Submitted:
08 September 2023
Posted:
11 September 2023
Read the latest preprint version here
Abstract
Keywords:
1. Summary of paper
Acknowledgements
2. How to measure excess mortality and vaccination rates
3. Before versus after the vaccination rollout
4. Conclusions
- (a)
- While we are confident survivor bias has played some role post-rollout, and equally confident it cannot account for the overall pattern, we see no clear way to determine where we should land between these two poles.
- (b)
- We have concentrated in our analysis on overall correlations, which mask the ongoing large variations in the performances of different countries, even neighbouring ones. Such variations indicate the presence of other important factors affecting EM rates. There are indeed obvious candidates for other factors affecting pandemic-era mortality - Covid itself, non-pharmaceutical interventions, underlying demographics, economic and public health status etc - and isolating the role of just the vaccines is inevitably difficult.
5. The April 2021 EM peak
6. Alternative measures of EM and vaccination rates
- (a)
- Since the Owid figures are no longer being updated for certain countries, we are not quite comparing “apples with apples". To remedy this, we also considered rates of full vaccination for every country on 31/12/2021 (M2), at which time every country was still updating its numbers. In cases where there is no data point for exactly that date, we interpolate linearly between the two adjacent data points.
- (b)
- M2 deals with the “apples to apples" issue, but ignores the possible effect of booster campaigns. In most countries, these ramped up only after the omicron variant took over, and hence into the first few months of 2022. Owid also provides data on the average number of vaccine doses per person. This measure (M3), at least to some extent, addresses the possible role of booster campaigns. It suffers from the same issue as M1, namely that certain countries have stopped updating their data, but there’s not much we can do about that.
- (c)
- M1 also misses those people who took the first dose of a two-dose primary vaccination but never took the second dose. Since those who suffered adverse reactions are likely to be overrepresented in this group, it makes sense to try to include them. Owid also provides data on the percentage of the population who have to date received at least one dose. This measure M4 has the same “apples to apples" problem as M1 and M3.
| Country | M1 | M2 | M3 | M4 |
|---|---|---|---|---|
| Austria | ||||
| Belgium | ||||
| Bulgaria | ||||
| Croatia | ||||
| Cyprus | ||||
| Czechia | ||||
| Denmark | ||||
| Estonia | ||||
| Finland | ||||
| France | ||||
| Germany | ||||
| Greece | ||||
| Hungary | ||||
| Iceland | ||||
| Ireland | ||||
| Italy | ||||
| Latvia | ||||
| Lithuania | ||||
| Malta | ||||
| Netherlands | ||||
| Norway | ||||
| Poland | ||||
| Portugal | ||||
| Romania | ||||
| Slovakia | ||||
| Slovenia | ||||
| Spain | ||||
| Sweden | ||||
| Average |
7. Covid mortality rates
- (a)
- There has never been, and probably cannot be, a universal standard as to what constitutes a death due to Covid. This problem became even more acute once the generally milder, but more infectious, omicron-derived variants took over.
- (b)
- As the pandemic waned after the first omicron wave, reporting of Covid deaths in many countries became more intermittent. Some countries moved from daily to less regular (usually weekly) updates in 2022, though essentially all 28 of the EU/EES countries we’ve been considering here, bar Iceland, were still updating their data regularly throughout 2022. In 2023, however, reporting has become progressively more patchy in most places and for many EU/EES countries, Worldometers has stopped updating their numbers altogether over the last few months.
8. Final remarks
References
- Aastad and O. A. Kvitastein, Is there a Link between the 2021 COVID-19 Vaccination Uptake in Europe and 2022 Excess All-Cause Mortality?, Asian Pacific Journal of Health Sciences, Vol. 10, No. 1 (2023). https://www.apjhs.com/index.php/apjhs/article/view/3017.
- Vanden Bossche and R. Rennebohm, The Inescapable Immune Escape Pandemic, Pierucci Publishing (2023).
- E. Dowd, “Cause Unknown": The Epidemic of Sudden Deaths in 2021 & 2022 (Children’s Health Defense), Skyhorse Publishing (2022).
- Eurostat: Excess mortality - statistics. https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Excess_mortality_-_statistics#Excess_mortality_in_the_EU_between_January_2020_and_December_2022.
- N. Fenton and M. Neil, Where are the numbers? (Substack). https://wherearethenumbers.substack.com/t/excess-deaths.
