How are the authors able to discern between vaccine related events, and non-vaccine related events? There is no oracle one can consult to determine this. That’s the entire point of having a second group which was not treated - to have a reference that one can compare against to determine if outcomes were correlated with the treatment. Even then, one cannot say with certainty if the events were caused by the treatment, or simply correlated; to say that all 231 distinct serious outcomes were not caused by the vaccine seems a very extreme statement to make, and can almost be disregarded prima facie; if the researchers were infallibly able to determine what adverse events were caused by the treatment, then why would they need another group to compare to?
Similarly, while there may be ethical concerns with using a placebo, statistics and biology do not care about ethical concerns. There are real results which come from medical treatments, and ignoring them does not make them go away; it just makes us ignorant of them.