"CDC data says the vast majority of those now dying from Covid in the US are unvaccinated. Same story in the UK."
We have been asked by readers on WhatsApp about a claim in the 1 November episode of The Guardian’s podcast Today in Focus which states that in the UK, like in America, the “vast majority” of those now dying from Covid-19 are unvaccinated.
The subheading of the podcast webpage also says “The majority of those dying of Covid-19 in the UK and the US have not been vaccinated”.
While this was true earlier in the pandemic in the UK, this is no longer the case “now” as is claimed. The podcast later discusses a September Office for National Statistics report which says that between January and July 2021, 37.4% of deaths amongst unvaccinated people involved Covid-19 compared to 0.8% amongst vaccinated people. This is correct, but doesn’t mean that most people dying from Covid-19 in the UK at the moment are unvaccinated.
The most recent report from the UK Health Security Agency (UKHSA) was published week commencing 25 October. Looking at Covid-19 deaths, it shows that currently more vaccinated than unvaccinated people are dying with the disease in England.
For example, in the over 80s, there were 1,209 reported deaths in fully vaccinated people, compared to 143 deaths in unvaccinated people and 40 deaths of partially vaccinated people, in data covering the period from 23rd September to 24 October.
This is also true in other nations of the UK. In Scotland, from 25 Sept to 22 October there were 454 reported deaths in people who had received two vaccines, 12 deaths in people who had received one dose and 64 deaths in unvaccinated people. In Northern Ireland, from 27 September to 24 October 2021 there were 83 reported deaths in fully vaccinated people, six deaths in partially vaccinated people and 27 deaths in unvaccinated people. Figures from Wales are not published.
In these documents from the different nations, there are slightly different criteria used as the definition of Covid-19 deaths: England’s figures are based on deaths within 28 days of a positive test or Covid-19 reported on the death certificate, Northern Ireland’s figures are based on deaths within 28 days of a positive test, while Scotland’s is taken from the number of deaths with Covid-19 as an underlying cause on the death certificate (and a previous positive test).
Does this tell us anything about the vaccines’ effectiveness?
As we have written about many times before, this does not mean that the vaccines aren’t working.
In the same document UKHSA says: “In the context of very high vaccine coverage in the population, even with a highly effective vaccine, it is expected that a large proportion of cases, hospitalisations and deaths would occur in vaccinated individuals, simply because a larger proportion of the population are vaccinated than unvaccinated and no vaccine is 100% effective”.
It adds: “This is especially true because vaccination has been prioritised in individuals who are more susceptible or more at risk of severe disease”.
In other words, although the risk of death with Covid-19 is much reduced with vaccination, because so many people in the UK have been vaccinated, and uptake has been highest and provided first to the most vulnerable people, it is expected that many people who become unwell with Covid-19 will now be among those who are vaccinated.
If you compare the number of deaths in vaccinated and unvaccinated people per 100,000, the rate of death is much higher in unvaccinated people. A recent report for the Office for National Statistics (ONS) found that, between 2 January and 24 September 2021, the age-adjusted risk of deaths involving Covid-19 was 32 times greater in unvaccinated people than in fully vaccinated people. The ONS and the Office for Statistics Regulation (OSR) caution that these figures are not a measure of vaccine effectiveness, and can change over time due to changes in infection rates, Covid-19 variants, changes to the types of people who are vaccinated or unvaccinated (for example which populations are included at times of different rollouts), immunity via infection and waning vaccine immunity.
In the most recent report, UKHSA estimated the vaccines to be 65-95% effective at preventing symptomatic disease with the Delta variant of Covid-19 with higher levels of protection against severe disease and death.
The UKHSA document also says numbers of deaths, or cases of Covid-19 in vaccinated or unvaccinated people should not be used to assess vaccine efficacy. We have previously written about some of the potential inaccuracies of using this kind of data to comment on vaccine efficacy. These include difficulty in accurately estimating the numbers of unvaccinated people, and changes in behaviour amongst vaccinated and unvaccinated people.
UKHSA has also noted that there is evidence that the vaccines offer waning protection over time against infection and symptomatic disease. It says though that protection against severe disease “remains high” in most groups at five months after the second dose.
There is also now a booster programme in the UK to give additional doses of vaccine to people who are in vulnerable groups and vaccinated over six months ago.