Journal article suggesting Covid-19 vaccines contributed to excess deaths skewed: S’pore experts

SINGAPORE – Covid-19 mRNA vaccines may have contributed to the 3.1 million excess deaths – that is, the number of deaths beyond what would be normal – in 47 Western countries between 2020 and 2022, suggested an article in a journal.

But experts in Singapore disagreed with the article published on June 3 in the BMJ Public Health journal, one of more than 60 titles published by the British Medical Journal.

They said the piece was “unbalanced” and that correlation is not the same as causation. The Ministry of Health (MOH) said it is aware of the article.

Its spokesman told The Straits Times: “MOH has studied excess deaths in Singapore from 2020 to 2022. Our studies showed that the excess deaths could be accounted for by deaths directly due to Covid-19, or due to underlying medical conditions which were made worse by Covid-19 infections.”

The authors of the article – three paediatric oncologists and an independent researcher, all from the Netherlands – pointed out that “in 2021, the year in which both containment measures and Covid-19 vaccines were used to address virus spread and infection, the highest number of excess deaths was reported”.

In that year, excess deaths in the countries studied hit 1.26 million. The figure was 1.03 million in 2020, the year the pandemic started, and 808,392 in 2022, when most Covid-19 measures were lifted. Britain was the first to approve the mRNA vaccine, in December 2020.

The pandemic, from Jan 30, 2020, to May 5, 2023,

accounted for seven million deaths.

The authors noted that investigations into worrying trends were not made public, such as the discovery of batch-dependent levels of toxicity in mRNA vaccines in Denmark, and the simultaneous onset of excess mortality and Covid-19 vaccination in Germany.

The article also said secondary analysis of clinical trials had shown that the mRNA vaccines from Pfizer had a 36 per cent higher risk of serious adverse events, while Moderna was at 6 per cent.

It said: “These serious adverse events lead to either death, are life-threatening, require inpatient (prolongation of) hospitalisation, cause persistent/significant disability/incapacity, concern a congenital anomaly/birth defect or include a medically important event, according to medical judgment.”

Most of these serious adverse events are common conditions like stroke and heart problems, the authors said. “This commonality hinders clinical suspicion and consequently its detection as adverse vaccine reactions.”

Professor Dale Fisher, a senior infectious diseases consultant at the National University Hospital (NUH), said most excess deaths were due to Covid-19 infection, including those that were not included as Covid-19 deaths.

He explained: “The other major cause comes from other medical conditions that received inadequate attention from the health system. This happens especially when the system, especially its hospitals, is overwhelmed.

“Beds are full, staff are unwell or burnt out. Patients can be afraid to even come to hospital. 

“Excess deaths from pre-existing cardiovascular disease, other respiratory diseases and dementia are well documented. Some services were closed and we saw tuberculosis and malaria programmes impacted in some countries.”

Prof Fisher said the authors over-emphasised the negative health impact of vaccines and social restrictions on the excess mortality rate.

While there were surely some deaths caused by vaccines, he said: “The authors present their findings in an unbalanced way.

“The restrictions and vaccines saved millions of lives and allowed the world to exit the pandemic earlier and more safely.”

Professor Paul Tambyah, speaking in his capacity as president of the International Society for Infectious Diseases, said that if the authors’ hypothesis was correct, then the countries with the highest vaccination rates would also have the highest mortality rates.

But he noted: “The countries with the highest excess mortality appear to have the lowest vaccination rates, while the countries with the lowest excess mortality have the highest vaccination rates, which seems to imply that there is no correlation between vaccination rates and excess mortality.”

While not wanting to make a “potentially spurious correlation” like the article did, Prof Tambyah said: “I would argue that perhaps those countries with the highest excess mortality are those which invest (or have) the least amount of government money on healthcare compared with those with low excess mortality.”

He said countries with less well-resourced healthcare systems have continued to suffer from the pandemic, not necessarily from the virus, but from delayed cancer diagnoses, among other issues.

Hence, Prof Tambyah, who is also a senior infectious diseases consultant at NUH, concluded: “There does not appear to be a correlation between high vaccination rates and high excess mortality.”

Professor Hsu Li Yang, an infectious diseases consultant who is vice-dean of global health at the NUS Saw Swee Hock School of Public Health, pointed out that two of the countries in the study, Australia and New Zealand, had low, or even negative, excess mortality in 2020 and 2021.

Both had reached peak vaccination rates in the later part of 2021, said Prof Hsu, but excess deaths in these countries shot up dramatically only in 2022.

He added: “For every country on the list, 2022 was also the year when reported Covid-19 cases really shot up dramatically, thanks to Omicron and its sub-variants, and also because countries dropped or eased the majority of their restrictions then.”

Therefore, the majority of experts globally attribute the cause of excess mortality “largely due to Covid-19 deaths and the disruption to the healthcare systems from 2020 to 2022”, he said.

Prof Hsu added: “The data is the data, but I confess to being really surprised that the BMJ Public Health editorial board let the discussion pass.”

MOH said it is difficult to comment on the excess deaths that occurred in the West.

“Much will depend on the spread of Covid-19, the timing of societies opening up, which will drive up excess deaths, and the health aftermath of earlier infections and lockdowns, as well as the pace of vaccine take-up, which will mitigate excess deaths.”

The MOH spokesman added that Britain and Sweden, which adopted a strategy of living with the virus very early on, incurred the most excess deaths in 2020.

In Denmark, which adopted an approach similar to Singapore of ensuring high coverage of vaccines before opening up, more excess deaths occurred in 2022, he noted. But Denmark’s approach resulted in much lower excess deaths compared with Britain and Sweden.

“Numerous studies have demonstrated how Covid-19 vaccination had lowered the risk of death as compared with not being vaccinated,” he added. “In fact, a well-quoted study from The Lancet (medical journal) found that 19.8 million deaths from Covid-19 were prevented globally within the first 12 months that vaccines became available.”