FOI Ref: FOI/2023/4806
You asked
To date I believe the ONS figures indicate there have been 58 deaths which involve the COVID-19 vaccine.
When identifying the number of deaths involving a COVID-19 vaccine if a death certificate is issued without the mention of the COVID-19 Vaccine, but it is later established due to developments in research, such as in the case of vaccine induced thrombosis and thrombocytopenia (VITT), would these cases be included in the figures or is it necessary to have the death certificate amended by the coroner for the death to be included in the figures?
Are all deaths that have a COVID-19 vaccine mentioned on the death certificated included in the figures?
Are only those deaths with a final death certificate included in the figures?
We said
Thank you for your enquiry.
Medical Certificate of Cause of Death
The medical certificate of cause of death has two parts, Part 1 contains the sequence of health conditions or events leading directly to death, while Part 2 can contain other health conditions that contributed to the death but were not part of the direct sequence. If the patient had other health conditions at the time, but they did not, in the opinion of the doctor certifying the death, influence the fact that the person died at that time, those health conditions are not included on the death certificate.
Doctors are required by law to certify the cause of death 'to the best of their knowledge and belief'. That means they use their medical expertise to decide the cause based on symptoms, physical examination, hospital records, laboratory tests, and all the other information available. If death is certified by a coroner, the Coroner's Court follows legal rules of evidence when deciding the causes of death. No-one has the power to tell a doctor or coroner to reach a particular decision about the cause of death.
When the doctor or coroner writes a death certificate, they take into account all the available information about the patient's health and the events surrounding their death. They then include on the death certificate only those health conditions that contributed to the cause of death.
You may find the following information on the government guidelines for doctors on completing a medical certificate of cause of death (MCCD) useful.
Amendments to the death certificate
The conditions mentioned on the death certificate are used to derive an underlying cause of death. In some cases, more information on cause of death may become available at a later stage after the death has been registered such that the underlying cause may be subsequently amended. Around 0.1% of deaths have their underlying cause amended. This amended or final cause is used in mortality statistics. Sometimes, the later information becomes available only after publication. Users with access to individual records of deaths as shown in the public record (which is never amended) may consequently find some differences with published statistics. Further information on this process can be found in Table 6 of User guide to mortality statistics.
Deaths involving COVID-19 vaccine
We regularly publish data on deaths by leading causes in our Monthly Mortality Analysis. These data are driven by information collected from the death certificate at death registration. Table 14 shows deaths involving COVID-19 vaccines causing adverse effects in therapeutic use. You can see from this that the number of deaths involving COVID-19 vaccines causing adverse effects in therapeutic use from March 2020 up to December 2022 in England was 59 deaths, 51 of which had this cause listed as the underlying cause. In Wales, there was one death, which was also listed as the underlying cause. Our Monthly Mortality Analysis will next be published on 23 February 2023.
If you would like to discuss this enquiry further, please contact health.data@ons.gov.uk.