Viral Post Misleads on COVID-19 Death Reporting, Vaccine Monitoring

SciCheck Digest

A tweet that migrated across social media platforms falsely suggests that any deaths in the 20 days following positive COVID-19 tests are to be attributed to the disease, “no matter what other factors were involved.” There is no such policy. And there’s also no evidence for the post’s suggestion that the vaccines are causing deaths that are being ignored.

More than half a billion doses of COVID-19 vaccines have now been administered in the U.S. and only a few, very rare, safety concerns have emerged. The vast majority of people experience only minor, temporary side effects such as pain at the injection site, fatigue, headache, or muscle pain — or no side effects at all. As the Centers for Disease Control and Prevention has said, these vaccines “have undergone and will continue to undergo the most intensive safety monitoring in U.S. history.”

A small number of severe allergic reactions known as anaphylaxis, which are expected with any vaccine, have occurred with the authorized and approved COVID-19 vaccines. Fortunately, these reactions are rare, typically occur within minutes of inoculation and can be treated. Approximately 5 per million people vaccinated have experienced anaphylaxis after a COVID-19 vaccine, according to the CDC.

To make sure serious allergic reactions can be identified and treated, all people receiving a vaccine should be observed for 15 minutes after getting a shot, and anyone who has experienced anaphylaxis or had any kind of immediate allergic reaction to any vaccine or injection in the past should be monitored for a half hour. People who have had a serious allergic reaction to a previous dose or one of the vaccine ingredients should not be immunized. Also, those who shouldn’t receive one type of COVID-19 vaccine should be monitored for 30 minutes after receiving a different type of vaccine.

There is evidence that the Pfizer/BioNTech and Moderna mRNA vaccines may rarely cause inflammation of the heart muscle (myocarditis) or of the surrounding lining (pericarditis), particularly in male adolescents and young adults.

Based on data collected through August 2021, the reporting rates of either condition in the U.S. are highest in males 16 to 17 years old after the second dose (105.9 cases per million doses of the Pfizer/BioNTech vaccine), followed by 12- to 15-year-old males (70.7 cases per million). The rate for 18- to 24-year-old males was 52.4 cases and 56.3 cases per million doses of Pfizer/BioNTech and Moderna vaccines, respectively.

Health officials have emphasized that vaccine-related myocarditis and pericarditis cases are rare and the benefits of vaccination still outweigh the risks. Early evidence suggests these myocarditis cases are less severe than typical ones. The CDC has also noted that most patients who were treated “responded well to medicine and rest and felt better quickly.”

The Johnson & Johnson vaccine has been linked to an increased risk of rare blood clots combined with low levels of blood platelets, especially in women ages 30 to 49. Early symptoms of the condition, which is known as thrombosis with thrombocytopenia syndrome, or TTS, can appear as late as three weeks after vaccination and include severe or persistent headaches or blurred vision, leg swelling, and easy bruising or tiny blood spots under the skin outside of the injection site.

According to the CDC, TTS has occurred in around 4 people per million doses administered. As of early April, the syndrome has been confirmed in 60 cases, including nine deaths, after more than 18.6 million doses of the J&J vaccine. Although TTS remains rare, because of the availability of mRNA vaccines, which are not associated with this serious side effect, the FDA on May 5 limited authorized use of the J&J vaccine to adults who either couldn’t get one of the other authorized or approved COVID-19 vaccines because of medical or access reasons, or only wanted a J&J vaccine for protection against the disease. Several months earlier, on Dec. 16, 2021, the CDC had recommended the Pfizer/BioNTech and Moderna shots over J&J’s.

The J&J vaccine has also been linked to an increased risk of Guillain-Barré Syndrome, a rare disorder in which the immune system attacks nerve cells. Most people who develop GBS fully recover, although some have permanent nerve damage and the condition can be fatal.

Safety surveillance data suggest that compared with the mRNA vaccines, which have not been linked to GBS, the J&J vaccine is associated with 15.5 additional GBS cases per million doses of vaccine in the three weeks following vaccination. Most reported cases following J&J vaccination have occurred in men 50 years old and older.

