Column: How a blunder by a respected medical journal is fueling an anti-vaccine lie

The paper published by the respected British Medical Journal earlier this month was eye-opening, to say the least. It questioned why excess deaths in Western countries remained unusually elevated during the COVID-19 pandemic even after vaccines were introduced in 2021.

The implication seemed clear: Rather than reducing cases and deaths, the COVID vaccines had fueled the tragic tide.

That finding was picked up within 48 hours by the Telegraph, a conservative British daily. It leaped across the Atlantic Ocean to the New York Post, a part of the Murdoch media empire, one day later.

British Medical Journal

Since then, it has been widely spread on social media by the anti-vaccination camp. The repetitions have become increasingly febrile, with some tweets blaming the vaccines for tens of millions of deaths.

Here's what you need to know: There is no truth to this finding, or to the anti-vaccine camp's interpretation of the BMJ paper.

The journal, which posted the paper on its Public Health webpage on June 3, has acknowledged that. In a public statement issued June 6, after the faulty interpretation began to spread worldwide, the journal observed: "Various news outlets have claimed that this research implies a direct causal link between COVID-19 vaccination and mortality. This study does not establish any such link."

On the contrary, the journal wrote, "Vaccines have, in fact, been instrumental in reducing the severe illness and death associated with COVID-19 infection."

Alas, the journal's warning came too late. As I write, the Telegraph's June 4 tweet hawking its misleading story has received 1.5 million views on X (formerly-Twitter), but the BMJ's warning notice, only 388,000 views.

These figures are proof positive of the old saw (attributed to Winston Churchill, among many others) that "a lie can make it halfway around the world before the truth can get its boots on."

Some researchers argue that the original paper, by a team of Dutch scientists, was so shoddy and inconsequential that it should not have been published at all.

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Among the critics is Ariel Karlinsky, an Israeli economist and statistician whose data constituted the core of the Dutch paper. Karlinsky has written that the BMJ should retract the paper and "open an inquiry into what happened there with editors and reviewers." The journal hasn't responded.

The use that anti-vaccine propagandists have made of the BMJ paper underscores the dangers of disinformation in public health today.

A recent study in Science analyzed the impact of what its authors labeled "vaccine-skeptical" published content on vaccine refusal. The authors examined anti-vaccine posts on Facebook during the first three months of the COVID vaccine rollout in early 2021.

They found that posts flagged by third-party fact-checkers as false received a relatively minimal 8.7 million views in that period. Posts that were not flagged by fact-checkers but "nonetheless implied that vaccines were harmful to health — many of which were from credible mainstream news outlets — were viewed hundreds of millions of times."

The flagged posts were more likely to inspire vaccine resistance, the authors wrote. Although unflagged posts individually had less impact on vaccine sentiment, the volume of those posts was so immense that cumulatively they did more damage to vaccine rates.

A single vaccine-skeptical article in the Chicago Tribune — headlined "A healthy doctor died two weeks after getting a COVID vaccine; CDC is investigating why" — was viewed by more than 50 million users on Facebook, more than 20% of the platform's U.S. user base. That was "more than six times the number of views than all flagged misinformation combined."

It's also true that articles that may be innocuous or inconclusive at their core can be distorted and magnified into explicitly anti-vaccine messages by being passed through the anti-vax network.

Something of the kind happened with the BMJ paper. Its language alluding to "serious concerns" about the impact of vaccines and "containment measures" such as lockdowns on excess deaths was transmogrified into the Telegram's headline stating that "Covid vaccines may have helped fuel rise in excess deaths" and similar language in the New York Post.

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The anti-vaxx camp, in repeating these claims, did so after removing or minimizing most of the qualifying language. The headline on a report published by Robert F. Kennedy Jr.'s anti-vaccine organization, Children's Health Defense, stated that the COVID vaccines "likely fueled rise in excess deaths," attributing that conclusion to "mainstream media."

The CHD report cited a blog post by anti-vaxx crusader Meryl Nass, republishing the Telegraph article. The Nass post was headlined "The Dam Has Broken," suggesting that major news sources were now accepting the dangers of the COVID vaccines.

Nass, by the way, is a Maine physician who has had her license suspended and been fined $10,000 for having prescribed ivermectin and hydroxychloroquine, two medicines known to be useless in treating COVID-19, to patients.

