I was shocked today to learn that New York City will end its requirement that City employees be vaccinated against COVID-19. The City's own data, paid for by its dollars and analyzed by its staff, are abundantly clear.

1. Vaccinating adults averts infections, hospitalizations, and deaths. [See images from City's website below for most recent data about this.]

2. Vaccinating adults has saved the City billions of dollars. One study published by the Health Department showed that the City's campaigns and mandates saved >$50 billion dollars. The paper concluded: "Every $1 invested in vaccination yielded estimated savings of $10.19 (95% CrI, $9.39-$10.87) in direct and indirect costs of health outcomes that would have been incurred without vaccination."

What I most fear is that the adult vaccination rate will now decline much more rapidly over time, increasing the number of New Yorkers infected, hospitalized, and dying from COVID-19. When the City removes its mandate, private sector employers and possibly higher education institutions will follow. Every day, new people enter the workforce, as teenagers become working adults. Given the relatively low rate of vaccination among children, this means that the percentage of the adult population vaccinated will decrease over time, and there will be no mechanism (e.g., workforce mandates) to "catch them up," as their risk of severe illness and death rises with each year they age and as new variants emerge. While prior infection does reduce future infections, hospitalizations, and deaths, multiple studies show that vaccination is safer and adds protection on top of virus-induced immunity.