Misunderstood study spurs COVID-19 vaccine debate

Excess deaths have remained high in the West since the COVID-19 pandemic began.

Research published in BMJ Public Health found that there were more than 3 million excess deaths in 47 countries across the Western world between January 1, 2020, and December 31, 2022.^[] 

“Excess mortality was documented in 41 countries (87%) in 2020, 42 countries (89%) in 2021 and 43 countries (91%) in 2022,” the study authors write.

“Excess mortality has remained high in the Western World for three consecutive years, despite the implementation of containment measures and COVID-19 vaccines. This raises serious concerns. Government leaders and policymakers need to thoroughly investigate underlying causes of persistent excess mortality.”

The study suggests that in 2020, there were 1,033,122 excess deaths. In 2021, there were 1,256,942 excess deaths; in 2022, preliminary data suggests there were 808,392 deaths. 

William Schaffner, MD, an infectious disease expert at Vanderbilt University, says the findings make sense. “It does not surprise me. And I would anticipate, if they took their studies further and added another year, into 2023…they would see excess deaths that would continue into 2024,” he tells MDLinx.  

The study did not determine the exact causes of the excess deaths, and the researchers say that determining the causes of persistent excess mortality is the next step.

“This insight into the overall all-cause excess mortality since the start of the COVID-19 pandemic is an important first step for future health crisis policy decision-making. The next step concerns distinguishing between the various potential contributors to excess mortality, including COVID-19 infection, indirect effects of containment measures and COVID-19 vaccination programmes,” the study authors write. 

Some reports about the study claim that the research implies a direct causal link between COVID-19 vaccination and excess deaths.^[]

Dean Blumberg, MD, Chief of Pediatric Infectious Diseases at University of California, Davis, says that this is a misinterpretation of the research. “There [have] been better outcomes in patients who have been vaccinated than those who have been unvaccinated, and that's been consistently clear. So that's trying to draw a correlation out of the timing of the introduction of the vaccines, but that doesn't lead to causation. That doesn't make any sense to me,” he tells MDLinx.

Dr. Blumberg argues that the incorrect reports are problematic. “They are damaging because they do influence people who don't go beyond the headlines, and then it can give them negative impressions of vaccines. And, of course, the vaccines have been life-saving. They've led to less long COVID, they've protected against death and other serious long-term adverse problems, such as the inflammatory diseases that are associated with each COVID infection, [like] strokes and myocardial infarction,” he says. 

The BMJ has since released a statement refuting claims that link the COVID-19 vaccine to excess deaths.^[]

“The message of the research is that understanding overall excess mortality since the COVID-19 pandemic is crucial for future health policy, but that identifying specific causes is complex due to varying national data quality and reporting methods.”

Both the researchers of the BMJ study and Drs. Schaffner and Blumberg note that there could be many potential reasons for the excess deaths that go beyond SARS-CoV-2 infection.

One of the possible reasons is interruption to routine medical care due to stay-at-home orders.

“That's very important because these interruptions in medical care sometimes extend over periods of time. And for people with chronic illnesses…heart disease, diabetes, and the like, I think it's quite understandable that if those illnesses are not well-controlled, they can become severe and, in some persons, caused death,” Dr. Schaffner says.

“I would imagine every country where there were COVID interventions or restrictions put in place, the entire healthcare system is trying to ‘catch up’ now to reach patients who had not received care, and to reinstitute that care in order to prevent those excess deaths.”

The authors of the BMJ study argue that their research should encourage government leaders and policymakers to determine the underlying causes of excess deaths and evaluate healthcare policies accordingly.^[] 

Drs. Schaffner and Blumberg both agree that this will be essential in preparing for future pandemics.

“We have to recognize that when we have global pandemic— of these respiratory viruses, whether it's flu or another COVID variant—we're going to have another pandemic,” Dr. Schaffner says.

“This is the sort of thing we need to factor into our thinking. As we introduce interventions—particularly social distancing, asking people to stay at home—we have to pay more attention to providing medical care to seriously ill people who are then homebound and remote from their usual sources of medical care.”