Pandemie van ongevaccineerden?

That has been the position of politicians for a long time, without clear substantiation: the hospitals would be full of unvaccinated people. We had a pandemic of the unvaccinated. With today's knowledge, we know that the administration of vaccinated people by general practitioners was up to 63% behind, so how could politicians suddenly be so sure that the hospitals were full of unvaccinated people?

And to get straight to the point: we do not have the right figures either, and it is doubtful whether the truth will ever come to light. But what we are gaining a better understanding of is the relationship between mortality from covid-19 and vaccination coverage. And again, the figures released by Statistics Netherlands February 23 released, also unlock this secret. They contain the figures we need. The only assumption we have to make is that the elixir effect of the corona vaccine does not exist and can be attributed to the overdue administration in CIMS and the HVE. With these CBS figures, we can divide covid-19 deaths into a vaccinated and unvaccinated part. Read the explanation of the calculation procedure in the article CBS has revealed vaccine efficacy.

Final Conclusion

Let's start with the final conclusion for a change, then the rest of the article will be a bit more readable. So we are going to split the figures into a vaccinated and unvaccinated part and within that the excess mortality and covid-19 deaths. We are also going to distinguish three periods:

• From April 2021 to the Delta Wave (1 April – 30 September 2021)
• From the Delta wave to Omicron (1 October 2021 – 31 May 2022)
• From Omicron (June 1, 2022 to December 31, 2022)

Actually, mortality from covid-19 is irrelevant, because it only determines the cause of death and not so much the total mortality. Corona was very often "Old man's Friend". The final result of the total mortality calculations is this histogram:

Blue is excess mortality and red is mortality from covid-19. Light colors are unvaccinated, dark vaccinated. If we start with mortality from covid-19 (red and orange), we see that this is lower in the vaccinated group than in the unvaccinated group. That is what we have been promised, although the difference is rather small.

But if we look at excess mortality (which includes mortality from covid-19), we see a completely different picture. Only during the Delta wave was there excess mortality among the unvaccinated. There was always excess mortality among the vaccinated, which still persists. Since Omicron, mortality from corona has decreased.

It is remarkable to see that until Omicron, mortality from covid-19 was higher than you would expect from the excess mortality figures. This is because CBS counted all deaths in which corona could have played a role as covid-19. The official RIVM figures are roughly 2-5 times smaller and then we can understand it.

In this histogram, an extra orange bar is included for the Delta wave. That is the number of unvaccinated people who died after correction for the MET=BY effect. These are the extra deaths AFTER the Delta wave, the cause of which was covid-19 death, while there was no excess mortality. We then see that the number of deaths from covid-19 among unvaccinated people was almost the same as among the vaccinated. After all, if you were vaccinated, corona could no longer play a role as a possible cause of death. See also the explanation under the chapter "Excess mortality of unvaccinated people".

Covid-19 mortality

We will now first look at how mortality from covid-19 behaved, if we compare the vaccinated with the unvaccinated. We first look at the absolute figures, with the vaccination rate rising from 0% in January 2021 to 91% at the end of 2022. This is what we see:

Blue is the number of unvaccinated deaths from covid-19 and that has just peaked in the first week of 2021, while no one had yet been vaccinated. The green line is the number of deaths from covid-19 that were vaccinated. Of course, that increases with increasing vaccination rates. As of May 2021, the number of vaccinated deaths is equal to unvaccinated. If you had started counting in a hospital at that time, there would in all probability be as many vaccinated and unvaccinated sick people who would have been admitted because of covid-19.

From July, we see that the proportion of vaccinated people is rising above the number of unvaccinated people. That in itself is not surprising, if the vaccination rate continues to increase, although you would want to see that much less clearly with a very effective vaccine. The image that hospitals would be full of unvaccinated people has now been reversed.

You can also assume that the mortality picture is roughly comparable to the hospital occupancy, which also debunks the myth that hospitals are full of unvaccinated people.

