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September 29, 2021

The extreme age skew of Covid-19 deaths—even in vaccinated people

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    While research has shown Covid-19 vaccines significantly reduce the risk of hospitalization and death, elderly, vaccinated people are still at higher risk of dying from the disease than younger, unvaccinated people, David Wallace-Wells writes for New York Magazine's "Intelligencer."

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    Covid-19 is far more lethal in older individuals, research shows

    Data has long shown that Covid-19 more severely affects the elderly than it does younger people. According to Wallace-Wells, for every five to eight years of age, an unvaccinated individual's chances of dying from Covid-19 roughly double—meaning that advanced age poses a greater risk than even the most significant comorbidities.

    The good news is that, across all age groups, vaccines greatly reduce the risk of severe Covid-19. A recent CDC study from Los Angeles, for instance, found that Covid-19 vaccines led to a 29-fold drop in hospitalization risk, and another CDC study suggested the vaccines led to an 11-fold drop in overall mortality risk.

    But breakthrough cases do happen—and although most such cases are mild, their risks are far greater for elderly patients. According to CDC data, 70% of breakthrough cases resulting in hospitalization and 87% of those ending in death were among patients over the age of 65. And in England, the median age of patients who died from a breakthrough infection was 84.

    This suggests that "in assessing an individual's risk of dying from Covid, age appears still as important—and maybe even more important—than vaccination status," Wallace-Wells writes.

    Just how high are breakthrough infection risks in older patients?

    According to an analysis of data from England conducted by the Financial Times, an 80-year-old vaccinated against Covid-19 has roughly the same mortality risk as an unvaccinated 50-year-old, Wallace-Wells writes. Even a vaccinated 45-year-old has a higher risk of death from Covid-19 than an unvaccinated 30-year-old.

    On the other hand, young children—many of whom are not yet eligible for vaccination—experience relatively low mortality risk from Covid-19, Wallace-Wells writes.

    According to recent data from the United Kingdom, an unvaccinated 10-year-old faces a lower risk of death from Covid-19 than a vaccinated 25-year-old. And in England, hospitalization rates among unvaccinated children were found to be lower than those for vaccinated people ages 18 to 29.

    As a result, an unvaccinated person over the age of 85 is more than 10,000 times more likely to die from Covid-19 than an unvaccinated child under the age of 10, Wallace-Wells writes.

    Could booster shots diminish the Covid-19 age skew?

    Research has found that immunity from the Covid-19 vaccines wanes over time, especially among the elderly. Because this population already faces disproportionate risks from Covid-19, boosters to restore their immunity could play a powerful role in reducing deaths, Wallace-Wells writes.

    According to Wallace-Wells, "the social impact of elevating protection among the most vulnerable by even a few percentage points would be absolutely enormous," given the age skew of Covid-19 mortality risk. "That's because if vulnerability is hundreds of times higher in one group than another, the impact of that boost is going to be much, much larger too," Wallace-Wells writes.

    When talking about booster shots, "it simply doesn't make sense to talk about vaccinated 15-year-olds and 95-year-olds in the same breath and unvaccinated 15-year-olds and unvaccinated 95-year-olds in a different breath," Wallace-Wells argues.

    Doing so "distorts the picture of the pandemic as a whole" because "a vaccinated 95-year-old is still probably over a thousand times more at risk of death, all else being equal, than an unvaccinated 15-year-old. Which means we probably shouldn't be giving those two groups the same advice about masks or social distancing or boosters." (Wallace-Wells, "Intelligencer," New York Magazine, 9/27)

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