Put it all together, and the evolution of the BMJ paper into a brief claiming that the COVID vaccines are harmful to health plays into the most extreme anti-vaccine disinformation in circulation — such as the incredibly ignorant and dangerous recommendation by Joseph Ladapo, the anti-vaccine quack appointed as Florida surgeon general by Gov. Ron DeSantis, that no one under 65 take a COVID vaccine.

The medical and immunological communities have overwhelmingly concluded that the COVID-19 vaccines have massively reduced hospitalizations and death from the disease. A December 2022 report card by the Commonwealth Fund concluded that after two years of administration, the vaccines had prevented more than 18 million additional hospitalizations and more than 3 million additional deaths.

This is the progress placed at risk by the torrent of anti-vaccine propaganda purveyed by RFK Jr.'s organization and other vaccination opponents.

That brings us back to the BMJ paper and its manifest flaws.

"Excess deaths," the metric purportedly examined by the Dutch authors, is simply the number of deaths in a country during a given period over and above those that would have been expected "under normal conditions," based on historical patterns.

In more than 40 Western countries during the three peak years of the pandemic, the authors reported, there were 1.033 million excess deaths in 2020, about 1.26 million in 2021 and 808,000 in 2022.

The authors expressed perplexity about why excess deaths actually rose in 2021, despite the arrival of the vaccines and the implementation of social anti-pandemic measures, and remained elevated the following year. "Government leaders and policymakers," the authors wrote, " need to thoroughly investigate underlying causes of persistent excess mortality."

The authors further commented that "consensus is also lacking in the medical community regarding concerns that mRNA vaccines might cause more harm than initially forecasted." That's a gross misrepresentation.

The consensus in the medical community is indisputably that the vaccines are safe and effective. Although they do cause occasional side effects (as do all vaccines), the health threats caused by COVID-19 itself are immeasurably more hazardous.

The truth is that the factors causing elevated excess mortality throughout the pandemic are not mysterious, but well-understood. Statistical data scientist Jeffrey S. Morris of the University of Pennsylvania put his finger on some of the most important.

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One is that far more people were exposed to COVID-19 in 2021 than in 2020. By the end of 2020, according to the World Health Organization, there were about 10,000 cases and about 238 deaths per million population; one year later, there 35,186 cases and 683 deaths per million. Furthermore, the COVID variants that appeared in 2021 — the Delta and Omicron waves — were far more transmissible and virulent (causing more hospitalization and death) than the initial variants.

Also in 2021, many of the most stringent anti-pandemic measures implemented in 2020 — school closings, lockdowns, business closures, mask mandates — were getting lifted by local authorities. This raised the level of exposure to the virus in the general public.

As for the vaccines, the Dutch authors seemed to conjecture that vaccination happened as if with the turning of a switch in January 2021. Of course that's untrue.

Figures compiled by the independent statistical clearinghouse Our World in Data — which were used by the Dutch researchers — show that the vaccines were rolled out only gradually through 2021. By mid-year, only about 20% of the population of countries that submitted figures had received even a single dose; by the end of 2021, nearly 50% were still unvaccinated.

"Even with a 100% effective vaccine, we would have seen high levels of morbidity and mortality from COVID-19 in 2021, leading to high number of excess deaths," Morris observes.

Statisticians have shown that the peaks and valleys of excess mortality during the pandemic coincide almost exactly with the emergence and peaks of Delta, Omicron and other variants of concern, indicating that excess deaths are almost certainly the result of COVID, not the COVID vaccines.

One other data point: As the British actuary Stuart McDonald points out, of the 47 countries surveyed by the Dutch researchers, the 10 with the lowest rates of excess deaths are those with the highest vaccine uptakes, such as Canada (83% vaccination rate in 2022 and only 5% excess deaths in 2020-22) and Germany (76% vaccinated and 6% excess deaths). By contrast, those with the lowest vaccination rates tended to have the most excess deaths, including North Macedonia (40% vaccinated at 28% excess deaths) and Albania (45% vaccinated, 24% excess deaths).

Is there a remedy for claptrap like the BMJ article? Sadly, very little. Qualified scientists and epidemiologists have risen up almost as one to expose the flaws of the BMJ paper. But the first line of defense against disinformation must be scientific journals themselves. In this case, if not for the first time, the BMJ has failed its responsibility for being a gatekeeper of sound science.

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This story originally appeared in Los Angeles Times.