Question explored with the scientific record
Conversation so far
- 1 What do you think of this idea? A personal health strategy of vaccine avoidance and non-vaccine avoidance of common infectious ailments will be a good way to avoid auto-immune diseases.
- 2 How about this follow up based on a lifetime of conversations: The older a person gets the more prudent it is for them to avoid communicable diseases. So often, in older people, even those over 45 or 50, a relatively innocent disease leads to serious complications.
- 3 I also meant to include health conditions in addition to autoimmune conditions. Pneumonia, for example, or sepsis, or organ failure etc.
Answered on this page ↓
I also meant to include health conditions in addition to autoimmune conditions. Pneumonia, for example, or sepsis, or organ failure etc.
The short version: for older adults, the real killers are pneumonia and sepsis, and the evidence on whether vaccines prevent those deaths is far weaker than the marketing suggests.
Pneumonia is a serious threat in older adults. About 1 in 20 people hospitalized with community-acquired pneumonia die, and that rises to about 8 in 100 for those over 80 [18]. Pneumococcal bacteremia kills about 11 in 100 older adults within 30 days [4]. Sepsis is worse: about 1 in 5 people hospitalized with sepsis die in the hospital [24]. These are real risks, and they increase sharply with age.
The vaccine evidence is mixed. The 23-valent pneumococcal vaccine (PPV23) shows no significant reduction in all-cause mortality in a 2024 meta-analysis, though it may reduce pneumonia-related deaths [3]. One study of octogenarians found that not being vaccinated was linked to higher heart failure and cardiovascular mortality [5], but that is observational. The CAPiTA trial, the best pneumococcal study, found the 13-valent vaccine reduced vaccine-type pneumonia by about 74% but did not show a reduction in overall pneumonia or death [13]. Influenza vaccine studies show protection against hospitalization and all-cause mortality, but only after statistical adjustment for bias [12].
| Condition | Risk without vaccine | Vaccine effect |
|---|---|---|
| Pneumonia death (80+) | ~8 in 100 hospitalized [18] | PPV23: no all-cause mortality benefit [3] |
| Pneumococcal bacteremia death (65+) | ~11 in 100 [4] | PCV13: 74% fewer vaccine-type cases [13] |
| Sepsis death | ~21 in 100 hospitalized [24] | No vaccine exists |
The COVID-19 vaccine evidence is contradictory. A Norwegian study of 4.6 million adults found lower all-cause mortality in the vaccinated [6], but a UK analysis found mortality risk in vaccinated people rose over time and crossed the unvaccinated line by late 2022 [10]. An Australian analysis concluded the claimed protection was implausible because it implied a 121% excess death rate in the unvaccinated [1]. These cannot all be true. The studies compare vaccinated to unvaccinated people who differ in health, wealth, and behavior, and no adjustment fully fixes that.
My call: pneumonia and sepsis are genuine threats in older adults, and the pneumococcal and influenza vaccines offer modest, real protection against specific infections, but the evidence does not show they reduce overall death, and the COVID-19 vaccine mortality data is too contradictory to trust. Confidence: moderate.
Sources used 10
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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.
DOI: 10.71189/jim/2026/v02n03a11 -
Mortality reduction with 23-valent pneumococcal polysaccharide vaccine: a systematic review and meta-analysis
This systematic review and meta-analysis evaluated the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPV23) in reducing all-cause and pneumonia-related mortality among adults, finding no significant reduction in all-cause mortality but a significant reducti…
DOI: 10.1186/s41479-024-00149-5 -
Characteristics and Outcomes of Older Adults with Community‐Acquired Pneumococcal Bacteremia
This study investigates the baseline characteristics and clinical outcomes of older adults with community-acquired pneumococcal bacteremia, revealing significant morbidity and mortality associated with the condition, particularly in those with coronary artery disease and immunoc…
DOI: 10.1111/j.1532-5415.2005.00528.x -
Higher risk for incident heart failure and cardiovascular mortality among community‐dwelling octogenarians without pneumococcal vaccination
This study investigates the association between lack of pneumococcal vaccination and increased risk of incident heart failure and cardiovascular mortality among community-dwelling octogenarians, revealing significant findings that suggest vaccination may play a protective role i…
DOI: 10.1002/ehf2.12056 -
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…
DOI: 10.1136/bmjph-2024-001859 -
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…
DOI: 10.12688/f1000research.154058.2 -
After adjusting for bias in meta-analysis seasonal influenza vaccine remains effective in community-dwelling elderly
A methodological meta-analysis comparing conventional and bias-adjusted approaches to estimating seasonal influenza vaccine effectiveness in community-dwelling elderly, showing that bias adjustment reduces heterogeneity and yields significant protection against hospitalization f…
DOI: 10.1016/j.jclinepi.2014.02.009 -
Pneumococcal Pneumonia and Invasive Pneumococcal Disease in Those 65 and Older: Rates of Detection, Risk Factors, Vaccine Effectiveness, Hospitalisation and Mortality
Pediatric PCV vaccination programs create herd protection that reduces pneumococcal disease in seniors, while PPV23 shows variable protection in older adults and overall vaccination uptake remains suboptimal, highlighting the need for targeted nursing-home strategies and surveil…
DOI: 10.3390/geriatrics6010013 -
The incidence of radiologically verified community-acquired pneumonia requiring hospitalisation in adults living in southern Sweden, 2016-2018: a population-based study
This population-based study estimates the incidence of radiologically verified community-acquired pneumonia (CAP) requiring hospitalization in adults living in southern Sweden from 2016 to 2018, revealing significant age-related disparities in incidence and mortality rates.
DOI: 10.1186/s12879-025-10468-7 -
Insurance type and sepsis-associated hospitalizations and sepsis-associated mortality among US adults: A retrospective cohort study
This retrospective cohort study using the 2003 Nationwide Inpatient Sample analyzes how health insurance type (Private, Medicare, Medicaid, Medicaid+Medicare, Uninsured) is associated with sepsis-related hospitalizations and in-hospital mortality among US adults, finding higher …
DOI: 10.1186/cc10243