile of the current vaccine that does not prevent infection nor stop its transmission, and the evidence that despite high vaccination rates, Germany, Italy, and the United Kingdom have experienced a surge in Covid transmission rates over the past weeks.
Cadets stated their case to the Academy administration that natural immunity provides them with superior protection against Covid compared to vaccine protection. They cited over 150 studies from multiple institutions, including the Centers for Disease Control and Prevention (CDC), that validate their argument. This immunity is robust, long-lasting and includes both “B” and “T” cell mediated protection.
They understand that if there is any benefit to vaccinating young adults, it wanes over a few months. The vaccine’s efficacy in averting hospitalization and death, the rationale the academy administration employs to justify mandatory vaccination, applies to the geriatric population, but not young adults who face one-thousandth the risk. Theirs is a straightforward request: Judge us by whether we have or not have immunity, not by our vaccination status.
The cadets’ response to the DOD’s rigid vaccine policy is that it is inconsistent with the manner in which religious and medical exemptions are enforced regarding other diseases. Currently 44 states and the District of Columbia allow religious exemptions for childhood vaccinations. The CDC recognizes natural immunity in lieu of vaccinations in cases of previous infection with measles and chickenpox.
Those who have attended a United States military academy understand the rigid hierarchy that pervades these institutions. From the rank of 4-star generals to the fourth class cadet, the lines between authority and subordination are clearly drawn. This command structure, indispensable in the military setting, when left unchecked, can readily intimidate and punish those who legitimately question this authority for religious or medical reasons.
Military physicians, who are under orders to administer Covid vaccines to all cadets irrespective of the circumstances, may not provide their patients with an accurate risk-benefit assessment and information required for proper informed consent.
Proper informed consent includes the risks and benefits of the procedure but also alternatives and their attendant risks and benefits. During the process the AMA proscribes withholding information without the patient’s knowledge or consent. To do so is ethically unacceptable. In structured environments, where patients are vulnerable and lack autonomy, the right to informed consent is based on accurate, untainted information and cannot be abridged. The courts have ruled that informed consent is binding only in the absence of fraud.
According to the FDA, recipients of a vaccine administered under an Emergency Use Authorization (EUA) must have the option to accept or refuse the vaccine and any other available alternative. Under the rules governing EUA, informed consent is a requirement with the exception of a few extenuating circumstances. The Pfizer BioNTech vaccine formulation, which is authorized under the EUA, is currently the only product administered to members of the armed forces. Comirnaty is the only FDA-approved vaccine, but it is not available in the United States.
The cadets have multiple reasons for concern about vaccine safety. In August 2021 Secretary of Defense Lloyd Austin announced mandatory Covid vaccination for all military personnel. At that time it was well known that the severe effects of the disease spared the vast majority of the healthy military age cohort, and also well known was the presence of a disturbing number and variety of serious, adverse vaccine side effects reported in the Vaccine Adverse Event Reporting System (VAERS).
These trends continued with greater public awareness of the ability of mRNA vaccines to cause myocarditis in young men, which in some cases is irreversible. In the military setting both the Pfizer and Moderna vaccines expose patients to a higher risk of contracting myocarditis than the disease. This past year 500 exceptionally conditioned athletes who received the Covid vaccination died of cardiac arrest during strenuous competition. This compares with a 38-year period ending in 2006 that averaged 29 deaths per year, which primarily were due to congenital heart disease in similar patient populations.
Cadets express concerns that government agencies have either failed to report or altered epidemiological information related to Covid. The New York Times recently reported that the CDC is not reporting large amounts of data it collects, and this month the agency removed over 72,000 deaths that it had falsely attributed to Covid.
The possibility of misreporting adverse events, data, and fraud regarding the Defense Medical Epidemiology Database (DMED), which links the diagnoses of all 1.4 million active duty military personnel to a unique code, became evident in Senate testimony two months ago. All DMED data is entered by healthcare professionals, and there is no monetary incentive to influence the procedure. The altered epidemiological data is confounding and raises concerns about its accuracy and effect on the informed consent process.
Excessive care is deficient care, especially when fraud is involved, and the informed consent process has been corrupted. Health care fraud occurs when an individual, group, or organization misrepresents or misstates the type, scope, or the nature of the medical treatment or service provided. For a procedure to be defined as a medical necessity it must be reasonably expected to meet at least one of four criteria: prevent disease, cure or reduce physical effects of the illness, reduce pain and suffering caused by the illness, or assist one to achieve maximum capacity in performing activities of daily living. It is not reasonable to apply these standards to cadets attending the Air Force Academy, who at worst would be expected to experience mild flu-like symptoms from the current Covid variant.
In view of the sincerity of the cadets’ religious objections and the adverse risk-to-benefit profile of receiving the Covid vaccine, what is the purpose of forcing these cadets to subject themselves to a procedure that affords them and those around them no discernible benefit? Is the purpose to provide reasoned, compassionate medical care or simply demand submission or even to purge them from the ranks?
To take advantage of these cadets’ vulnerability and deny them the opportunity to serve their country is radical and unconscionable. The Air Force Academy Wing is fortunate to have cadets such as these, who despite harassment and the onerous predicament in which they have been placed, make only one request — to remain members of the Cadet Wing.