Coronavirus: The vaccinated deaths disparity

How Covid deaths are classified, the dominant variant, the timing of doses are all complicating factors

The narrative surrounding Covid-19 vaccines has changed since they were introduced over a year ago. The early promise was that they provided immunity from infection, but it’s now increasingly clear that they do not.

Whether a vaccinated person remains less likely to catch and transmit the virus than an unvaccinated person – or whether it’s about the same, or indeed whether the vaccinated are more likely to be infected when it comes to Omicron – is still unclear, with data to support all three positions.

The consensus, however, is that vaccines help when it comes to illness, hospitalisation and death.

This is now a central plank in the campaign to get people vaccinated. It’s also led to a perception that vaccination confers near-total protection against severe Covid.

“The best safeguard is to be triple-jabbed, rather than taking your chances with the virus,” said medical correspondent Fergus Walsh on the BBC News at Ten last Tuesday. Closer to home, health ministry permanent secretary Christina Yiannaki noted on February 5 that “the chance of going to the intensive care unit is zero when you are vaccinated”. (To be fair, the Greek word ‘midenizei’ could also translate as ‘close to zero’.)

The day before Yiannaki made that statement, the monthly report for the month of January – our worst month for deaths since the start of the pandemic – came out, seeming to support her claims.

The mortality data in Cyprus is very encouraging for vaccination. Of the 104 people who died of (or with) Covid in January, 69 per cent were unvaccinated and a further 20 per cent partly vaccinated. Only 11 per cent were fully vaccinated: two per cent double vaccinated and nine per cent boosted.

Some other countries (notably Greece) have posted similar figures. Strangely enough, however, the mortality data in many other places is wildly different.

Britain is a good example: the UK Health Security Agency (UKHSA) issues a ‘Covid-19 vaccine surveillance report’ every week, giving very complete data. The report for Week 5, issued on February 3, looks back at the first four weeks of 2022, i.e. the month of January.

The figures for Covid deaths within 28 days of a positive specimen (p. 45) show 5,554 deaths in total. Of these, only 1,015 (18 per cent) were among the unvaccinated; 1,703 (30 per cent) were double vaccinated, and 2,585 (46 per cent) were boosted.

This is almost the opposite of the Cyprus figures. What’s more, UKHSA data has shown a similar trend for months now.

Another example comes from Australia. The New South Wales government issues daily bulletins about Covid (they can be found at www.health.nsw.gov.au). On February 5 – the day of Ms Yiannaki’s statement – the state reported 18 deaths from Covid, with the following breakdown: “Two people who died had received three doses of a Covid-19 vaccine, 14 people had received two doses, one person had received one dose, and one person was not vaccinated”.

That makes five per cent unvaccinated, 77 per cent double vaccinated, 11 per cent boosted.

Nor was this a fluke result. The next two days saw another 42 deaths reported: seven (16 per cent) unvaccinated, 27 (64 per cent) double vaccinated, seven (16 per cent) boosted. The remaining person had received one jab.

The first thing to note, of course, is that these results don’t indicate a lack of vaccine effectiveness. Even if 70 per cent of deaths are vaccinated, that’s still less than the percentage of the total population who are vaccinated. One should also note that Australia’s death rate is very low, for a country that never had a big wave prior to this one.

In other words, being vaccinated does remain pretty helpful (at least so far) against severe illness and death. Still, ‘pretty helpful’ is a whole other ballpark from ‘near-total protection’ – especially at a time when vaccine magic is being used as a justification for SafePasses and restrictions on the unvaccinated. Why the divergence?

“Different countries will have different data, and will also present it differently,” Christos Petrou, associate professor at the University of Nicosia and part of the government’s vaccination advisory team, told the Cyprus Mail.

“It depends on the virus that is circulating, and many other factors that may be different between one country and the other,” agrees Petros Karayiannis, professor at the University of Nicosia Medical School and also a government advisor on coronavirus.

One example offered by Karayiannis has to do with Covid restrictions: “If you relax the measures – if you remove the masks, the distances and what have you – like the US and UK have done, that’s why they see more vaccinated people going down with the infection.”

Maybe so – but surely that speaks to cases, not severe illness necessarily. Besides, what about New South Wales? They’re still quite strict in Australia.

Karayiannis points to the difference that the dominant variant in Australia is currently Delta, whereas our cases stem from the less-lethal Omicron. Again, though, we’re talking about deaths; almost all of our mortality in Cyprus is still from Delta.

Another potential confounder, mentioned by both scientists, has to do with the timing of the second and third dose, especially in the immunocompromised.

“If they’ve been vaccinated, and seven months have elapsed and they haven’t had the third dose, for example, then it’s understandable that some may get sick,” says Karayiannis. “You need to compare like for like, and I’m not sure whether we can do that because of all the variables.”

Again, this sounds plausible – but then, are local differences really so sizeable? Haven’t countries been marching largely in lockstep, at least in the West? Don’t we in Cyprus have roughly comparable vaccination rates with these other nations, and didn’t we all start boosting at around the same time?

After all, we’re not talking about a small disparity in data: 11 per cent vaccinated deaths is a long way from 75-80 per cent. Even in the US – with a lower vaccination rate than Cyprus – former CDC director Robert Redfield noted back in October, in his capacity as senior advisor to the governor of Maryland, that over 40 per cent of deaths in Maryland were fully vaccinated. The Maryland Department of Health later clarified that the true figure was 32 per cent – but also added that they expected that percentage to grow, “as more Marylanders get the vaccine”.

Cyprus, for whatever reason, has different numbers. “I don’t understand what other factors may be at play here, but this is what we see,” says Prof. Karayiannis firmly. “Deaths – the vast majority – are non-vaccinated people, and that’s it.”

Could it have something to do with what Petrou alluded to, that countries “present” their data differently? After all, 96 of our 104 deaths in January had Covid as the ‘underlying cause’, presumably meaning other comorbidities were also present. Is it perhaps a case of the unvaccinated ranks being swelled by end-of-life patients – those who were too old and frail to take a vaccine anyway – whom we classify as Covid deaths, whereas other countries don’t?

Hard to say, without further research. One thing, however, seems clear. Vaccines do seem to help against severe Covid – but the narrative that getting jabbed in a timely fashion is enough to keep you out of the ICU should be taken with a pinch of salt.