A few nursing home patients died earlier than expected after getting the Covid-vaccine
If patients in nursing homes are not expected to live that much longer anyway, there is little to gain from being vaccinated against Covid-19, a Norwegian group of experts conclude.
When the first reports of deaths among frail and elderly nursing home patients in Norway were made public in January, it attracted international attention. According to NRK, Norwegian national broadcaster (link in Norwegian), both Russian and Chinese media used these deaths in Norway as evidence that western mRNA- vaccines were not safe.
A Norwegian expert group was tasked with examining 100 deaths. The experts have now published their final report in the Journal of the Norwegian Medical Association.
They conclude that for the majority of the nursing home patients, there was no obvious connection between being vaccinated and subsequently dying.
A few patients however, who were extremely frail, experienced side effects from the vaccine that likely accelerated an already ongoing process of dying.
100 deaths examined
The first leg of the Norwegian vaccination programme was to get the vaccine out to those most at risk of dying from Covid-19, namely patients in nursing homes.
The vaccinations with Pfizer’s mRNA vaccine started on December 27. By mid-February almost 30 000 residents at nursing homes had been vaccinated. During this same period, the Norwegian Medicines Agency received 100 reports about possible fatal side effects.
“Of these 100 reported cases, we believe it is highly likely that the vaccination led to death occurring earlier than it would have otherwise for ten nursing home patients”, Torgeir Bruun Wyller says to NRK.
He is one of five geriatric specialists who have examined the cases on behalf of the Norwegian Medicines Agency.
Extremely difficult to evaluate
The expert group also conclude that there is a possible connection between the vaccination and the death of a further 26 patients.
Five deaths are not classified, while for the remaining 59 cases a connection to the vaccination is unlikely.
Wyller tells NRK that examining the cases has been extremely demanding.
“These were very frail patients who in any case did not have much time left to live. To determine whether or not they died earlier than expected due to the vaccine, turned out to be terribly difficult”, he says.
Not entirely unexpected
As mortality in nursing homes is high in general, it was expected that some patients would die shortly after receiving the vaccine – as they would have done in any case. The Norwegian Medicines Agency still wanted an independent evaluation of the deaths.
“Frail patients can benefit from vaccination because they are at great risk of serious illness and even death if they become infected with the COVID-19 virus”, Sigurd Hortemo, senior medical consultant, says in a press release from the Norwegian Medicines Agency.
“Nevertheless, the expert group believes that, for some of these frail patients, common adverse reactions may have contributed to a more serious course of their disease”, he says.
As of May 18 2021, a total of 155 deaths have been reported within a time frame connected to vaccination. Most of these are elderly and very frail patients in need of care, according to the press release.
Mild side effects can be fatal to the frail
The average age of the 100 examined patients was 88 years. They were all considered very frail and did not have long left to live.
“If we assume that ten or perhaps 36 of these deaths were accelerated by the vaccine, then this number is very low”, Wyller says to NRK.
He gives an example: a patient with heart failure and water in the lungs was given the vaccine. The night after the vaccination, the patient experienced typical side effects such as a fever and feeling unwell. Shortly after, the patient died.
“This death could have occurred just then anyway, but because it happened so shortly after vaccination, we believe it is likely that what would otherwise have been mild side effects, may have complicated this person’s illness”, Wyller says to NRK.
He cannot say exactly by how many days or weeks this person’s life has been shortened, but suggest that it would be a matter of weeks, perhaps a few months.
All in all, Wyller supports the strategy of first vaccinating those most at risk from dying of Covid-19.
“However, when we look at this in hindsight, perhaps a few of these first patients should not have been vaccinated”, he says.
Already included in guidelines
Wyller and the four other experts conclude that a more careful evaluation of cost-benefit from receiving the vaccine could have been done in the case of the most frail nursing home patients.
“Patients with a very short life expectancy have little to gain from being vaccinated. There is a genuine risk that the time of death will be brought forward and that the patient will suffer adverse reactions to the vaccine during the last days of their life ”, they state.
This very point was included in the vaccination guidelines from the Norwegian Institute of Public Health – who are responsible for vaccinations in Norway – already on January 11.
Wyller et al, Dødsfall i sykehjem etter covid-19-vaksine, Tidsskriftet Den Norske Legeforening, May 2021