Post #1208: A funny thing about deaths in the elderly.

 

They happen all the time.

This post is about the incorrect assertion that the COVID-19 vaccine is deadly.  That seems to be making the rounds now, with some sciency-looking bells and whistles to boot, fictionally attributed to the CDC’s Vaccine Adverse Event Reporting System (VAERS).

To cut to the chase, no, the vaccine isn’t deadly.  Or, at least, not based on what you can find in the VAERS data.

But let me do this systematically.  Which, of course, means starting off with a first-person anecdote.

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True anecdote

I spent most of my career as a consultant to Fortune-500 health care companies.  My job, more-or-less, was to provide them with correct information about various aspects of the U.S. health care system, using whatever data sources I could find.

At one point, one of my best clients asked me to profile the Medicare beneficiaries who had received one of their newest implantable medical devices.

I told my client that I’d do my standard workup, showing the demographics, comorbidities, annual health care costs, and so on, for the population using their device.  And, of course, because this was the U.S. Medicare program, and these devices were largely being implanted in very old and very frail people, I proposed to show the one- and two-year post-implant mortality rate. 

I was immediately told to cease and desist.  And never bring up mortality rates again.

At first, I was confused.  If you look at a population of tens of thousands of Medicare enrollees, and track them for a couple of years, you’re going to see some deaths.  Not, in this case, as a consequence of the implanted device.  Just as a natural consequence of old age.  And, among other things, knowing that mortality rate gives you some grasp of typical person-years of use your device might get (and so, of the need for eventual device replacements).

But the cause for concern wasn’t based on science or logic.  It was based on the law.  The Federal government required the company to maintain a registry of every such implanted device.  Death was a “reportable adverse event” in that registry.  Any death, no matter what the cause.  If I’d reported the mortality rate to the company, in theory, they would have had a legal liability to track down and individually report all of those deaths.

We all agreed that was ridiculous.  The device in question was safe, and the deaths I was counting were due to natural causes.  But they knew the law, and I didn’t.  The deaths in the registry were not restricted to deaths related to the implanted device.  And if the company was made aware of those naturally-occurring deaths, they’d have incurred an obligation to report.

I need to say just one more thing.  If they’d allowed me to do it, I would have shown them that the mortality rate of the medical device users was lower than that of a comparable group of Medicare enrollees matched by age and gender.  And that’s for an obvious reason: One had to be of reasonably sound mind, and in reasonably good health, to be a candidate for the device in the first place.  As a consequence, the background rate of deaths was lower for the device-recipient population than for the average of all Medicare beneficiaries.

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VAERS abuse.

Which brings me to today’s topic, the U.S. Vaccine Adverse Events Report System or VAERS.  This seems to be making the rounds, of late, in the nut-o-verse, by those who argue against getting the COVID-19 vaccines.  In this case, the claim is that the vaccine is lethal. 

And, as usual, this perfectly innocent data source is being abused by people who can’t bother to read what’s written in plain English on the website (emphasis mine):

When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.

Source:  Guide to Interpreting VAERS Data

That seems fairly clear, doesn’t it?  If not, just keep reading that guide:

These coincidences make it difficult to know whether a particular adverse event resulted from a medical condition or from a vaccination. Therefore, vaccine providers are encouraged to report all adverse events following vaccination, whether or not they believe the vaccination was the cause.

Again, not a lot of ambiguity there.  Still not good enough for you?  If you want to access the VAERS data, you have to swear that you read and understand the data limitations.  Like so:

But some people probably still didn’t get the message.  Let me translate:

If you don’t know what you’re doing, then don’t try to draw conclusions with the VAERS data.

Because, apparently, the nut-o-verse is now arguing that VAERS data proves (PROVES!!!!) that tens (or is it hundreds?) of thousands of people died because of the COVID-19 vaccine.

But apparently, nobody noticed?  And/or there’s been a conspiracy to keep quiet about this.  Which is why the underlying data are available for public access?

In any case, this PROOF!!! is typically loosely attributed to “the VAERS Report”.  Of which, as far as I can tell, no such thing exists.

So, let me track this down.  Document the facts.  And do some simple expected-mortality calculations, an area in which I have some expertise.

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A simple illustrative calculation.

Before I even look at the VAERS data, I’m going to do a quick calculation of expected deaths among the elderly.

As of today, about 80% of the U.S. population age 65+ is vaccinated.  And, as you know if you’ve been vaccinated with either of the popular vaccines (Pfizer,Moderna), at least three weeks elapses between your first and second shot.

So, let me ask a hypothetical question:  If the U.S. elderly had been vaccinated at random, how many would you have expected to die between their first and second shots of vaccine?  In other words, how many people in (80% of) the U.S. age 65+ population would you expect to die within three weeks of any randomly-chosen day?

