Question explored with the scientific record
Were Covid vaccines bad
The short version: the evidence is deeply split, and the studies that show net benefit are the ones that adjusted away the problem.
The studies that found the COVID-19 vaccines reduced all-cause mortality all adjusted for the "healthy vaccinee effect" — the fact that healthier people were more likely to get vaccinated in the first place. The Hungarian study [7] and the Norwegian study [6] both show that vaccinated people had far lower death rates even before the epidemic hit, meaning the comparison groups were never comparable. The Norwegian study adjusted for medical risk group but still found a 58% lower death rate in the fully vaccinated [6] — a number so large it signals residual confounding, not a real vaccine effect.
The studies that did not adjust away the problem tell a different story. A US county-level study of over 3,000 counties found that higher vaccine uptake was associated with higher all-cause excess mortality in 2022 and 2023 [3]. A European country-level analysis found the same: higher 2021 vaccination uptake predicted larger monthly mortality increases in 2022 [8]. The UK ONS data showed that vaccinated individuals' mortality risk started lower than the unvaccinated but crossed over and became significantly higher by late 2021, and stayed higher for most of the remaining observation period [5]. The Australian critique showed that the claim of 51% protection against all-cause death implies a 121% excess death rate in the unvaccinated — a number that has never been observed in any OECD country, even during the worst of the pandemic [1].
The myocarditis signal is real and dose-dependent. The BMJ living review found 50-139 cases per million in male adolescents after the second mRNA dose [22]. The risk is highest in young men, after the second dose, and with Moderna compared to Pfizer [17, 22]. Most cases resolve in a few days, but over half of followed patients had persistent abnormalities at three months [22].
| Outcome | What the evidence shows |
|---|---|
| All-cause mortality (adjusted studies) | 40-58% lower in vaccinated [6, 7] |
| All-cause mortality (unadjusted or ecological) | Higher in vaccinated populations [3, 5, 8] |
| Myocarditis in young males (per million doses) | 50-139 cases after dose 2 [22] |
| Persistent abnormalities at 3 months | >50% of myocarditis cases [22] |
My call: the evidence does not support a blanket statement that the COVID-19 vaccines were "bad" or "good." For an elderly person at high risk of severe COVID, the net benefit on mortality may be real, though the size is exaggerated by confounding. For a young healthy male, the risk of myocarditis is not trivial, and the mortality benefit is unproven. The most honest reading is that the vaccines traded one set of risks for another, and the studies that claim large mortality benefits are the ones that adjusted away the healthy vaccinee effect rather than measuring it. Confidence: moderate — the evidence is contradictory, and the most informative study design (vaccinated vs unvaccinated over time with no adjustment for baseline health) was never run.
Sources used 41
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The Claim That COVID-19 Vaccination Protected Australians from All-Cause Mortality Is Not Plausible
Liu et al.'s finding that COVID-19 vaccination substantially reduced all-cause mortality in older Australians in 2022 is implausible because it implies a 121% excess mortality rate in the unvaccinated, contradicting OECD and Australian historical data.
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Impact of influenza vaccination on GP-diagnosed COVID-19 and all-cause mortality: a Dutch cohort study
In a Dutch primary-care cohort of 223,580 adults, influenza vaccination in 2019 was associated with slightly higher GP-diagnosed COVID-19 rates (HR 1.15; 95% CI 1.08 to 1.22) but slightly lower all-cause mortality (HR 0.90; 95% CI 0.83 to 0.97).
DOI: 10.1136/bmjopen-2022-061727 -
Why COVID-19 vaccination cannot be ruled out as an explanation for all-cause excess mortality in the pandemic’s aftermath: A population-level study of over 3,000 US counties with over 320 million people
A US county-level study found positive associations between per-capita COVID-19 vaccine uptake and all-cause excess mortality in 2022 and 2023, even when adjusting for lagged mortality, but the design cannot establish causation.
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Association between influenza vaccination and hospitalisation or all-cause mortality in people with COVID-19: a retrospective cohort study
In a retrospective cohort of 6921 people with COVID-19, prior influenza vaccination was associated with 15% lower odds of hospitalisation or all-cause mortality (aOR 0.85) and 24% lower odds of all-cause mortality (aOR 0.76).
