The effect of vaccines: mortality decreases in all ages and the deceased are getting younger and younger

Covid-19 continues to be a disease that strikes the vulnerable and the age factor is the most decisive. This has not been changed by vaccines. But its progress is progressively modulating the profile of the patient who dies from the coronavirus. The group with the highest mortality has gone from those over 80 years of age to septuagenarians. And, little by little, those between 60 and 69 are falling. This does not mean that more young people are dying now. On the contrary: deaths decrease in all ages and are now almost 10 times less than in January. But the proportion is distributed differently as the older age groups are protected.

Mortality data from the Carlos III Health Institute show that at the beginning of May —for up to three weeks the data are not consolidated and are unreliable— those over 80 years of age accounted for 35% of mortality, just half that in January. The relative space of these deaths is occupied by the following bands: septuagenarians now make up 37% of the deceased (in January they were 20%); in their sixties, 17.4% (more than double that of four months ago); people between 50 and 59, 7.8% (before 2.7%); those from 40 to 49 by 2.8% (instead of 0.6% in January). In your thirties, the cases are so rare that the comparison is difficult. In February 15 people died in this strip; in March, 10; in April, 12; from May 1 to 9, 3. In younger people, deaths are even more infrequent: most days nobody dies under the age of 30.

The photo has changed radically since the beginning of the year: in January there were more than 500 deaths a day. At the beginning of May, they were starting to drop below 50. And the trend is clearly downward. The accumulated incidence has slowed its decline and has been practically stagnant for a few days, but most infections occur among people under 50, with much less probability – although there are – of becoming seriously ill or dying from covid.

Experts have little doubt that these data are the result of vaccination. Both the number of deaths in absolute terms and their redistribution closely correspond to the advance by age group of punctures. Older people continue to die, but the vast majority is because they were infected before immunization. José Carlos Igeño, head of the ICU at the San Juan de Dios Hospital in Córdoba, explains: “That people are not misled. They think that if the elderly are protected, those who die now must be young. And no. They are mostly people over 60 or 70 years old who were admitted to the ICU a long time ago, even months ago, and there is nothing to do. Many of them die from multidrug-resistant opportunistic fungi and bacteria that colonize and crush lungs that were already very bad due to COVID. “

Gabriel Heras, head of the Intensive Service of the Southern Area of ​​Granada, coincides with this diagnosis. “The vaccination cycles are being fulfilled. Nobody very old comes in anymore. And every time less than 60 and 70 years. Now we are seeing people in their fifties. And those who die are usually older people who have been hospitalized for a long time, with great muscle weakness and post-ICU syndrome, in which the risk of complications increases, “he says.

Younger and younger new entrants to intensive care now have a common common denominator: obesity. Together with diabetes and hypertension, they are the most associated comorbidities. This is the conclusion of a study with more than 4,000 patients that will be presented next week by the intensivist Alejandro H. Rodríguez at the congress of the Spanish Society of Intensive, Critical Medicine and Coronary Units.

Among them there are people who enter with one dose of the vaccine, or just put the second, when there has not yet been time for it to generate an immune response. But the researcher has found practically none with the two established guidelines. It is something that can happen: vaccines are not foolproof. There is a small percentage of people who, even with them, can get sick and, more unlikely, go to hospital or even die. The Ministry of Health does not publish data on this circumstance, but, according to the analyzes of the clinicians consulted, it is extremely rare.

Health data they show how both the plants and the intensive care units of the hospitals are gradually being emptied, although there is still a long way to go: the beds have a similar level of occupancy at the beginning of September, when the second wave was gaining strength; and the ICUs, which decline more slowly, similar to the beginning of October.

The weight that the elderly has lost in ICU admissions has been gained by these other profiles of younger people with other pathologies, but, in general, the cases are less serious and have a higher probability of survival, says Rodríguez. Again, this refers to relative terms. It is not necessary to deduce that more young people with overweight or other pathologies enter, it is that now these profiles are proportionally more frequent.

Pablo Demelo, an internist at the Gregorio Marañón Hospital in Madrid, explains that now the cases of people even under 40 years of age have more dedication. “They are normally less serious, they are discharged before discharge, but now they stand out more because there are fewer elderly patients,” he explains.

A report by the health data consultancy IQVIA predicts that in the best of vaccination scenarios, hospital admissions for covid will gradually decline during the summer and will be anecdotal or practically non-existent in September. Everything suggests that the trend will continue towards that path: fewer and fewer deaths, fewer incomes and with a proportionally younger profile, as the immunization of the elderly is consolidated. Virtually everyone over 70 is protected with two doses. The most critical age group now is that of the sixties. Although 9 out of 10 have received a puncture, only 13% have the complete pattern. This is because most have received AstraZeneca, which is 12 weeks apart, so the second dose will still take weeks for many of them.

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