- J. Finsterer, Neurological side effects of SARS-CoV-2 vaccinations, Acta Neurologica Scandinavica, Vol. 145, No. 1 (2022), 5–9. [CrossRef]
- R. A. K. Kadali, R. Janagama, S. Peruru and S. V. Malayala, Side effects of BNT162b2 mRNA COVID-19 vaccine: A randomized, cross-sectional study with detailed self-reported symptoms from healthcare workers, International Journal of Infectious Diseases, Vol. 106 (2021), 376–381. [CrossRef]
- O. Karlstad, P. Hovi, A. Husby, T. Härkänen, R. M. Selmer, N. Pihlström et al, SARS-CoV-2 Vaccination and Myocarditis in a Nordic Cohort Study of 23 Million Residents, JAMA Cardiology, Vol. 7, No. 6 (2022), 600–612. [CrossRef]
- M. Klugar, A. Riad, M. Mekhemar, J. Conrad, M. Buchbender, H. P. Howaldt et al, Side Effects of mRNA-Based and Viral Vector-Based COVID-19 Vaccines among German Healthcare Workers, Biology-Basel, Vol. 10, No. 8 (2021). [CrossRef]
- M. E. Oster, D. K. Shay, J. R. Su, J. Gee, C. B. Creech, K. R. Broder et al, Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021, JAMA, Vol. 327, No. 4 (2022), 331–340. 20 December. [CrossRef]
- Our World in Data: Excess mortality during the Coronavirus pandemic (COVID-19). https://ourworldindata.org/excess-mortality-covid.
- Our World in Data: Coronavirus (COVID-19) Vaccinations. https://ourworldindata.org/covid_vaccinations.
- M. Patone, X. W. Mei, L. Handunnetthi, S. Dixon, F. Zaccardi, M. Shankar-Hari et al, Risk of Myocarditis After Sequential Doses of COVID-19 Vaccine and SARS-CoV-2 Infection by Age and Sex, Circulation, Vol. 146, No. 10 (2022), 743–754. [CrossRef]
- Worldometers Coronavirus Tracker. https://www.worldometers.info/coronavirus.
| 1 | There is, of course, ongoing debate as to when the first Covid-19 cases actually appeared in Europe. In official data, however, the first Covid deaths are generally recorded in March 2020 and this was also the month when non-pharmaceutical public health interventions began to be applied widely across the continent. |
| 2 | |
| 3 | |
| 4 | Because both Covid and all-cause excess mortality subsided for a few months after April 2021, it wouldn’t make much difference where we placed the cutoff during this period. By late summer of 2021, large majorities of those who would eventually be fully vaccinated had already received their doses. |
| 5 | Netherlands is an outlier since, despite mounting an aggressive vaccination campaign, official statistics show it ending up with a lower than average rate of full vaccination. If we take into account boosters, however, it instead ends up above average - see column M3 of Table 7 in Section 6. Latvia is the only country to switch in the opposite direction. |
| 6 | See Footnote 5. |
| 7 | |
| 8 | The exclusion of June 2023 this time will also contribute something to reducing the shift. |
| 9 | In some cases, since a data point for the last day of a month was missing, we had to interpolate between adjacent data points to arrive at an approximate monthly total. This introduces miniscule errors. |
| 10 | Since the total population of a country isn’t constant, this introduces further tiny errors. |
| 11 | For row M3 in Table 10, we get for . A “fully vaccinated and boosted" population would have . |








| Country | Country | ||||
|---|---|---|---|---|---|
| Malta | Cyprus | ||||
| Portugal | Sweden | ||||
| Spain | Latvia | ||||
| Italy | Lithuania | ||||
| Ireland | Netherlands | ||||
| Denmark | Czechia | ||||
| Belgium | Estonia | ||||
| Finland | Hungary | ||||
| France | Slovenia | ||||
| Iceland | Poland | ||||
| Germany | Croatia | ||||
| Austria | Slovakia | ||||
| Norway | Romania | ||||
| Greece | Bulgaria | ||||
| Average |
| Country | Country | Country | |||
|---|---|---|---|---|---|
| Finland | Portugal | Latvia | |||
| Netherlands | Belgium | Croatia | |||
| Ireland | Denmark | Hungary | |||
| Cyprus | France | Czechia | |||
| Slovenia | Sweden | Slovakia | |||
| Estonia | Italy | Lithuania | |||
| Austria | Spain | Bulgaria | |||
| Norway | Poland | Romania | |||
| Germany | Greece | Iceland | N/A | ||
| Malta |
| Country | Country | Country | |||
|---|---|---|---|---|---|
| Cyprus | Austria | France | |||
