This is where universal mandates for school children fail: risk from mRNA vaccines falls unevenly on one group (boys and young men, perhaps especially with a history of prior infection), while benefit from vaccines accrues primarily to a different group (high risk children without prior infection).

I do think that the risk of Covid-19 to children (and healthy people in general) has been understated by many who appear to relish devaluing the Covid-19 vaccines or school mitigation measures. Being a healthy child does not equate to being invincible against severe disease; studies vary, but a JAMA Network review found 40-62% of pediatric hospital admissions with Covid-19 reported comorbidities — not 100%.

That said, severe disease does tend to concentrate among children and adolescents with health problems. While approximately 19% of U.S. children are diagnosed with obesity, 35% of those hospitalized with Covid-19 are obese. 7% of U.S. children have asthma, but 15% of pediatric Covid-19 hospitalizations carry that diagnosis. Neurologic and developmental disorders are rare, but constitute 14% of Covid-19 admissions…

My point: the annual risk of hospitalization due to Covid-19 for a healthy school age boy even with no prior immunity could conceivably drift down to a level approaching the risk of hospitalization from a second Pfizer vaccination. I have been informed in past months that this is a “fringe” belief, but as of this week Pfizer rather surprisingly admits this possibility in their documents for FDA review! In times of low community prevalence, they state: “the model predicts more excess hospitalizations due to vaccine-related myocarditis/pericarditis compared to prevented hospitalizations due to COVID-19 in males and in both sexes combined.”