Young People’s Risk of Death After COVID-19 Vaccination or Infection

There have been myriad studies into the correlation between COVID-19 vaccination and the risk of cardiac diseases, especially in young men. However, no research has established the impact of COVID-19 vaccination on mortality.

A new study, published this week in Nature Communications, utilized national electronic health data in England to gauge the impact of COVID-19 vaccination and/or COVID-19 infection on the risk of cardiac and all-cause mortality in young people aged 12-29 years.

“Previous studies have shown an increase in the risk of myocarditis and myopericarditis associated with mRNA vaccines including BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna),” the study authors wrote. “However, the absolute risk of severe complications is low and needs to be assessed against the increased risks associated with SARS-CoV-2 infection if unvaccinated.”

This self-controlled case series design included 3807 deaths among 12–29-year-olds in England, occurring from December 8, 2020-May 25, 2022. Among them, 11.7% (n = 444) were due to a cardiac event and 39.7% (n = 1512) arose in individuals with a COVID-19 vaccination record.

The investigators noted that 62.8% (n = 950) of first doses, 51.6% (n = 505) of second doses and 98.8% (n = 239) of third doses in the death registrations dataset were mRNA based (either the Pfizer-BioNTech or Moderna vaccines), rather than non-mRNA based (the Oxford-AstraZeneca vaccine) or another vaccine or unknown. Among the 979 persons who received 2 doses for a primary vaccine series, 11.3% (n = 111) received a different type of vaccine for each dose.

During the study period, there were 1420 hospital deaths among 12–29-year-olds, 44.4% (n = 630) of which were linked to a vaccination record. In the hospital mortality cohort, 63.3% (399) of first doses, 53.5% (228) of second doses and 98.2% (108) of third doses were mRNA based.

The investigators found that in the first 12 weeks after COVID-19 vaccination, English young adults aged 12-29 years did not have a significant increase in mortality.

However, subgroup analyses revealed there was a significant increase in the risk of cardiac death in women after receiving a first dose of a non-mRNA COVID-19 vaccine. Additionally, there was a smaller, nonsignificant increase in cardiac death in men after receiving a second dose of mRNA vaccine.

It is vital to note that COVID-19 infection remains more associated with cardiac and all-cause mortality than COVID-19 vaccination. “Whilst COVID-19 vaccination has been linked to an increased risk of myocarditis and other cardiac events in young people, we found no evidence of substantially increased mortality risk, either due to cardiac events or overall, from mRNA vaccines,” the study authors concluded, “which suggest that cases of myocarditis or myopericarditis due to mRNA COVID-19 vaccines are unlikely to be fatal.”