IRELAND’S COVID SITUATION has deteriorated somewhat in recent weeks, with concerns from public health officials about the impact of the virus putting the brakes on what would have been the lifting of all remaining restrictions on Friday.

Despite the success of the vaccine rollout over the course of the year, the country has seen a notable rise in the number of hospitalisations, ICU admissions and deaths as a result of Covid-19 since the end of the summer.

Health officials are not the only people who have been raising concerns about these figures, however.

The notable increase in ICU admissions and deaths due to Covid-19 has led to various claims from anti-vaccine groups on social media seeking to undermine the use of vaccines.

In recent weeks, these groups have leaned on data published by the Health Protection Surveillance Centre (HPSC) every week to claim that the number of Covid-19 deaths since April is higher among vaccinated than unvaccinated people.

This had led to claims that vaccines aren’t working, that unvaccinated people aren’t putting pressure on the health service, and that Ireland is only pushing the use of vaccines because of the government’s links to Big Pharma.

None of these claims are true and there is important context missing from the claims which rely on the HPSC’s data, namely the definition of a ‘vaccinated’ person.

Vaccines are still preventing much higher levels of severe illness and death than currently being experienced in Ireland, and unvaccinated people with Covid-19 are still making up a higher proportion of deaths than fully vaccinated people. 

HPSC data

The HPSC released its latest report on Covid-19 deaths on Friday – you can read it here.

It found that between 1 April and 16 October this year, there were 402 deaths in Ireland of people who had had a confirmed case of Covid-19 and who were notified to the HPSC as having died from the disease. Of these:

• 42% of people (or 155 deaths) were among people who died 14 days or more after receiving all recommended doses of a vaccine.
• 55.7% of people (or 224 deaths) were among people who had received at least one dose of a vaccine;
• 44.3% of people (or 178 deaths) were among people who had not been vaccinated or had not been registered as vaccinated on Ireland’s Covid-19 immunisation system.

(Note: these percentages add up to more than 100 because people in the first group – fully vaccinated people – are also contained within the second group).

It should be noted here that the number of Covid-19 deaths since April remains lowest in the category of fully vaccinated people – that is, those who died more than two weeks after receiving all doses of the vaccine they were given.

An individual is only considered vaccinated against Covid-19 after that point; until then, the vaccine does not offer them the fullest possible protection against the virus and they are more at risk of serious illness and death.  

But despite this statistic, vaccine sceptics and anti-lockdown groups have nevertheless suggested that the HSPC’s own data undermines the aims of the vaccination programme.

They point to trends from the health surveillance centre – which publishes its figures weekly – to imply that vaccines are no longer working because a higher proportion of partly or fully vaccinated people have died with Covid-19 in recent weeks.

In contrast, the HSPC’s data shows that the number of deaths among unvaccinated people as a percentage of the overall total has gradually fallen.

Between April and 11 September, 59.4% of deaths (149 of 251) occurred in people who were not recorded as having been vaccinated; this compares to 44.3% of deaths (178 of 402) in the period from April and 16 October.

Meanwhile, the number of deaths among people who have received at least one dose of a vaccine has risen over the same period, from 40.6% (102 of 251 deaths) up to 11 September to 55.7% (224 of 402 deaths) up to 16 October. 

Similarly, the percentage of fully vaccinated people who have died of Covid-19 has almost doubled from 24.3% of deaths (61 of 251) up to 11 September to 43.3% of deaths (174 of 402) up to 16 October.

In other words, between 11 September and 16 October, just 29 unvaccinated people died from Covid-19 compared with 149 people who received at least one dose (including 113 fully vaccinated people).

Deaths occur in vaccinated people because of what are known as ‘breakthrough’ cases, which we previously explained here.

The main aim of the Covid-19 vaccines is to prevent Covid-19 from making people seriously ill, or dying – but the unfortunate reality is that this won’t always be the case, because vaccines are not 100% effective at preventing the spread of the virus.

In the majority of cases, vaccines will prevent serious illness and death, but occasionally some deaths do occur.

Additional data

Earlier this week, The Journal asked members of the National Public Health Emergency Team (NPHET) to explain why more people who are vaccinated are dying as a result of Covid-19 than those who are not vaccinated.

Speaking at NPHET’s first media briefing in over two months, Professor Philip Nolan noted that Covid-19 vaccines don’t entirely reduce the risk of death from the virus, particularly among older populations. 

“The situation is that the vast majority of people – in fact, almost 100% of people – who are at risk of dying from this virus have been vaccinated,” he explained.

“And what that means then is [that] vaccination greatly reduces the risk of dying from this virus, but it doesn’t eliminate the risk.

“It sadly does mean that, with very large levels of circulating virus, some older people will become infected and a very small number of those people will die.”

HPSC data on deaths from Covid-19 - including age profile - also outlines the impact of the virus on older people since September.

It shows how the median ages of new Covid-19 deaths in each of the six weeks between 8 September and 19 October (roughly the period covered by the vaccination data), were 81, 74, 79, 79, 85 and 76 respectively.

Similar data from the Central Statistics Office (CSO), which also publishes information about Covid-19, shows that there were 156 deaths recorded between 11 September and 19 October.

Of these deaths, 136 were among people aged over 65, including 81 people over the age of 80 (in fact, no age was given for eight of the 12 of the remaining deaths). 

Although the vaccination status of these individuals is not known, the figures show the extent to which the over-65s are impacted by Covid-19 despite almost everybody over the age of 60 in Ireland being fully vaccinated.

But this doesn’t mean that vaccine aren’t working – in fact, the situation would likely be a lot worse if it weren’t for the vaccine, as Nolan further elaborated this week.

“On a simple calculation, it’s likely that vaccination – in terms of its added protection over infection – has prevented at least 1,700 deaths between June and now,” he said.

And if you add in the fact that it’s also protected very many people from infection, it’s prevented a very large number of deaths indeed.

There is no way to point to all of the deaths that didn’t occur among older people as a result of the vaccine rollout: one simply can’t point to figures that don’t exist.

Impact of unvaccinated

Something that can be pointed to, however, is how Covid-19 deaths are more likely to occur among unvaccinated people.

Following up on Nolan’s comments this week, Chief Medical Officer Dr Tony Holohan explained that although more people who have received a vaccine are dying from the virus, deaths among the unvaccinated population greatly outnumbered these per capita.

“It’s important to say that even though the majority of deaths that are reported might be among vaccinated people, the proportion of those deaths that are in unvaccinated is much higher than in the population generally,” he said.

Recent figures cited by public health officials put the total number of unvaccinated people in Ireland (that is, those over the age of 12 who are eligible for a vaccine) at around 300,000.

That translates to 1 death per 1,685 people among the unvaccinated in Ireland since April, or 1 death per 10,344 people since 11 September (the date of the first HPSC vaccine deaths report).

Official figures also show that 3.8 million people in Ireland have received at least one dose of a vaccine (as of 18 October).

That translates to 1 death per 16,964 people since April, or 1 death per 25,503 people since 11 September – smaller per capita rates than among the unvaccinated population.

The disproportionate impact of unvaccinated people on the health service does not just translate to deaths, and can also been seen in HPSC data on admissions to intensive care, the critical part of the health service that is nearing capacity.

Between 1 April and 16 October, 68% of the 438 people admitted to intensive care were not vaccinated – including 59% of the 137 ICU admissions since 11 September.

Although it’s inevitable Covid-19 cases will continue to emerge, and though they can cause serious illness, they are much less likely to do so among the vaccinated population.

The majority of strain on the health service due to Covid-19 continues to be caused by those who have not been fully vaccinated.