Fact check: Fatality rate among fully vaccinated people who developed COVID-19 misleading, experts sayMay 1, 2021
The claim: Death rate among COVID-19 vaccinated people is significantly higher compared to unvaccinated population
New data this week has found fully vaccinated adults 65 or older are 94% less likely to be hospitalized with COVID-19 than their same-aged peers – and 64% less likely if they have only received one dose of the mRNA vaccine.
These findings are the first large-scale, real-world results confirming Pfizer and Moderna’s clinical trial data (and early reports from Israel), said the U.S. Centers for Disease Control and Prevention, which conducted the study.
But vaccination, while highly effective, doesn’t fully prevent coronavirus in some people. In the last few weeks, states across the U.S. have reported cases of COVID-19 infection among fully vaccinated people, also known as vaccine breakthrough infections.
On social media, a small number of deaths among this group has prompted comparisons to the COVID-19 death rate among the general population.
“The death rate for fully vaccinated people is SIGNIFICANTLY higher than non-vaccinated,” claims Instagram user Ian Smith in an April 25 post.
Smith’s post includes a screenshot of an April 24 tweet claiming the CDC has reported “7,157 Fully Vaccinated Americans Have Contracted COVID-19, 88 Have Died…”
As of April 20, the CDC has indeed reported a total of 7,157 cases of COVID-19 among fully vaccinated people and 88 deaths.
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But public health experts say calculating a death rate from those numbers and comparing it to the general population is misleading.
USA TODAY has reached out to Smith for comment.
Data mostly reflects serious COVID-19 cases
To calculate an accurate death rate, the total number of positive COVID-19 cases among vaccinated individuals must be known. But that number isn’t, said Lisa Miller, an epidemiologist and clinical professor at the Colorado School of Public Health.
“We don’t know that because we’re not out there testing everyone (vaccinated),” she told USA TODAY.
This gap in reporting is also acknowledged by the CDC, which relies on voluntary reporting from state health departments.
“Not all real-world breakthrough cases will be identified because of a lack of testing. This is particularly true in instances of asymptomatic or mild illness,” the agency said, emphasizing the data only serves as a “snapshot” to help “identify patterns… among vaccine breakthrough cases.”
Without a true number of asymptomatic and mild cases, this snapshot is skewed towards severe COVID-19 cases, said Kristin Nelson, an assistant professor of epidemiology at the Emory University Rollins School of Public Health.
Infected vaccinated people with severe symptoms are more likely to seek medical attention, be hospitalized or die. These are the cases noticed and investigated by state health departments that later reach the CDC, both Nelson and Miller told USA TODAY.
It’s important to note that the CDC has said 11 of the 88 deaths among COVID-19 infected, fully vaccinated people were “asymptomatic or not related to COVID-19.”
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The number of vaccine breakthrough infections is also quite small compared to the more than 100 million U.S. adults who have been fully vaccinated as of April 30.
Vaccinated people are those most at risk
The most obvious reason to avoid comparing the vaccinated and unvaccinated death rates are the types of people in each group.
Every state has prioritized people most at risk, so the group of people vaccinated is heavily skewed toward those whose age and medical history make them prone to serious cases of COVID-19, and death from it. So when the expected breakthrough cases do occur, it’s not surprising some deaths would result.
Let’s look at age, for example.
Older adults are at the greatest risk of developing severe illness, requiring hospitalization and dying, with eight out of 10 COVID-19 deaths reported occurring among adults aged 65 years and up, according to the CDC. And 37% of people vaccinated to date are in that age bracket, even though people 65 and older are just 16%of the total population.
So those vaccinated are a pool of people predisposed to more severe cases.
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Among the over 7,000 breakthrough infections reported, nearly 46% are associated with people over the age of 60. We don’t know the ages of those who have died after breakthrough infections because the CDC hasn’t released that data.
Our rating: False
We rate the claim that the death rate from COVID-19 among fully vaccinated individuals is significantly higher than the unvaccinated FALSE, based on our research. Experts say because the total number of vaccine breakthrough infections is unknown and voluntary state reporting to the CDC skews toward more serious COVID-19 cases, it is not possible to directly infer an accurate death rate. And regardless, any comparison between the vaccinated and non-vaccinated is heavily skewed by the fact that the vaccinated group at present has a much higher proportion of older adults who are most at risk.
Our fact-check sources:
- U.S. Centers for Disease Control and Prevention, April 28, Fully Vaccinated Adults 65 and Older Are 94% Less Likely to Be Hospitalized with COVID-19
- USA TODAY, April 18, A cautionary tale: COVID-19 infection after vaccination is rare, but breakthroughs can happen. It happened to this man.
- U.S. Centers for Disease Control and Prevention, accessed April 29, COVID-19 Breakthrough Case Investigations and Reporting
- Lisa Miller, April 29, phone interview
- Kristin Nelson, April 29, phone interview
- U.S. Centers for Disease Control and Prevention, accessed April 30, Trends in Number of COVID-19 Cases and Deaths in the US Reported to CDC, by State/Territory
- U.S. Centers for Disease Control and Prevention, accessed April 30, COVID-19 Vaccinations in the United States
- U.S. Centers for Disease Control and Prevention, April 16, Older Adults
- U.S. Centers for Disease Control and Prevention, Feb. 18, Risk for COVID-19 Infection, Hospitalization, and Death by Age Group
- Tara Kirk Sell, April 27, phone interview
- USA TODAY, April 30, 100M Americans have received two doses or one J&J shot; US to restrict flights from India: Live COVID-19 updates
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