In the Delta wave, almost five times as many vaccinated people died as unvaccinated people, but if there are 8 times as many vaccinated people as unvaccinated people, that still represents a certain effectiveness.

And now in proportion

Can we see whether vaccination has had a protective effect? The difference turns out to be very small. To do this, we can convert the graph above into percentages compared to vaccination coverage.

In this graph, the blue line is the percentage of deaths from covid-19 that are unvaccinated. Of course, the line starts at 100% in January 2021, because no one had been vaccinated yet. With the increase in vaccination coverage, this share will drop to around 15% by the end of 2023. But how should we interpret this?

There is a lower limit and an upper limit to be calculated for each week of the year. The upper limit is easy. If the vaccine were to provide 100% protection, then not a single vaccinated person would die from covid-19 and therefore the percentage of unvaccinated people would always be equal to 100%. If the vaccine would not provide any protection, then the percentage who die unvaccinated is equal to the percentage who are actually unvaccinated and that is the orange line. With an assumed protection of 95%, we would have to follow the blue striped line. So the line is closer to "no protection at all" than to the promised 95%.

HVE

A difficult effect to calculate that we have not yet included is the HVE. So that is the effect that, on the one hand, very healthy people were vaccinated to regain their freedom and, on the other hand, people who were too sick and who were no longer vaccinated and therefore remained registered as unvaccinated. We have now approached this effect using a model, by assuming that 75% of those who saw their end approaching in the 4 weeks prior to their vaccination call, no longer took the vaccine. That's a model, of course, but by approaching it that way, we can get a sense of what this would do to the numbers. In this graph, the HVE-adjusted mortality is shown with a blue dashed line.

We now see that there is virtually nothing left of the protection of the vaccine in the first half of the year.

In the younger groups that were vaccinated afterwards, there is such a low mortality rate that it has hardly any influence. In the case of those who have been vaccinated early, we even see negative protection in the first two months, as we saw earlier if we only follow the vaccinated. In June, protection does seem to be increasing again, but we have to realize that mortality from covid-19 was very low at the time. Small errors in registrations result in large differences in the percentages. But not in absolute figures. However, it is now clear that the HVE is a factor that should not be underestimated and completely swallows up the little protection that the vaccine still seemed to give. But these figures remain a model-based estimate.

Because this is an uncertain estimate of the HVE effect, we will leave these figures for what they are and do not include them in the final conclusion. So we give the advantage to the vaccination!

Excess mortality

Until now, we have looked at deaths with covid-19 as the cause of death, but in the end it is about the decreased or increased risk of death. So we have to include excess mortality and compare it with the chance of dying from covid-19 and that suddenly gives very different insights. Also read a more detailed description of the calculation technique in Excess mortality for dummies.

Still with the 23 February figures from Statistics Netherlands, we can redistribute excess mortality between vaccinated and unvaccinated people. If we only look at mortality among vaccinated people, we get this picture:

The figures have been converted to deaths per week per 100,000 vaccinated people, so that we can make a good comparison. That is why the first 3 months are missing, because there were still too few vaccinations to obtain a reliable figure. The black line is the number of deaths per week as excess mortality among the vaccinated. The red line is the number of deaths from covid-19.

In the first few months, it is striking that mortality from covid-19 is much higher than there was excess mortality. This has everything to do with the fact that CBS also records deaths with Corona counts as a COVID-19 cause. A lot has been written about this, see e.g. Disinformation from CBS? But we'll have to make do with it here, because all CBS tables are based on this.

We will also see a huge flu wave at the end of 2022. This was more severe in the vaccinated group than in the unvaccinated. Something about reduced resistance to viral infections in vaccinated people?

Without going into further detail, we can actually see at a glance that excess mortality is in line with the deaths from covid-19. There were 8626 vaccinated deaths from corona in 2021 and the excess mortality among vaccinated people was 9096. We would like to emphasise that mortality from covid-19 was below the definition of Statistics Netherlands, while the official figures from the RIVM are about half.