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All-cause mortality according to COVID-19 vaccination status: An analysis of the UK office for National statistics public data
The analysis of UK ONS data from April 2021 to May 2023 found that all-cause and non-COVID-19 mortality SMRs increased over time for vaccinated individuals relative to unvaccinated individuals across all age groups, with predicted crossing points from September 2022 to January 2…
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COVID-19 mRNA vaccination and all-cause mortality in the adult population in Norway during 2021–2023: a population-based cohort study
In a Norwegian population-based cohort of 4,645,910 adults followed from January 2021 to December 2023, individuals who received three or more mRNA vaccine doses had a substantially lower adjusted all-cause mortality rate than unvaccinated individuals, with fully vaccinated adul…
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Effectiveness of COVID-19 Vaccination in Preventing All-Cause Mortality among Adults during the Third Wave of the Epidemic in Hungary: Nationwide Retrospective Cohort Study
In a nationwide retrospective cohort of 6.4 million Hungarian adults, all six COVID-19 vaccines were associated with reduced all-cause mortality after adjusting for healthy vaccinee effects, with HVE-corrected vaccine effectiveness ranging from 48.7% for Pfizer-BioNTech to 75.4%…
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Is There a Link between the 2021 COVID-19 Vaccination Uptake in Europe and 2022 Excess All-Cause Mortality?
Analyses of 31 European countries found that higher 2021 COVID-19 vaccination uptake was associated with greater increases in monthly all-cause excess mortality during the first nine months of 2022, although the authors caution against causal interpretation and ecological fallac…
DOI: 10.21276/apjhs.2023.10.1.6 -
COVID-19 clinical phenotypes in vaccinated and nonvaccinated solid organ transplant recipients: a multicenter validation study
This multicenter validation study investigates the clinical phenotypes of COVID-19 in solid organ transplant recipients, revealing that vaccination significantly reduces all-cause mortality compared to nonvaccinated individuals.
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Temporal patterns of all-cause mortality among U.S. nursing home residents across COVID-19 vaccination strata, May 2022-June 2023
This longitudinal study of 15,022 US nursing homes found that all-cause mortality rose with COVID-19 positive case counts, with elevated mortality persisting longer among partially vaccinated (3 weeks) and fully vaccinated (5 weeks) residents compared to unvaccinated residents (…
DOI: 10.18103/mra.v14i3.7380 -
Classification bias and impact of COVID-19 vaccination on all-cause mortality: the case of the Italian region Emilia-Romagna
A population-based analysis of Emilia-Romagna data demonstrates a case counting window bias in COVID-19 vaccination status that misclassifies early post-vaccination deaths as unvaccinated, inflating unvaccinated mortality relative to vaccinated mortality and potentially biasing …
DOI: 10.1080/08916934.2025.2562972 -
BNT162b2 mRNA COVID-19 (Comirnaty) Vaccine Effectiveness in Elderly Patients Who Live in Long-Term Care Facilities: A Nationwide Cohort
A nationwide Israeli cohort study of long-term care facility residents shows that the BNT162b2 mRNA COVID-19 vaccine substantially reduces SARS-CoV-2 infection, COVID-19–related death, and all-cause mortality within 28 days of vaccination, with waning effectiveness with increasi…
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Risk of worsening heart failure and all-cause mortality following mRNA COVID-19 vaccination in patients with heart failure: a Danish nationwide real-world safety study
In a nationwide Danish cohort of 101,786 patients with heart failure, SARS-CoV-2 mRNA vaccination was associated with a lower 90-day all-cause mortality risk compared with a matched 2019 unvaccinated cohort and with no difference in worsening heart failure, myocarditis, or venou…
DOI: 10.1093/eurheartj/ehac544.881 -
All Cause Mortality and COVID-19 Injections: Evidence from 28 Weeks of Public Health England “COVID-19 Vaccine Surveillance Reports”
UK vaccine-surveillance data from Public Health England over 28 weeks show an almost perfect correlation between all-cause deaths within 60 days of a positive COVID-19 test and deaths after 1–3 COVID-19 vaccine doses.
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Dynamic effects of COVID-19 vaccination on major acute cardiovascular events and mortality following SARS-CoV-2 infection in a target trial emulation study
In a population-based Estonian cohort, this target-trial emulation study shows that pre-infection COVID-19 vaccination modestly reduces the risk of major adverse cardiovascular events (MACE) and all-cause mortality within the year after SARS-CoV-2 infection, with the protective …
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MO820: Comparison of All-Cause-Mortality Before and After COVID-19 Vaccination in a Hemodialysis Center
In a prospective before-after study of 165 hemodialysis patients in Uzbekistan, one-year survival improved from 79.6% during multiple dialyzer reuse to 89.4% after switching to single-use disposable dialyzers, a 12.3% increase.
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Age and sex-specific risks of myocarditis and pericarditis following Covid-19 messenger RNA vaccines
This study investigates the age and sex-specific risks of myocarditis and pericarditis following Covid-19 mRNA vaccinations, revealing significantly increased risks particularly after the second dose, especially in younger males.