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COVID-19 is dangerous: The disease is estimated to have caused more than 579,000 deaths in the U.S. alone, and it can cause lingering health problems for some who get it. The COVID-19 vaccines now authorized for emergency use in the U.S., meanwhile, were found in clinical trials to be safe and effective at preventing symptomatic illness. Nearly 250 million doses have been administered thus far.

But a post circulating online distorts the facts to imply that COVID-19 deaths are inflated by a supposed mandate concerning positive COVID-19 tests. It also baselessly suggests that vaccines are causing deaths that are being ignored.

“Funny isn’t it, if you die within 20 days of testing positive for the Rona (no matter what other factors were involved) You’ll be counted as a COVID death,” the May 2 tweet reads. “However, if you drop dead within 24 hours of taking the vaccine it has nothing to do with it.”

One Instagram post of a screenshot of the tweet garnered more than 32,000 likes. Another earned more than 8,000 likes.

But there is no rule that those who “die within 20 days of testing positive” for COVID-19 are to be automatically classified as having died from the disease, “no matter what other factors were involved.”

We’ve previously addressed similar false claims surrounding COVID-19 death certificates and have explained that there is no federal law governing the death certificate process. The Centers for Disease Control and Prevention does provide guidance on certifying deaths, including some specific to COVID-19.

The CDC specifically advises that “COVID-19 should not be reported on the death certificate if it did not cause or contribute to the death.”

And there is no evidence that any state or local agencies have such a 20-day rule, either.

It’s possible that COVID-19 could be listed as a contributing factor to — but not the underlying cause of — a death in some cases. But at least 90% of death certificates citing COVID-19 to date list the disease as the underlying cause, or the illness that triggered the chain of events leading to the person’s death, according to CDC data available as of May 5.

It’s worth noting, in the context of the baseless implication that COVID-19 deaths are being systematically misreported, that excess death estimates further reinforce the toll of the pandemic. From March 2020 through the start of 2021, the U.S. experienced about 20% more deaths than would have been expected in the same time period, analyses show. The estimates are higher than the official COVID-19 death toll for that period; excess mortality can also capture indirect effects of the pandemic, such as people who may have died from other causes because they avoided seeking medical attention.

The tweet’s suggestion that COVID-19 vaccines are causing deaths that are not being investigated also doesn’t carry weight.

The U.S. government has several monitoring systems in place to track reports of adverse events — including the Vaccine Adverse Event Reporting System. Patients and caregivers are asked to report “any clinically important medical event or health problem that occurs after vaccination” to VAERS, even if they’re not sure if it was a result of the vaccine.

The CDC and Food and Drug Administration review each case report of deaths that follow vaccination to determine whether they were caused by the vaccine. There has not been an established link for the overwhelming majority of the reports.

The FDA’s fact sheet for health care providers administering the Johnson & Johnson vaccine now says that “a causal relationship” between the vaccine and rare cases involving both blood clots and low blood platelets “is plausible” based on the evidence available. The monitoring systems were used to identify those cases. As of May 4, there were 23 confirmed reports of people developing the condition after receiving the J&J vaccine, and at least three individuals have died. More than 8.4 million doses of the J&J vaccine have been administered.

Federal officials on April 13 recommended a brief pause on the J&J vaccine while the issue was investigated and, 10 days later, lifted the pause — saying that the “known and potential benefits outweigh its known and potential risks.” Both the FDA and CDC now include warnings about the rare risk. The CDC says that “[w]omen younger than 50 years old especially should be aware of the rare but increased risk of this adverse event” with the J&J vaccine, and that other COVID-19 vaccines are “available for which this risk has not been seen.”

So health officials do probe reports of adverse events that follow vaccinations, including deaths, contrary to the tweet’s suggestion.

Editor’s note: SciCheck’s COVID-19/Vaccination Project is made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over our editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation. The goal of the project is to increase exposure to accurate information about COVID-19 and vaccines, while decreasing the impact of misinformation.

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