Are Pandemic-Related Excess Deaths Due to COVID or Vaccines? Depends on Who’s Counting (Part 2)

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In Part 1 of this report, we reviewed a recent preprint linking excess deaths in Australia to the mRNA vaccine campaign. In Part 2, we consider the challenge of identifying the root cause of excess deaths, whether from COVID-19 or non-COVID-19 causes, such as vaccine adverse events or public health restrictions.

Summary of Key Facts

  • COVID-19 deaths may have varying definitions set by hospitals and states.
  • Vaccine-attributable deaths require more study to understand the mechanism of injury.
  • Estimates of excess mortality vary worldwide, causing them to be challenged as unreliable. 
  • Excess deaths among young people may have more to do with public health mitigations than the virus itself.
  • Australian officials have formally linked a young woman’s death due to cardiac arrest with the mRNA-1273 booster.

Are Excess Deaths Due to COVID or Vaccines? Hard to Decide

Cleaning Up the Death Data Could Start With Admissions to the Hospital

Reviewing reasons for excess loss of life during the pandemic depends on accurately ascribing causes for deaths.

To begin this work, states and countries should agree upon a standard case definition of a “COVID death.”

Consensus around the “case definition” is a core element of any public health investigation, whether the situation is food poisoning at a baseball picnic or a global pandemic. It would also settle an important distinction: hospitalization “with” versus “from” COVID-19.

Throughout the pandemic, a fraction of patients have tested positive for SARS-CoV-2 upon admission to the hospital, but they were not admitted for COVID-19, the disease caused by SARS-CoV-2. These patients may have been admitted for appendicitis, a broken leg, a psychiatric condition, an overdose, or an obstetric condition.

Estimates of these “incidental” admissions have ranged from 42 percent in New York in January 2022 to 90 percent in Los Angeles in July 2022. The fraction of incidental admissions was lower earlier in the pandemic prior to widespread vaccine-induced and natural immunity-reduced severity of illness. For instance, a Los Angeles study conducted between August and October 2020 found 12 percent of admissions were not related to COVID-19. Nevertheless, it is very difficult to ascribe COVID-19 as the underlying cause of death without a chart review. For instance, an audit of deaths by Irish researchers concluded: “The COVID-19 death definition in Ireland may require revision so it can distinguish between deaths caused by COVID-19 and those in which COVID-19 played a less direct role.”

By Allison Krug, MPH and Yuhong Dong, M.D., Ph.D.

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