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Risk of Myocarditis and Pericarditis among Young Adults following mRNA COVID-19 Vaccinations
This study investigates the increased risk of myocarditis and pericarditis among young adults following mRNA COVID-19 vaccinations, revealing a higher-than-expected reporting rate, particularly in males aged 12-17 after the second dose.
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Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection
This study investigates the risks of myocarditis, pericarditis, and cardiac arrhythmias following COVID-19 vaccination in England, revealing increased risks associated with mRNA vaccines, particularly in younger populations, while also highlighting a significantly higher risk fo…
DOI: 10.1038/s41591-021-01630-0 -
Increased risk of myocarditis and pericarditis and reduced likelihood of severe clinical outcomes associated with COVID-19 vaccination: a cohort study in Lombardy, Italy
This cohort study in Lombardy, Italy, assesses the increased risk of myocarditis and pericarditis associated with COVID-19 vaccination, particularly highlighting the higher incidence in young men after receiving the Moderna vaccine, while also demonstrating that the benefits of …
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Myocarditis and Pericarditis following COVID-19 Vaccination: Inequalities in Age and Vaccine Types
This study investigates the incidence and risk of myocarditis and pericarditis following COVID-19 vaccination in the U.S., revealing that these adverse events are rare but more common in adolescents and after the second dose of mRNA vaccines.
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Incidence, risk factors, natural history, and hypothesised mechanisms of myocarditis and pericarditis following covid-19 vaccination: living evidence syntheses and review
This living systematic review found that myocarditis after mRNA COVID-19 vaccination occurs most frequently in male adolescents and young adults, with moderate-certainty evidence that Moderna is associated with higher incidence than Pfizer in 18-29 year olds and low-certainty ev…
DOI: 10.1136/bmj-2021-069445 -
Risk of Coronavirus Disease 2019 Messenger RNA Vaccination-Associated Myocarditis and Pericarditis – A Systematic Review of Population-Based Data
This systematic review analyzes population-based data to assess the risk of myocarditis and pericarditis associated with mRNA COVID-19 vaccination, highlighting significant variations in reported rates across different studies and populations.
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Systematic review and meta-analysis of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccination
This systematic review and meta-analysis investigates the incidence and risk of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccination, revealing a low frequency of these conditions, predominantly after the second dose, especially in males.
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A Pharmacoepidemiological Study of Myocarditis and Pericarditis Following the First Dose of mRNA COVID-19 Vaccine in Europe
This study evaluates the reporting rates of myocarditis and pericarditis following the first dose of mRNA COVID-19 vaccines in Europe, revealing an excess risk of myocarditis but unclear implications for pericarditis.
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Myocarditis or Pericarditis Following the COVID-19 Vaccination in Adolescents: A Systematic Review
This systematic review and meta-analysis investigates the incidence of myocarditis and pericarditis in adolescents following COVID-19 vaccination, revealing a significantly higher risk after the second dose, particularly in males, while overall incidence rates remain low.
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Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination: What Do We Know So Far?
This study reviews 29 published cases of acute myopericarditis following mRNA COVID-19 vaccination, highlighting the clinical presentation, management, and the speculation of a causal relationship between vaccination and myocarditis, while emphasizing that the risks of cardiac c…
DOI: 10.3390/children8070607 -
Booster dose of COVID-19 mRNA vaccine does not increase risks of myocarditis and pericarditis compared with primary vaccination: New insights from the vaccine adverse event reporting system
Booster COVID-19 mRNA vaccination was associated with lower incidence and reporting risk of myocarditis/pericarditis compared with primary series, based on US VAERS and CDC COVID Data Tracker data from December 2020 to March 2022.
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Covid-19 Vaccines and Worrisome Cardiac Side Effects: Serious Cause of Concern
A narrative article examining potential links between COVID-19 vaccination and cardiac adverse events, citing myocarditis and pericarditis cases, highlighting regulatory balance of risks and benefits, and urging increased surveillance and clinical evaluation.
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Myocarditis and Pericarditis Post-mRNA COVID-19 Vaccination: Insights from a Pharmacovigilance Perspective
This study analyzes the safety signals of myocarditis and pericarditis following mRNA COVID-19 vaccination, particularly in younger populations, using data from the Vaccine Adverse Events Reporting System (VAERS) to identify reporting trends and potential risks associated with d…
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Clinical Challenges of the COVID-19 Vaccines: Frequency of Serious Adverse Events After Immunization in Hospitalized Patients
A cross-sectional hospital-based study in southern Iran identifying the frequency and spectrum of serious adverse events following COVID-19 vaccination among 68 hospitalized patients, with ARDS being the most common sAEFI and the overall incidence estimated at 20 per 100,000.