Answer:  About 100,000.  Details given in the table below, along with citation as to source.  I went back to our last normal year (2019) to answer that, to avoid using the excess mortality rate observed in 2020.

Again, just to be clear:  If we vaccinated 80% of the U.S. elderly at random, we would expect to see about 100K persons die within three weeks of their first vaccine shot.

Actually, it’s an interesting exercise in and of itself to see what the same calculation would yield with 2020 data.  Absent a pandemic, those mortality rates change quite slowly over time.  Any difference between the number above, and a number calculated with 2020 data, would be attributed almost entirely to the pandemic.

Using the 2020 provisional mortality data from CDC, I can redo the table.

Probably doesn’t look like much, to most of you.  But I’ve been using these data for decades, and that, my friends, is your basic holy shit result.

It’s not unexpected.  We know that total U.S. deaths jumped quite a bit last year, leading the the steepest drop in U.S. life expectancy since WWII.  But if I were going for academic publication, I’d ask (at least) two other people to calculate those numbers above independently, before I tried to publish them.  Just to be sure I hadn’t made a mistake.  Because, in all the years I’ve been dealing with analysis of the Medicare program (and by inference, the elderly), I’ve never seen anything even remotely like that.

How anyone could deny the reality or seriousness of this continues to amaze me.

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Now let’s take a peek at the VAERS data.

Did I mention that those abusing the VAERS data apparently can’t read what’s on the website?  Well, surprise, in this section, I demonstrate that they can’t do a simple query of the data correctly either.

VAERS gives you the option of downloading the raw data, or analyzing it through the CDC Wonder interface.  I’ve used Wonder in the past (primarily for mortality data), so I’m going to take my first shot at this via CDC WONDER.

And if you didn’t get the message the first couple of times around, you can’t access the data in Wonder unless you click the box agreeing to this disclaimer.  The type is small, but the message is much the same as that give above.

 

However, we do find the additional disturbing detail that John Q. Public may submit reports of adverse vaccine events to VAERS.  I am unsure of the extent to which the information in the publicly-available database is verified, if at all.

With that caveat, here’s the query (with citation as to source).  I simply asked for all deaths associated with provision of any COVID-19 vaccine:

And here’s the result.  CDC counts a total of fewer than 6000 deaths, for persons of all ages, reported at any time following of any COVID-19 vaccine.

Reported deaths, for all ages, at any time span, amount to 6% of what you could plausible have expected to see in the elderly, from natural causes alone, in three weeks.  So, far from evidence that the vaccine is harmful, we could, tongue-in-cheek, say that the mere act of vaccination seemed to hold death at bay, immediately and dramatically, for this population.

But that, of course, is nonsense.  The smaller-than-expected death count could happen for any of several reasons (reporting is incomplete, deaths clearly unrelated to vaccination were not reported, and so on).  But I would bet that, at least in part, this occurs because they elderly individuals nearing death were not taken out to be vaccinated.  Much like my anecdote above, if you were were willing and able to be vaccinated, chances are you were in fairly good shape.  Or, at least, not a death’s door.

In addition, note how the death counts above mimic the general prevalence of mortality in the U.S. population by age.  As if most of the deaths were purely incidental to the act of vaccination.  The lunatic fringe wants to use this information incorrectly, to argue that the vaccine itself is deadly.  But, somehow, it’s only deadly to the oldest old?  That makes no sense.

If I restrict to deaths no  more than seven days following administration, I get about half that number of deaths, like so:

Deaths occurring within seven days following administration of COVID-19 vaccine:

Again, that makes sense if what you are looking at is people dying of natural causes.  They are dying at a fairly steady rate in the days following vaccination.  And as the more time elapses from the day of vaccination to day of death, reporting of deaths falls off.

There will be some small number of deaths directly related to vaccination.  As I understand it, in adults, these are largely from people who have a severe allergic reaction, and die as a consequence of untreated anaphylactic shock.  This is the reason they ask you to wait 15 minutes after you are vaccinated.  Most (but not all) such cases will begin to show symptoms within that time period.

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A deeper dive.

To go any further than this, I’ll have to process the raw underlying data.  That set of files is available via links on the VAERS website.  When processed and put together, the raw files show 5908 deaths in 2021, just a few hundred more than the tabulated data above.

First, just over 10% of the deaths list COVID-19 as a symptom.  I printed the narrative descriptions for the first dozen or so such cases, and here are a few that are typical, emphasis mine:

Case descriptions where COVID-19 appears among symptoms:

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Conclusion

I’ll be brief.  Some people may die from a reaction to the COVID-19 vaccine.  To be clear, some people die from just about every vaccine.  But the whole point is, that number is orders-of-magnitude fewer than the number who would die without it.

If you read claims that a vast number of people have died from COVID-19 vaccines, that’s wrong.  If you read that the government itself says so, that’s wrong.  If you read that “the VAERS Report” shows that, that’s wrong.

