Pandemic/Statistics/COVID-19 Vaccine Breakthrough Deaths/UK

COVID-19 Vaccination Breakthrough Deaths UK

Statistics for people who have been fully vaccinated against SARS-CoV-2 but unfortunately contract COVID-19 and subsequently die.

UK Data for the Delta Strain - published 6 August 2021

Data for SARS-CoV-2 variants of concern and variants under investigation in England is published regularly in the UK. The image below is taken from Report Number 20 dated 6 August 2021.

This is particularly interesting because Table 5 (below) compiles data for persons tested for the Delta strain, presenting for emergency care, by age group and by vaccination status.

Source: Public Health England SARS-CoV-2 variants of concern and variants under investigation in England Technical briefing 20 6 August 2021

Comments

Some comments about the data in Table 5 follow:-

1. The data is cumulative - collected between 1 February 2021 and 2 August 2021 - so the 'bottom line' is not an indicator of the current situation. For that we would have to compare with a previous report, say number 19, calculate the differences and then see the pattern for the more recent past.
2. That comparison has not been done because the UK celebrated 'Freedom Day' since Report 20 so the new reality will be seen some time in the future.
3. The data is collected by age group. That is easy to see on the top row, but easily missed on the bottom row which should not have split over the page. To get a realistic picture we need to compare outcomes by age group, not just the totals.
4. The term 'hospital presentation' or 'presented to hospital' is used below to mean the confirmed Delta cases in Table 5 row one, who presented to emergency care. After that some were subsequently admitted as inpatients.
5. The Table has some explanatory notes which were not captured in the image. Please refer to the original document for clarification.

Analysis

The data in Table 5 is best analysed by age group and then a comparison by category, vaccinated or unvaccinated:-

1. Age 50 or over

   1. Vaccinated persons aged 50 or over presenting for Emergency care
      
      • 21,472 persons who had been fully vaccinated presented to hospital as breakthrough cases with COVID-19.
      • 389 of those people couldn't be saved, and died.
      • The death rate in the fully vaccinated and aged 50 or over group was 18 per 1000 hospital presentations.
   
   
   2. Un-vaccinated persons aged 50 or over presenting for Emergency care
      
      • 3,440 people aged 50 or over who had not been vaccinated presented to hospital.
      • 205 of those people died.
      • The death rate in the un-vaccinated and aged 50 or over group was 59.6 per 1000 hospital presentations.



2. Age under 50

   1. Vaccinated persons aged under 50 presenting for Emergency care
      
      • 25,536 persons who had been fully vaccinated presented to hospital as breakthrough cases with COVID-19.
      • Only 13 of those persons died.
      • The death rate in the fully vaccinated and under 50 group was 0.51 per 1000 hospital presentations, or 5.1 per 10,000 hospital presentations.
   
   
   2. Un-vaccinated persons aged under 50 presenting for Emergency care
      
      • 147,612 people aged under 50 who had not been vaccinated presented to hospital.
      • Only 48 of those people died.
      • The death rate in the un-vaccinated and aged under 50 group was 0.325 per 1000 hospital presentations, or 3.25 per 10,000 hospital presentations.

Conclusions

The cumulative data from the UK which compares outcomes after contracting COVID-19 and the Delta strain of the SARS-CoV-2 virus and requiring emergency care clearly shows:-

1. People aged 50 and over have a higher survival rate if they have been fully vaccinated and subsequently contract COVID-19, considered a breakthrough case, compared with people in the same age group who have not been vaccinated. In this age group, the death rate for vaccinated people was 18 per 1000 hospital presentations, compared with 59.6 per 1000 hospital presentations for unvaccinated persons.
2. People aged under 50 who presented for emergency care had a significantly higher survival rate than those aged 50 or over, regardless of their vaccination status. The death rates were from 3.25 to 5 per 10,000 hospital presentations.
3. The comparison would suggest that unvaccinated people in the under 50 age group were less likely to die than those who were vaccinated but the group sizes are significantly different. For example, 147,612 (3.25 per 10,000) vs 25,536 (5.1 per 10,000). So an alternative interpretation could be that vulnerable people in this age group chose to get vaccinated and people confident in their health had deferred vaccination.
4. A point that is worth noticing is the large number of unvaccinated people who presented for emergency care over this time period. A reality must be faced that if vaccination rates in the UK had been lower then the number of unvaccinated people requiring emergency care would have been higher. If the hospital system becomes overwhelmed then the outcome for many could be worse. So the survival of the unvaccinated people was assured by the capacity of the health system to cope with their need.

Further Reading

1. UK Government, Investigation of SARS-CoV-2 variants of concern: technical briefings
   Technical briefing documents on novel SARS-CoV-2 variants.
   https://www.gov.uk/government/publications/investigation-of-novel-sars-cov-2-variant-variant-of-concern-20201201


2. The Conversation What is a breakthrough infection? 6 questions answered about catching COVID-19 after vaccination 28 July2021


3. John S. Schieffelin et al. What should define a SARS-CoV-2 “breakthrough” infection? Pub May 11, 2021 J Clin Invest. 2021;131(12):e151186. https://doi.org/10.1172/JCI151186

Severe Acute Respiratory Syndrome CoronaVirus 2

CoronaVirus Disease 2019 (caused by SARS-CoV-2)