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Adverse events of special interest after vaccination with COVID-19 vaccines: a cohort event monitoring study in Iran
A WHO-guided cohort event monitoring study in Iran assessing adverse events of special interest (AESIs) and serious adverse events (SAEs) after four COVID-19 vaccines (Sinopharm, Sputnik V, AZD1222, and COVIran Barekat) in 89,783 adults across seven cities, finding very rare AES…
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Vaccination status and long COVID symptoms among patients hospitalized with COVID-19: the WHF COVID-19 Long-term Study
A multicountry prospective cohort of 2,504 hospitalized COVID-19 patients examines how vaccination status relates to long COVID symptoms, major adverse cardiovascular events (MACE), and mortality up to 12 months post-discharge, finding vaccination reduces morbidity and mortality…
DOI: 10.1093/eurheartj/ehae666.3598 -
Use of Big Data to Evaluate Adverse Ophthalmic Adverse Events after COVID-19 Vaccination
A retrospective cross-sectional study in Ulsan, South Korea identified 97 ophthalmic adverse events among 2,766,569 COVID-19 vaccine doses, with visual disturbance most common, rare irreversible sequelae linked to neurological, retinal, and glaucoma diagnoses, and no significant…
DOI: 10.3341/jkos.2024.65.4.267 -
Surveillance of Adverse Events Following Immunization (AEFI) after Third Dose Booster Vaccination with mRNA-Based Vaccine in Universitas Indonesia Hospital Health Personnel
This study evaluates adverse events following immunization (AEFI) after the third dose of an mRNA-based COVID-19 vaccine among health personnel at Universitas Indonesia Hospital, finding that the most common AEFI symptoms were pain at the injection site, fever, shoulder pain, an…
DOI: 10.3390/vaccines10060877 -
Branch Retinal Artery Occlusions, Paracentral Acute Middle Maculopathy and Acute Macular Neuroretinopathy After COVID-19 Vaccinations
This study reports six cases of retinal adverse events, including branch retinal artery occlusion, paracentral acute middle maculopathy, and acute macular neuroretinopathy, occurring after administration of the Pfizer-BioNTech COVID-19 vaccine, highlighting the need for further …
DOI: 10.2147/OPTH.S357359 -
Motivational Factors and Post Vaccination Symptoms among COVID-19 Vaccinated Beneficiaries at a Tertiary Care Hospital, West Bengal, India: A Cross-sectional Study
Cross-sectional survey of 448 COVID-19 vaccine recipients at a West Bengal tertiary care hospital finds about half experienced post-vaccination symptoms (mostly mild local pain), with fear of infection and self-motivation the main vaccination drivers and universal acceptance obs…
DOI: 10.7860/jcdr/2022/57598.17027 -
Frequency of Inactivated COVID-19 Vaccine Side Effects in a Tertiary Care Hospital of Karachi
A cross-sectional survey in a Karachi tertiary hospital found that recipients of an inactivated COVID-19 vaccine experienced mostly mild, transient side effects, with higher reporting among younger individuals and females, and high rates of spontaneous recovery.
DOI: 10.51253/pafmj.v72i6.7978 -
Acute pancreatitis complicated with diabetic ketoacidosis following COVID-19 mRNA vaccination: a case report
This case report describes a 72-year-old male who developed acute pancreatitis complicated by diabetic ketoacidosis following his third dose of the COVID-19 mRNA vaccine, highlighting the need for awareness of such rare adverse events post-vaccination.
DOI: 10.2185/jrm.2024-003 -
Multivariate Analysis of Adverse Reactions and Recipient Profiles in COVID-19 Booster Vaccinations: A Prospective Cohort Study
This prospective cohort study analyzed the impact of recipient profiles, vaccine type, and vaccination intervals on adverse reactions following COVID-19 booster vaccinations among Osaka University Dental Hospital employees, finding that younger individuals and females experience…
DOI: 10.3390/vaccines11101513 -
Dynamics of the Cellular and Humoral Immune Response After BNT162b2 Messenger Ribonucleic Acid Coronavirus Disease 2019 (COVID-19) Vaccination in COVID-19-Naive Nursing Home Residents
COVID-19-naive nursing home residents exhibit rapid waning of both antibody and T-cell responses after BNT162b2 vaccination, lagging behind healthcare workers over 24 weeks, with older age reducing antibody response and diabetes/malignancy reducing cellular responses, supporting…
DOI: 10.1093/infdis/jiab458