This graph was used to calculate the histogram as shown at the beginning of the article. They are the six totals over the three mentioned periods and then converted into an average mortality: the red and blue bars.

Excess mortality of unvaccinated people

Of course, we can also make the same graph for the unvaccinated part of the population.

Most notable is the sharp decline in mortality in the first months of 2021. So without vaccination! Excess mortality changed to undermortality at the end of February.

But just as striking is that from March 2021 onwards, the decline in corona among the unvaccinated stagnated (indicated by the black dots), while there was no longer any excess mortality. Apparently, we see here the consequence of the CBS-WHO definition, that corona may have played a role in the death here. These were the people who were ill during the second wave, possibly caused by corona. We see exactly the same thing in the three months after the Delta wave. A lot of deaths with corona and at the same time under-mortality. This was not observed in the vaccinated: after all, these people had been vaccinated and then it could not be corona! Here we see the "WITH=BY" corona effect.

These numbers can therefore be found in the histogram as the light blue and orange bars. We also performed a calculation, in which the figures below the dotted line (where MET=BY corona was counted) were replaced by the figures of the vaccinated. Also calculated per 100K. That's shown as the orange bar. So if we ignore the MET=BY figures, then the mortality among the unvaccinated during and after the Delta wave is almost the same as the mortality among vaccinated people.

From the summer of 2022, we will see an average under-mortality among the unvaccinated, while we will see excess mortality among the vaccinated.

As of April 2021, the excess mortality picture among unvaccinated people has fluctuated around zero. Only during the Delta wave there was considerable excess mortality. In the vaccinated, on the other hand, we see a structurally increased mortality, so we see the picture here of a Pandemic of the vaccinated. However, it does seem that vaccination prevents the cause of covid-19 death to a small extent.

Doubt

There is considerable uncertainty, especially with regard to vaccination figures. This is caused by the fact that the CIMS only has registration of those who have been vaccinated. So if you don't appear on the registry, you're considered unvaccinated. But there can be several reasons why you are not on the register as a vaccinated person. The refusal of the vaccinated person to register, but also administrative errors and backlogs, especially among general practitioners. This phenomenon is described in the article Excess mortality was mainly among general practitioners. Although a backlog of up to 63% has eventually been made up, the people who died in the first weeks after their vaccination in particular will still be missing.

Nivel has established that 2.6% of the vaccinated are ultimately missing from CIMS. That doesn't seem like much, but it makes a huge difference in calculating the number of unvaccinated people. If 10% of covid-19 deaths are seen in a given week, that includes 90% of the 10% of 2.6% who WERE vaccinated, so only 7.7% died unvaccinated and that is almost 25% less.

The question is whether the 2.6% seen by GPs is representative of the whole of the Netherlands. That is why we calculate with 1% missing. But we have to assume that the proportion of deaths among the unvaccinated could be significantly lower, if the missing part turns out to be larger. So there is still a lot of uncertainty.

Conclusions

So the image of a "Pandemic of the unvaccinated" put down by the government does not seem to be correct. During the Delta wave, five times as many vaccinated people died as unvaccinated people, according to figures released by Statistics Netherlands (CBS).

What does seem to be true is that vaccination prevents covid-19 to some extent, but to a much lesser extent than we were promised. We also do not see these figures reflected in lower excess mortality, which is worrying. In fact, the opposite seems to be the case.

There is a lot of uncertainty in the right numbers. In particular, the HVE seems difficult to predict and for that reason it is not included in the calculations for the histogram. However, it seems to fit in with the remnant of protection that remains.

Both after the second wave and after the Delta wave, we see that in the absence of excess mortality, many deaths are still registered as "WITH corona" among the unvaccinated. This seems to point to the application of the cause of death covid-19 guideline of the CBS, whereby every death in which corona could have played a role.