Inadequate support: The claim appears to compare two death counts: breakthrough COVID-19 deaths and total COVID-19 deaths. But there is no evidence that these data were collected using the same methods. It cannot be assumed that they are comparable. Furthermore, the figures presented in the claim are at odds with available counts from several states.
Misleading: The claim alleged that the CDC is changing the definition of “fully vaccinated” to restrict it to people who received booster shots. While the CDC acknowledged that it is considering such a change, no decision has been taken as of 25 October 2021, contrary to what the claim suggests.
FULL CLAIM: “they are pushing boosters because hospitals and morgues are filling up with fully vaccinated people. So they are needing to change the definition of what it means to be fully vaccinated” “40% of deaths from C19 last week [...] were fully vaccinated, [...] that’s a jump of 51.2%”
REVIEW
The number of COVID-19 deaths rose again in the U.S. from July 2021 to mid-September 2021, amid concerns of the Delta variant spreading and vaccine-induced immunity waning over time. While data show that vaccines are safe and effective against COVID-19, the U.S. Food and Drugs Administration (FDA) authorized the administration of booster shots to reinforce vaccine-induced immunity.
Some used the surge in COVID-19 deaths as evidence that vaccines are ineffective. For instance, writer Elijah Schaffer claimed in a tweet and on Instagram that fully vaccinated individuals accounted for 40% of COVID-19 deaths in the week preceding his social media posts. He also alleged that the 40% represented a jump of 51% from the previous week, according to the U.S. Centers for Diseases Control and Prevention (CDC). This claim was also propagated by U.S. Representative Marjorie Taylor Greene according to NBC News.
Schaffer further alleged that health authorities needed to change the definition of “fully vaccinated” to include only people receiving the booster shot as a way to conceal the supposed ineffectiveness of COVID-19 vaccines. His reasoning implies that going forward, those who are currently fully vaccinated would be considered as unvaccinated.
However, his claims are unsupported by existing evidence and his analysis of COVID-19 deaths by vaccination status is flawed, as we explain below.
The claim that the CDC changed its definition of full vaccination is false. In a 15 October 2021 update, the CDC stated that individuals are considered fully vaccinated two weeks after the second injection of a two-dose vaccine (Moderna and Pfizer-BioNTech), or two weeks after the injection of a one-dose vaccine (Johnson & Johnson). On 22 October 2021, the head of CDC declared “We may need to update our definition of ‘fully vaccinated’ in the future”. Therefore, no such decision had been taken on 23 October, at the time of Schaffer’s post.
Schaffer didn’t provide sources supporting his claim regarding the proportion of fully vaccinated individuals among COVID-19 fatalities. In order to verify his claim, Health Feedback turned to analyzing CDC data of COVID-19 mortality.
The CDC provides the number of breakthrough COVID-19 deaths, that is, the COVID-19 deaths occurring in fully vaccinated individuals. As of 18 October 2021, the CDC had counted 10,857 COVID-19 deaths from breakthrough infections. One week earlier, this number was 7,178, which is 3,679 fewer deaths. This indeed represents a 51.2% increase from one week to the other. During the same time frame, the CDC also reported an additional 10,010 COVID-19 deaths. By comparing both numbers, we found that COVID-19 deaths of vaccinated individuals apparently represent 37% of the total number of COVID-19 deaths, a percentage rather close to Schaffer’s claim.
However, his analysis suffers from several flaws. At least two additional parameters need to be taken into account to determine if the vaccines are effective.
First, as the vaccinated population grows larger, we expect to see the absolute number of vaccinated people getting sick to rise, even with effective vaccines, because no vaccine provides 100% protection. For this reason, one needs to compare the proportion of COVID-19 deaths between the vaccinated people and the unvaccinated population.
To illustrate why this is necessary, consider a population where everyone has been vaccinated against COVID-19. As explained before, COVID-19 vaccines significantly reduce the risk of getting sick and die, but they don’t completely eliminate that risk. Therefore, a certain proportion of vaccinated people would still die from COVID-19. In this scenario where everyone has been vaccinated, 100% of the COVID-19 deaths would occur among vaccinated individuals. Therefore, the finding that most of the COVID-19 deaths come from vaccinated people doesn’t on its own tell us anything about the vaccines’ effectiveness. Biostatistician Lucy D’Agostino McGowan explained this concept in a Twitter thread.
Second, one must take into account the demographics of the vaccinated and unvaccinated groups. The COVID-19 vaccination campaign began by vaccinating people most vulnerable to the disease. Therefore, they are over-represented in the fully vaccinated population. While 57.6% of the general population is fully vaccinated as of 23 October 2021, 84.9% of the people above 65 are. This means that the fully vaccinated population is older and more frail than the unvaccinated population. Therefore, we cannot directly compare COVID-19 mortality rates between the two.
While Schaffer didn’t account for these two factors, the CDC did so in performing their analysis of the number of COVID-19 deaths among unvaccinated and vaccinated people, as reported by 16 U.S. jurisdictions. In order to account for the difference in population size, as discussed earlier, they calculated the proportion of COVID-19 deaths in each group.
And in order to account for the age difference between both populations, the results were age-standardized. At the latest date available in the study, the researchers found that the mortality rate among the unvaccinated group was 9.14 deaths for 100,000 persons. In comparison, it was 0.74 deaths for 100,000 among fully vaccinated. In other words, once we take into account the difference in population size and population age, the COVID-19 mortality rate of fully vaccinated people was 12 times lower than for unvaccinated individuals.
Another problem is that Schaffer’s post doesn’t provide information that addresses this question of data collection methods. When comparing two death counts, it is crucial that they are obtained using the same methods, such as a similar exhaustivity and timeline of death reporting. But this information isn’t available, and therefore, it is unknown whether the percentages calculated by Schaffer represent the true difference in number of deaths between vaccinated and unvaccinated people.
In order to verify the claim, Health Feedback took the approach of examining state-level data where the vaccination status of people who died from COVID-19 was available, which is provided by several states.
For instance, Tennessee reported that, through the month of September 2021, breakthrough COVID-19 cases represented only 15% of the monthly COVID-19 death count. In Louisiana, fully vaccinated individuals only accounted for 26% of the COVID-19 deaths from 14 to 20 October 2021. Fully vaccinated individuals accounted for 20% of COVID-19 deaths in September 2021 in Oregon, and they were 24% in South Carolina over the same period. From 1 October to 18 October, California reported 17.5% of COVID-19 deaths came from fully vaccinated individuals.
In short, what data we do have at the state level contradicts Schaffer’s claim that fully vaccinated people make up the bulk of COVID-19 deaths.
CONCLUSION
In summary, U.S. health authorities are recommending booster shots to counter the waning of vaccine-induced immunity, but this doesn’t mean that vaccines don’t work. Claims that fully vaccinated people account for 40% of COVID-19 deaths result from incorrect analysis, as it doesn’t take into account the difference in population size and demographics between the vaccinated and unvaccinated population. When done correctly, fully vaccinated people are more than ten times less likely to die from COVID-19 than unvaccinated individuals.
