Young mortality and registration delay
What has changed about deaths of young people in England & Wales in 2020 and 2021?
The Office for National Statistics published analysis on excess deaths in young people. Mortality risk rises as you age, so deaths in young people are exceptional events. Given when registrations increased, there was concern over the role of Covid-19 vaccinations.
Analysts assessed whether deaths following vaccination were higher than a baseline period. This self-controlled case series study looks at weeks one to six after vaccination. That risk period compares to seven to 12 weeks after the dose — the baseline period.
The analysis considers deaths in vaccinated young people aged 12 to 29, up to 16th February 2022. For all deaths, the risk ratio — dividing the risk in the main period by the risk in the baseline period — was 0.94 (0.79 to 1.10). Young people had a similar mortal risk in the six weeks after getting the vaccine. That risk is near to 7–12 weeks after, consistent with no difference.
Myocarditis — inflammation of the heart muscle — is a rare adverse event after vaccination. For cardiac-related deaths, the risk ratio was 0.99 (0.67 to 1.46). Again, that observed ratio is concordant with no real disparity in the risk of these deaths.
Why did registrations rise then? Compared to the average in 2015 to 2019, there was a deficit of registrations in 2020: of about 275 deaths. For 2021, recorded deaths were higher, by around 180 deaths in people aged 15 to 29 in England and Wales. This is a simple analysis, comparing average counts in those five years to more recent years. More complex analyses would standardise for population size and age structure.
Fewer registrations in 2020 and greater numbers in 2021 could be two sides of the same coin. The pandemic disrupted the work of coroners, such as during the first lockdown in 2020. In general, formal recording occurs after this investigative process.
That deficit in 2020 for young people was, for most part, in deaths from external causes. These kinds of deaths are most likely to experience delays in entering registries.
Another way is to compare deaths by year of occurrence, rather than by registration. The analysts calculated adjusted figures, seeking to account for delays. For men aged 15 to 29, that estimated deficit was around 100 deaths in 2020. For young women, there was an adjusted excess of about 10 deaths.
It will take time for the picture of this pandemic to become clearer.