Expected Deaths Post COVID-19 Vaccination: Pre-empting the Anti-Vaccine Propaganda

By Dato’ Dr Amar-Singh HSS, Consultant Paediatrician; Dr Alan Teh Kee Hean, Consultant Haematologist; Dr Lim Joo Kiong, Consultant Surgeon; Professor Dr Nor Azmi Kamaruddin, Consultant Endocrinologist and Datin Dr Lim Swee Im, Medical Practitioner

This is a brief article to help us understand that there will be some expected deaths after receiving COVID-19 vaccination, especially among the elderly. The aim of the article is to pre-empt the anti-vaccine lobby and any attempt to damage our national COVID-19 vaccination programme. We will use data from the United Kingdom (UK), United States of America (USA) and the European Union (EU) to explain what we mean.

The USA reported a death rate for people aged 65 years and older in 2019 as 3,917 per 100,000 population (1,765 per 100,000 for those aged 65-74 years, 4,308 for 75-84 years and 13,229 for 85 years and over). The most common cause of death for people 65 years and older in the USA and EU was heart disease, stroke (cerebral vascular disease), cancer and chronic lower respiratory disease; very similar to what occurs in Malaysia.

If we translate this information to our population (proxy data), this means that for every 100,000 Malaysians aged 65 years or older, close to 4,000 will die each year (rates will be higher the older they are). This is equivalent to 75 deaths per week for every 100,000 persons 65 years and older. Data from our Department of Statistics Malaysia (DOSM) shows that 7.1% of the population is aged 65 and above, i.e. 2.34 million people. This means that there will be 1,755 expected deaths per week for Malaysians aged 65 years and older, without COVID-19 vaccination. These are the expected ‘baseline’ deaths every week.

Hence if we give COVID-19 vaccination to 100,000 Malaysians aged 65 years and older, we can expect at least 75 of them to die in the next seven days from other diseases like a heart attack or stroke. These will NOT be deaths due to the vaccine, but the expected deaths from other illnesses. However because a COVID-19 vaccine had been given, some individuals may then claim the deaths were due to the vaccination and fuel the anti-vaccine lobby.

As of this point, just over 200 million doses of vaccines have been given worldwide. The USA (CDC Vaccine Adverse Event Reporting System) and UK (Department of Health Yellow Card reporting system) monitor all vaccine adverse events. So far from 26 million vaccine doses delivered in these two countries, some (baseline) deaths have occurred as expected but a review of individual reports does not suggest the vaccine played a role in the deaths. Currently the only recognised serious side effect is a severe allergic reaction (anaphylaxis) that occurs in between 4 to 11 cases out of 1,000,000 doses.

Our Ministry of Health (MOH) will be monitoring all such events after the vaccination and will be looking for any evidence of a link between the vaccine and any adverse outcome. We should only be alarmed if the rate of deaths rises significantly above the baseline rate.

It is important for the public to understand this as we embark on our national COVID-19 vaccination programme. Some of our loved ones may die after the vaccination but this will likely NOT be due to the vaccination. As members of the public we should stay abreast of the science and data as it emerges and not fall prey to rumours or anti-vaccine propaganda.

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