People who were vaccinated against COVID-19 were also less likely to die from non-COVID-19-related causes compared with unvaccinated people, researchers found.
The adjusted relative risk of non-COVID-19 mortality ranged from 0.31 (95% CI 0.30-0.33) for those who received two doses of Moderna to 0.54 (95% CI 0.49-0.59) for Johnson & Johnson recipients, reported Stanley Xu, PhD, of Kaiser Permanente Southern California in Pasadena, and colleagues.
There was no increased risk of COVID-19 mortality among vaccine recipients either, the authors wrote in an early edition of the
They noted that prior research suggested a downstream effect of vaccination, in which nursing home residents who received an mRNA vaccine had lower all-cause mortality compared with unvaccinated residents, but this had not been replicated in a "general population setting."
The authors examined data from 11 million people enrolled in seven sites of CDC's from December 2020 to July 2021. They looked at vaccination status for individuals ages 12 and up as of May 31, but interestingly, drew the unvaccinated cohort from people who received at least one influenza vaccine in the last 2 years "to ensure comparable health-seeking behavior," they said.
Non-COVID-19 deaths were defined as those that did not occur within 30 days of a positive SARS-CoV-2 test via RT-PCR or rapid test or an incident COVID-19 diagnosis.
Overall, the cohort was comprised of 6.4 million vaccinated people and 4.6 million unvaccinated people. Among the 3.5 million who received the Pfizer vaccine, 9% were ages 12 to 17. All told, 2.6 million people received Moderna, and 342,169 people received Johnson & Johnson.
After excluding COVID-19-associated deaths, the standardized mortality rates were 0.35 and 0.34 per 100 person-years for Pfizer and Moderna recipients, respectively, compared with 1.11 per 100 person-years for unvaccinated individuals. The rate for Johnson & Johnson recipients was 0.84 per 100 person-years versus 1.47 per 100 person-years for the unvaccinated comparison group.
There were no significant differences in standardized or adjusted mortality rates among adolescents ages 12 to 17 who received the Pfizer vaccine compared with unvaccinated adolescents. Men and women had comparable adjusted relative risks "across vaccine type and dose," and all racial and ethnic groups who received the vaccine had lower mortality risks than their unvaccinated counterparts, Xu and colleagues noted.
This reinforces the safety profile of COVID-19 vaccines, they said. "The lower mortality risk after COVID-19 vaccination suggests substantial healthy vaccine effects ... which will be explored in future analyses."
Disclosures
Xu disclosed no conflicts of interest.
Other co-authors disclosed support from Dynavax Technologies, Pfizer, Sanofi Pasteur, Merck, GlaxoSmithKline, Protein Science, the National Human Genome Research Institute, the NIH, and Merck Sharp & Dohme Corporation.
Primary Source
Morbidity and Mortality Weekly Report
Xu S, et al "COVID-19 vaccination and non–COVID-19 mortality risk -- seven integrated health care organizations, United States, December 14, 2020–July 31, 2021" MMWR 2021; DOI: 10.15585/mmwr.mm7043e2.