Across the UK, more people than usual have been dying from non-Covid causes last year—and no one knows why.
A wave of unexplained extra deaths from causes other than Covid-19 have hit the UK, the first nation to start mass vaccination with novel vaccines.
Since July 2021, seven months after the vaccination programme started in earnest, over 10,000 more people than usual have died in England and Wales alone from conditions unrelated to the coronavirus, according to data from the Office for National Statistics.
This figure is lower than the number of people who died of Covid over the same period, but so far the trend has defied easy explanation, with the media describing it as an “unexplained surge” and a “mystery”.
Given the correlation with the vaccine rollout, the provisional nature of vaccine approvals, and some people’s fear of the long-term effects of vaccines, a reasonable question to ask might be whether the extra deaths could have anything to do with vaccines, and if not, how do we know?
Paul Hunter, professor in medicine at the University of East Anglia, notes that “in general the excess deaths seem to be primarily cardiovascular”, and that many of them are happening at home.
We know that some vaccines, such as Oxford AstraZeneca, have been linked to deaths from rare blood clots, known as thrombo-embolic events with concurrent thrombocytopenia. The Medicines and Healthcare products Regulatory Agency (MRHA) lists 435 such suspected events and 76 deaths at the time of writing (late January 2022).
And we know that mRNA vaccines have been linked to rare cases of heart inflammation (myocarditis). The agency in charge of approving vaccines and monitoring vaccine safety in the UK, Medicines and Healthcare products Regulatory Agency, has listed 1,082 suspected myocarditis cases for Pfizer, 270 for Moderna, and 422 for Oxford AstraZeneca.
Could similar side effects be more common than previously thought, causing some of the excess mortality recorded by the UK stats office? Many of the studies looking at side-effects of Covid jabs have concluded the jabs are generally safe, though they usually only look at data a few weeks after the jab. So how do we know that some people are not developing rare side-effects months later that are not being picked up?
I’ve put some of these questions to some of the UK’s preeminent experts and official agencies in charge to try to find out the answers.
“I know of no evidence that would point to this being a late complication of immunisation and personally I doubt that this would be the case,” Hunter told me.
“In any event, Covid infections are far more likely to cause such deaths and without vaccines very many more people would have died and would still be dying.”
But asked about how we know that delayed vaccine side-effects are not triggering at least some of the excess deaths if no one is actively studying possible links on an ongoing basis, Hunter did not reply.
Similarly, Peter Openshaw, professor of experimental medicine at Imperial College London, told me that “the vaccine studies are prospective and very carefully controlled—we would know if they were causing deaths”.
“They aren’t, basically. They save many lives,” he added. “The risk of death is much greater if you are not vaccinated.”
But asked about how we can exclude the possibility that some vaccines may be causing further complications in a small proportion of people that then might lead to death, given the data on unexplained excess mortality, he did not respond.
It is a tricky subject to discuss, with experts generally reluctant to comment beyond restating that vaccines are safe, perhaps out of fear of muddying the water on vaccine safety and departing from the official government and generally-accepted scientific line that the Covid vaccines are indeed largely safe.
It’s worth noting that there is no evidence that vaccines are behind the unexplained deaths, and that there is good evidence that vaccines have saved millions of lives already.
But given how new they are, and given a wave of unexplained deaths that followed their mass administration, it is perhaps strange that the question of whether there is any link between the correlation is not even being asked – even if only to explain and dismiss it.
Other causes
Instead of vaccines, Hunter thinks at least some of the excess deaths are driven “by people with heart attacks and strokes not being able to get to hospital in time”. He added: “It is also plausible that in some of this could be a late complication of Covid itself as we know that Covid can cause residual damage.”
Similarly, Openshaw thinks excess deaths might be due to Covid but not recorded as such. “In infectious disease outbreaks like flu, the excess deaths are often 5-10 times greater than the actual attributed deaths,” said Openshaw. “This is because many who die do not get a full work-up and deaths are put down to other causes.”
Others have blamed extra deaths on people being reluctant to seek medical help during pandemic, or the National Health Service (NHS) being overloaded and not as readily accessible to people.
But all of these are just ideas without clear-cut evidence to back one explanation over another.
Perhaps several different factors are playing a role. So how do we know that vaccine side effects are not one of them? If many flu deaths are wrongly attributed to other causes in normal times, how do we know that deaths from vaccine side effects, if any, aren’t wrongly attributed to something else now?
The official view
The UK’s Medicines and Healthcare products Regulatory Agency is confident that it is on top of the data and sees no reason for worry.
An MHRA spokesperson said the agency “carefully reviews all reports suspected to be associated with Covid-19 vaccines” and that there is “no indication that the vaccination campaign is increasing overall mortality rates”.
They said that their “continuous analysis” includes an evaluation of natural death rates over time, to determine if “any specific trends or patterns are occurring that might indicate a vaccine safety concern”. It also includes an evaluation of observed versus expected data from clinical records to determine “whether events are occurring more frequently in association with vaccination that would be expected to occur naturally”.
“All suspected adverse [events] remain under careful and continual review, including a thorough analysis of expected rates of illness in the absence of vaccine,” they said. “There are currently no indications of specific patterns or rates of reporting that would suggest the vaccine has played a role.”
The MHRA added: “Vaccination and surveillance of large populations means that, by chance, some people will experience and report a new illness or event in the days and weeks after vaccination. A high proportion of people vaccinated early in the vaccination campaign were very elderly and/or had pre-existing medical conditions. Older age and chronic underlying illnesses make it more likely that coincidental adverse events will occur, especially given the millions of people vaccinated.”
