The Center for Disease Control and Prevention (CDC) October 22 weekly morbidity and mortality weekly report (COVID-19 Vaccination and Non–COVID-19 Mortality Risk — Seven Integrated Health Care Organizations, United States, December 14, 2020–July 31, 2021) says vaccinated persons tend to be substantially healthier than unvaccinated persons.
By September 21, 2021, an estimated 182 million persons in the United States were fully vaccinated against COVID-19. Clinical trials indicate that Pfizer-BioNTech, Moderna, and Johnson & Johnson vaccines are effective and generally well tolerated.
In a cohort of 6.4 million COVID-19 vaccinees and 4.6 million demographically similar unvaccinated persons, recipients of the Pfizer-BioNTech, Moderna, or Johnson & Johnson vaccines had lower non–COVID-19 mortality risk than did the unvaccinated comparison groups. There is no increased risk for mortality among COVID-19 vaccine recipients.
However, daily vaccination rates have declined approximately 78% since April 13, 2021, and vaccine safety concerns have contributed to vaccine hesitancy. A cohort study of 19,625 nursing home residents found that those who received Pfizer-BioNTech or Moderna vaccines had lower all-cause mortality than did unvaccinated residents, but no studies comparing mortality rates within the general population of vaccinated and unvaccinated persons have been conducted.
To assess mortality not associated with COVID-19 after COVID-19 vaccination in a general population setting, a cohort study was conducted during December 2020–July 2021 among approximately 11 million persons enrolled in seven Vaccine Safety Datalink sites. After standardizing mortality rates by age and sex, this study found that COVID-19 vaccine recipients had lower non–COVID-19 mortality than did unvaccinated persons.
After adjusting for demographic characteristics, this study found that there is no increased risk for mortality among COVID-19 vaccine recipients. This finding reinforces the safety profile of currently approved COVID-19 vaccines in the United States.
The lower mortality risk after COVID-19 vaccination suggests substantial healthy vaccinee effects (i.e., vaccinated persons tend to be healthier than unvaccinated persons) which will be explored in future analyses. Mortality rates among Johnson & Johnson vaccine recipients were not as low as those among mRNA vaccine recipients. This finding might be because of differences in risk factors, such as underlying health status and risk behaviors among recipients of mRNA and Johnson & Johnson vaccines that might also be associated with mortality risk.