CDC director’s comments that 75% of COVID-19 deaths are among people with four comorbidities applies only to vaccinated people
COVID-19 vaccines provide a high level of protection against severe disease. The small number of severe cases and deaths among vaccinated adults is dominated by those who have multiple risk factors. These people were at very high risk of severe COVID-19 from the start of the pandemic, and while the vaccines have brought down their risk considerably, they still remain at higher risk than other vaccinated people who don’t have the same risk factors. Unvaccinated people have approximately ten times the risk of hospitalization and death due to COVID-19.
Lack of context: Rochelle Walensky’s comments were about the proportions of vaccinated people who had severe outcomes from COVID-19. Many social media posts and articles that quoted her didn’t make this distinction, giving a wrong impression of the effectiveness of the vaccines.
An article published on the website for The Joe Pags Show, the talk show of commentator Joe Pagliarulo, used a partial quote from Rochelle Walensky, the director of the Centers for Disease Control and Prevention (CDC), to suggest that 75% of COVID-19 deaths were in people with at least four comorbidities.
The article went viral on Facebook, receiving more than 2,800 user engagements on the platform according to social media analytics tool CrowdTangle, along with more than 1,300 user engagements on Twitter. This partial quote of Walensky’s was widely shared on social media. A Facebook video by PragerU received more than 22,000 views, while an article by The Federalist acquired more than 3,200 user engagements on Facebook, including more than 1,400 shares.
However, many articles and posts quoting her didn’t explain that this figure was referring to vaccinated people only, as we will explain below. This created a misleading impression that people without risk factors for COVID-19 should not be concerned about severe outcomes regardless of their vaccination status.
In an interview on Good Morning America on 7 January 2022, Walensky spoke about a new study on the risk factors for severe COVID-19 cases in vaccinated adults. The study looked at data from 465 facilities in a large U.S. health care database of 1.2 million adults who had been fully vaccinated between December 2020 and October 2021. The main findings of the report were that severe outcomes from COVID-19, including death, were rare among this group. Out of the 1.2 million people, there were only 189 identified cases with severe outcomes.
The report defined severe COVID-19 outcomes as hospitalization with a diagnosis of acute respiratory failure, need for noninvasive ventilation, admission to an intensive care unit including all persons requiring invasive mechanical ventilation, or death.
The study found that there were eight risk factors that had a statistically significant increased risk of severe outcome compared to other vaccinated people. These were: an age of 65 years and over, immunosuppression, and six underlying conditions (pulmonary disease, liver disease, chronic kidney disease, neurologic disease, diabetes, and cardiac disease).
Many of these have previously been identified as risk factors for severe cases of COVID-19[2,3]. The COVID-19 vaccines lower the risk of severe disease in people with these risk factors, but their risk remains higher than in vaccinated people without underlying conditions. The study found that 78% of the deaths of vaccinated people occurred in those who had at least four of these risk factors.
During the interview, Walensky said:
“A study of 1.2 million people who were vaccinated between December and October and demonstrated that severe disease occurred in about 0.015% of the people who received their primary series and death in 0.003% of those people. The overwhelming number of deaths, over 75%, occurred in people who had at least four comorbidities. So really these are people who were unwell to begin with.”
However, the article on the Joe Pags Show website, and the social media accounts reposting the video, quoted Walensky out of context, giving the impression that the 75% figure applied to all COVID-19 deaths. Instead, she was referring to the small number of deaths seen in the vaccinated population.
The confusion may have been due to editing of the original interview that was broadcast by Good Morning America. An updated version of the interview was published on their YouTube channel on 10 January with a note saying: “This video clip has been updated to include an extended version of a [Good Morning America] interview with [CDC] Director Rochelle Walensky. A shorter version edited for time was broadcast on Friday, January 7.”
Without the context that the study only examined outcomes for vaccinated people, this figure would be misinterpreted as COVID-19 only causing deaths among the very ill. However, this study excluded deaths from unvaccinated people, who are over ten times more likely to die from COVID-19 than vaccinated individuals, according to an analysis of figures from April to July 2021 in 13 U.S. jurisdictions.
Figure 1 was created using CDC data from April to October 2021 and shows that most COVID-19 deaths are among the unvaccinated. This is despite the fact that the majority of the population has been vaccinated.
Figure 1. COVID-19 deaths by vaccination status from April to October 2021. Data retrieved from data.cdc.gov on 13 January 2022.
“CDC director admits over 75% of Covid deaths had at least 4 pathological conditions (comorbidities).Since the total death rate is 0.27% this means healthy people have a 0.0% death risk.”
Like the Joe Pags Show article, Del Bigtree didn’t mention that the study only looked at people who are vaccinated. This gives the impression that healthy people don’t need a vaccine, whereas the unvaccinated account for the majority of deaths (Figure 1) and vaccination significantly lowers the risk of severe disease in all groups. Looking at the death rates among people aged 65-79 (one of the risk factors identified in the study), it is clear that vaccination significantly decreases the risk of COVID-19 death (Figure 2).
Figure 2. COVID-19 death rates by vaccination status for people aged 65-79 from April to October 2021. Graph retrieved from Our World in Data on 13 January 2022.
Vaccines alone cannot provide complete protection against severe cases of COVID-19, especially in people with weakened immune systems. This is why efforts to limit transmission in the community, such as masks, social distancing, and testing, would be needed to reduce deaths among these groups.
Update (17 January 2022):
Articles that originally published the misleading quote on The Daily Wire and The Post Millennial have since been updated with prominent corrections to explain the correct context of the CDC director’s statistic.
- 1 – Yek et al. (2021) Risk Factors for Severe COVID-19 Outcomes Among Persons Aged ≥18 Years Who Completed a Primary COVID-19 Vaccination Series — 465 Health Care Facilities, United States, December 2020–October 2021. Mortality and Morbidity Weekly Report.
- 2 – Kompaniyets et al. (2021) Underlying Medical Conditions and Severe Illness Among 540,667 Adults Hospitalized With COVID-19, March 2020–March 2021 Mortality and Morbidity Weekly Report.
- 3 – Hippisley-Cox et al. (2021) Risk prediction of covid-19 related death and hospital admission in adults after covid-19 vaccination: national prospective cohort study. The BMJ.
- 4 – Scobie et al. (2021) Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 US Jurisdictions, April 4–July 17, 2021. Mortality and Morbidity Weekly Report.