Here are the facts.

So far, the U.S. has administered over 350,000,000 COVID-19 vaccine shots, to roughly 195,000,000 individuals.  That’s per the CDC COVID data tracker, accessed today (8/10/2021).

The US VAERS system lists just under 6000 cases with COVID-19 vaccination and any mention of death.

The US VAERS system is INCREDIBLY EXPLICIT that the adverse events that it records are not necessarily due to the vaccine.  I think I was clear about that in the discussion above.

If you actually look at the VAERS COVID-19 cases with mention of death:

• There are vastly fewer deaths than you would expect, based merely on deaths from natural causes in the elderly who were vaccinated.  That’s not hugely surprising to anyone who has worked with death and medical procedure data before.  Basically, they don’t perform voluntary medical procedures on people who appear likely to die within a few days or weeks.
• The pattern of deaths by age matches the overall mortality rate by age.  So if the vaccine were in fact dangerous, curiously enough, it somehow manages to be  NOT very  dangerous at all to middle-aged people.  And vastly less so to youths.
• About 10% of the VAERS vaccine-associated deaths are literally deaths from COVID-19, based on the caregivers reports.  These tend to be (e.g.) nursing home residents who were mass-vaccinated after a COVID-19 outbreak, and weren’t vaccinated in time to prevent infection with COVID-19.
• A high proportion of the remaining deaths mention things like hospice, cancer, and so on.  The caregivers involved literally attributed the deaths to something other than the vaccine.

The upshot is that, out of the 195M people who have been vaccinated so far, there are almost certainly some who died as a result of the vaccination.  If other vaccines are a guide, that number is probably quite small.  Anyone who claims that 5,000 or 50,000 or whatnot have died, because the Federal government’s VAERS system says so, are flatly incorrect.

They simply haven’t taken the time to read what VAERS says, or, certainly, to download the case reports and actually read a few.  As I now have.

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An afterword on disinformation

I just can’t help being amazed, time and again, how the sophisticated tools of information are being used to further the spread of ignorance.

Just think about this one a bit.  What sort of person would be:

• too stupid to understand that vaccines save lives;
• so credulous as to think that tens of thousands of deaths have somehow slipped by, unremarked; and yet
• sophisticated enough to know that VAERS exists, let alone claim to have queried the database and found tens of thousands of deaths; then
• able to write a succinct set of comments in the newspaper, free from grammatical errors; while
• ignoring the repeated, clear, and unambiguous statements on the VAERS website that adverse events in VAERS aren’t necessarily related to the vaccination; and
• ignoring that the actual VAERS case reports themselves often directly attribute those deaths to other causes, foremost of which is, in fact COVID-19.

How could one person combines such raw ignorance of vaccines with such sophisticated ability to access vaccine-related data and then skillfully misrepresent the results?

I don’t think that person exists. I think that a lot of what you see along these lines is deliberately fabricated to mislead.

If you were a foreign power — Russia,say — and you wanted to keep America in turmoil, you could do no better than by prolonging our COVID-19 nightmare.  And beyond a doubt, the cheapest, easiest, and least risky way to do that would be to spread as much disinformation as possible.

And so, I continue to feel that much of what circulates among the lunatic fringe is just too high-quality to have been generated natively by the lunatics themselves.  Too well-crafted, too “sticky”.

And, as in this case, too frequently constructed using a classic How to Lie With Statistics technique, the semi-attached figure.  That’s a number that seems to indicate something, but isn’t actually attached to the conclusion that others would have you make.

In fact, there are almost 6000 COVID-19 vaccination records in VAERS that mention death.  That’s a true figure.  But, no, that doesn’t mean that the COVID-19 vaccine killed 6000 people.  So the figure is in fact about COVID-19 vaccinations, and deaths, but it’s only semi-attached to the idea of death from COVID-19 vaccine.

As I continue to see that sort of slick, purpose-driven, carefully-crafted propaganda, I have a hard time believing it arises by accident.

And when those are always visible as comments to newspaper articles, or circulated in social media, I can’t help but feel that those channels are helping to tear America down.  We’d be far better off if comments sections never existed.

You might well have some reason for not getting vaccinated.  That’s one thing.  But not getting vaccinated because of the supposedly high risk of death, that’s not a thing.  That’s just carefully crafted bullshit, a lie purposefully designed to discourage people from getting the COVID-19 vaccine.

Maybe it’s my years spent serving Fortune 500 companies, but I firmly believe that bullshit is generally a bad basis from which to make a decision.  And yet, to live in America is to have people feed you bullshit at every turn.  Not just the easy-to-spot kind, but plausible, carefully-crafted, deliberately-misleading bullshit.  As if, somehow, somewhere, somebody was profiting from the collective bad decisionmaking of the American population.