| Slovakia | Spain | Finland | |||
| Poland | Italy | Ireland | |||
| Bulgaria | Croatia | Latvia | |||
| Malta | Portugal | Iceland | |||
| Slovenia | Lithuania | Belgium | |||
| Czechia | Estonia | Denmark | |||
| Greece | Germany | Norway | |||
| Netherlands | Hungary | Sweden | |||
| Romania |
| Country | Country | ||||
|---|---|---|---|---|---|
| Austria | Ireland | ||||
| Belgium | Italy | ||||
| Bulgaria | Latvia | ||||
| Croatia | Lithuania | ||||
| Cyprus | Malta | ||||
| Czechia | Netherlands | ||||
| Denmark | Norway | ||||
| Estonia | Poland | ||||
| Finland | Portugal | ||||
| France | Romania | ||||
| Germany | Slovakia | ||||
| Greece | Slovenia | ||||
| Hungary | Spain | ||||
| Iceland | Sweden |
| Country | Country | ||||
|---|---|---|---|---|---|
| 2021 | 2022 | 2021 | 2022 | ||
| Austria | Ireland | ||||
| Belgium | Italy | ||||
| Bulgaria | Latvia | ||||
| Croatia | Lithuania | ||||
| Cyprus | Malta | ||||
| Czechia | Netherlands | ||||
| Denmark | Norway | ||||
| Estonia | Poland | ||||
| Finland | Portugal | ||||
| France | Romania | ||||
| Germany | Slovakia | ||||
| Greece | Slovenia | ||||
| Hungary | Spain | ||||
| Iceland | Sweden |
| Country | Country | Country | Country | ||||
|---|---|---|---|---|---|---|---|
| Denmark | Malta | Malta | Malta | ||||
| Iceland | Iceland | Hungary | Hungary | ||||
| Slovenia | Slovakia | Iceland | Lithuania | ||||
| Italy | Norway | Lithuania | Estonia | ||||
| Ireland | Romania | Greece | Italy | ||||
| Estonia | Greece | Denmark | Spain | ||||
| Portugal | Ireland | Spain | Slovakia | ||||
| Lithuania | Poland | Austria | Denmark | ||||
| Spain | Belgium | Italy | Slovenia | ||||
| Malta | Austria | Norway | Austria | ||||
| Germany | Estonia | Slovenia | Romania | ||||
| Cyprus | Lithuania | Ireland | France | ||||
| Hungary | Denmark | Romania | Iceland | ||||
| Croatia | Cyprus | Estonia | Czechia | ||||
| Slovakia | Portugal | Portugal | Ireland | ||||
| Romania | Spain | Poland | Greece | ||||
| Austria | Germany | Germany | Portugal | ||||
| Poland | Slovenia | Cyprus | Germany | ||||
| Greece | Hungary | Czechia | Cyprus | ||||
| Norway | France | Slovakia | Belgium | ||||
| Czechia | Sweden | Belgium | Poland | ||||
| Latvia | Italy | Sweden | Norway | ||||
| Finland | Czechia | France | Netherlands | ||||
| Belgium | Netherlands | Netherlands | Sweden | ||||
| Sweden | Finland | Croatia | Croatia | ||||
| Netherlands | Croatia | Finland | Bulgaria | ||||
| Bulgaria | Latvia | Bulgaria | Finland | ||||
| France | Bulgaria | Latvia | Latvia | ||||
| Average | Average | Average | Average |
| Measure | ||||
|---|---|---|---|---|
| M1 | ||||
| M2 | ||||
| M3 | ||||
| M4 |
| Measure | ||||
|---|---|---|---|---|
| M1 | ||||
| M2 | ||||
| M3 | ||||
| M4 |
| Measure | ||||
|---|---|---|---|---|
| M1 | ||||
| M2 | ||||
| M3 | ||||
| M4 |
| Country | Country | Country | |||
|---|---|---|---|---|---|
| Lithuania | Hungary | Ireland | |||
| Bulgaria | Austria | Finland | |||
| Slovakia | Greece | Germany | |||
| Croatia | Cyprus | Iceland | |||
| Romania | Netherlands | France | |||
| Italy | Estonia | Sweden | |||
| Czechia | Slovenia | Malta | |||
| Poland | Belgium | Norway | |||
| Latvia | Portugal | Denmark | |||
| Spain |
| Country | Country | ||||
|---|---|---|---|---|---|
| Austria | Ireland | ||||
| Belgium | Italy | ||||
| Bulgaria | Latvia | ||||
| Croatia | Lithuania | ||||
| Cyprus | Malta | ||||
| Czechia | Netherlands | ||||
| Denmark | Norway | ||||
| Estonia | Poland | ||||
| Finland | Portugal | ||||
| France | Romania | ||||
| Germany | Slovakia | ||||
| Greece | Slovenia | ||||
| Hungary | Spain | ||||
| Iceland | Sweden |
| Country | Country | ||||
|---|---|---|---|---|---|
| 2021 | 2022 | 2021 | 2022 | ||
| Austria | Ireland | ||||
| Belgium | Italy | ||||
| Bulgaria | Latvia | ||||
| Croatia | Lithuania | ||||
| Cyprus | Malta | ||||
| Czechia | Netherlands | ||||
| Denmark | Norway | ||||
| Estonia | Poland | ||||
| Finland | Portugal | ||||
| France | Romania | ||||
| Germany | Slovakia | ||||
| Greece | Slovenia | ||||
| Hungary | Spain | ||||
| Iceland | Sweden |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).