That doesn’t explain why there should be a higher than usual number of non-Covid deaths in the UK coinciding with the vaccination campaigns, but the MHRA claims there is no evidence that the unexplained extra deaths are linked to vaccines.
Whether its current methods would actually catch non-specific, long-term effects of vaccines is an interesting question, especially given reports that it missed the link between the AstraZeneca jab and rare blood clots, reportedly because its algorithms were not sensitive enough.
“The expected benefits of the vaccines in preventing Covid-19 and serious complications associated with Covid-19 far outweigh any currently known side effects in the majority of patients,” an MHRA spokesperson told me. “Overall, our advice remains that the benefits of the vaccines outweigh the risks in the majority of people.”
The government’s health department did not respond to questions on the topic, while Public Health England, and the UK Health Security Agency both referred questions to the Office for National Statistics (ONS) which has been releasing the mortality data on a weekly basis.
Asked about whether we know that excess deaths are not linked to side-effects of Covid vaccines, an ONS spokesperson said that registrations of deaths include “underlying cause of death” as determined by a doctor or a coroner, including a data code U12.9 for “death involved adverse reactions to the Covid-19 vaccine”.
For deaths registered between March 2020 and October 2021 there are only 13 deaths registered with the U12.9 code, Alex Howland, customer services and data release manager at the ONS told me.
“Due to the smaller number of deaths involving the Covid-19 vaccination, these figures would not have a large impact on excess deaths,” Howland said. “However, if there was a surge in the number of vaccination related deaths, these would be factored into excess death breakdowns.”
Asked about what assurances we have from the data that the excess mortality is not being triggered by vaccines a few months down the line, Howland noted that doctors are required by law to certify the cause of death “to the best of their knowledge and belief” and that coroners follow legal rules of evidence when deciding the causes of death.
“No-one has the power to tell a doctor or coroner to reach a particular decision about the cause of death,” he said. “There are long-standing guidelines and processes which have to be followed, and some changes have been made to these to allow for the circumstances of the pandemic—but there is no change to the legal and professional obligation to record the cause of death accurately.”
Correlation vs causation
But Kevin McConway, emeritus professor of applied statistics at the Open University told me that if vaccinations were indeed changing mortality patterns, “you wouldn’t really pick up a vaccine effect in patterns of cause” from the ONS data.
This is because they would, hypothetically, be affecting frail people making them more likely to die from the things frail people usually die from anyway, such as cardiovascular issues, certain cancers, or dementia.
“You’re right to ask how one can a priori discount some sort of vaccine effect speeding up some deaths without looking carefully at individual cases. I don’t think one can discount it entirely. There might be such an effect.”
So, it’s possible in theory that some unknown vaccine side-effects are somehow speeding up some deaths, and are simply being tallied up as deaths from other natural causes such as heart disease.
But, McConway added, there are many more likely, more mundane reasons that deaths are up, such as lack of adequate healthcare, delayed effects of Covid, or heatwaves.
“I think most, or many, medics would consider these as more likely causes of excess mortality than vaccine adverse effects—but actually for most of these you can’t tell without looking in detail at specific cases.”
“And looking in detail at specific cases isn’t exactly easy…you’d have to examine in detail a very large number out of the group of people who died from just about anything. There’s no resource to do that on that scale.”
But even if there were, he says, without a specific proposed mechanism of how vaccines would be contributing to such deaths, what would studies even look for in such detailed examinations?
“In a sense,” he says, “proposing that there might be some effect of vaccines on mortality, that runs across several immediate causes of death, isn’t a scientific hypothesis (at least not in Popper’s sense) because it can’t be tested, at least not unless there are fairly detailed proposals for the mechanism by which it might work.”
That said, McConway added that if vaccines did have such side effects, anything “beyond a tiny number of cases” would have shown up either in MHRA work or in similar studies carried out by similar authorities in the EU, USA, various universities, etc.
“At the minute, all we’ve seen is that these excess non-Covid deaths have gone up, and vaccinations have gone up too,” he said, but added that “correlation is not causation. A lot of other things have also changed at the same time.”
“I haven’t seen anything…that makes it clear that there are any big changes in the pattern of causes of death, apart from people dying of Covid of course,” concluded McConway.
So, the expert consensus at the moment is that any excess non-Covid deaths the UK is seeing is unlikely to have anything to do with vaccine side-effects.
That is, if there are any excess deaths at all.
Data uncertainty
Some experts question whether more people are dying than usual.
Hunter noted that there is still “quite a bit of uncertainty” about how many excess deaths there are.
“ONS and UKHSA are reporting excess deaths, but actuaries are suggesting that the excess deaths are not as great because expected deaths due to an ageing population would be rising,” he said. “So, there is still debate about whether this non-Covid excess death is real.”
Similarly, McConway thinks the excess mortality may just be down to how the ONS is recording and reporting data.
“You get these numbers of non-Covid excess deaths by two processes of subtraction, involving three sets of numbers: total actual deaths from all causes, total actual deaths involving Covid, estimated total deaths from all causes if Covid had never existed. All of these are subject to some uncertainty and statistical error,” he said.
“Statistically, it’s hard even to estimate the size of these excess death numbers, and if we’re really not sure how big they are (for all kinds of reasons), then looking for an interpretation is going to be difficult and possibly a waste of time.”
So not only are extra deaths unlikely to be caused by vaccines, it is unlikely that there are more deaths than usual to be explained away.
“I’m very far from convinced that there are non-Covid excess deaths in the UK at present, at least not in any substantial numbers,” concluded McConway. “If there are, I haven’t seen any evidence that vaccines play anything remotely approaching a significant role in increasing numbers of non-Covid deaths.”
He runs the section Balkan Science Beat.
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