A recent study has sparked another round of headlines claiming that COVID vaccines caused excess deaths. This was accompanied by a predictable outpouring of I-told-you-sos on social media.
Author
Paul Hunter
Professor of Medicine, University of East Anglia
Excess deaths are a measure of how many more deaths are being recorded in a country over what would have been expected based on historical trends. In the UK, and in many other countries, death rates have been higher during the years 2020 to 2023 than would have been expected based on historic trends from before the pandemic. But that has been known for some time. A couple of years ago I wrote an article for The Conversation pointing this out and suggesting some reasons. But has anything changed?
The authors of the new study, published in BMJ Public Health, used publicly available data from Our World in Data to determine which countries had "statistically significant" excess deaths - in other words, excess deaths that couldn't be explained by mere random variation.
They studied the years 2020 to 2022 and found that many, but not all, countries did indeed report excess deaths. The authors did not try to explain why these excess deaths occurred, but the suggestion that COVID vaccines could have played a role is clear from their text - and indeed widely interpreted as such by certain newspapers.
There is no doubt that a few deaths were associated with the COVID vaccines, but could the vaccination programme explain the large number of excess deaths - 3 million in 47 countries - that have been reported?
Based on death certificates, during 2020 and 2021 there were more deaths from COVID than estimated excess deaths in the UK. So during the year 2021 when most vaccine doses were administered, there were actually fewer non-COVID deaths than would have been expected. It was only in 2022 that excess deaths exceeded COVID deaths.
If the vaccination campaign was contributing to the excess deaths that we have seen in recent years, then we should expect to see more deaths in people who have been vaccinated than in those who have not. The most reliable analysis in this regard was done by the UK's Office for National Statistics (ONS). In this analysis, the ONS matched death registrations with the vaccine histories of each death recorded. They then calculated "age-standardised death rates" to account for age differences between those vaccinated and those not.
What the ONS found was that in all months from April 2021 to May 2023, the death rate from all causes was higher in the unvaccinated than in people who had been vaccinated at least once.
That deaths from all causes were lower in the vaccinated than the unvaccinated should come as no surprise given that COVID was a major cause of death in 2021 and 2022. And there is ample evidence of the protective effect of vaccines against severe COVID and death. But what is even more convincing is that, even when known COVID deaths were excluded in the ONS report, the death rate in the unvaccinated was still higher, albeit not by very much in more recent months.
Some COVID deaths would certainly not have been recognised as such. But, on the other hand, people with chronic conditions, such as diabetes, were a high priority for vaccination. And these people would have been at increased risk of death even before the pandemic.
Possible causes
If the vaccine is not the cause of the excess deaths, what was?
The major cause of the excess deaths reported in the first two years of the BMJ Public Health study was deaths from COVID. But by 2022, excess deaths exceeded COVID deaths in many countries.
Possible explanations for these excess deaths include longer-term effects of earlier COVID infections, the return of infections such as influenza that had been suppressed during the COVID control measures, adverse effects of lockdowns on physical and mental health, and delays in the diagnosis of life-threatening infections as health services struggled to cope with the pandemic and its aftermath.
We do need to look very carefully at how the pandemic was managed. There is still considerable debate about the effectiveness of different behavioural control measures, such as self-isolation and lockdowns. Even when such interventions were effective at reducing transmission of COVID, what were the harms and were the gains worth the harms? Nevertheless, we can be confident that the excess deaths seen in recent years were not a consequence of the vaccination campaign.
Paul Hunter consults for the World Health Organization. He receives funding from National Institute for Health Research and has received funding from the World Health Organization and the European Regional Development Fund.
