In a publication in Public health BMJ On June 3, Saskia Mostert, MD, PhD, and colleagues discuss excess mortality during the COVID-19 pandemic, and this article has already sparked much debate and confusion on traditional and social media and has been used as fodder for anti-vaccines. defenders. The paper’s results were interpreted to mean that vaccines are dangerous, leading to critical comments from other researchers as well as some authors who felt their work was not cited properly.
We provide a brief summary of some of these criticisms, add some additional concerns about the paper, and argue for the paper’s withdrawal.
Multiple concerns
Mostert et al. discuss estimates of excess mortality – the increase above an expected pre-pandemic baseline – during the COVID-19 pandemic period of 2020 to 2022 for 47 countries in the Western world. They conclude that excess mortality was high during these years, despite the implementation of containment measures and COVID-19 vaccines, and that this raises serious concerns. They write: “Government leaders and policymakers must thoroughly investigate the underlying causes of persistent excess mortality. »
The article’s abstract does not clearly show what the authors saw in the excess mortality data that concerns them at this point. However, as significant sections of the paper are devoted to discussing the perceived problems of serious adverse effects of vaccines and indirect mortality caused by non-pharmaceutical interventions, the public response to the article has been to view the article as evidence in favor of vaccination and mitigation. being the main causes of the excess mortality – rather than the much more plausible explanation that widespread COVID-19 illness was the main cause of the excess mortality.
The article’s abstract does not clearly show what the authors saw in the excess mortality data that concerns them at this point.
The work of Mostert and his colleagues has been questioned by others, as cataloged on even pub and by Retraction watch. Stuart McDonald, MBE, has an in-depth discussion in a blog post detailing numerous concerns regarding the document. A commentary co-written by one of the plagiarized authors, Ariel Karlinsky, is also expected to appear soon. Finally, the research institutes of three of the four authors have have distanced themselves paper. The funding organization cited said he was incorrectly listed as a sponsor of the publication.
Only 3 days after publication, the journal that published the work, Public health BMJissued a statement pointing out that media coverage of the publication distorted the content of the study. The statement, however, does not address allegations of plagiarism or whether the article is being considered for retraction. In a BMJ of June 13 Press releasethe journal announced its intention to publish an expression of concern regarding the article and to investigate the quality of the research.
Here are some concerns that such an investigation should address.
Misquotations and omissions on the effects of vaccines
Mostert et al make a lengthy argument that COVID-19 vaccines are associated with a high risk of serious adverse events. They write: “Many studies have reported that COVID-19 vaccination can induce myocarditis, pericarditis, and autoimmune disease. » For this, they misquote a criticism of Dotan et al. on the risk of autoimmunity following SARS-CoV-2 infection. Dotan et al. had actually concluded that vaccination could solve this problem.
They cite a study (Fraiman et al) which calculated as many as 1-2 serious adverse events per 1,000 vaccines, in stark contrast to the findings that there was no evidence of serious adverse events in the original Pfizer and Moderna clinical trial publications. It would have been more useful to cite real world evidence from a cohort study of 23 million Nordic residents: what actually happened when millions of people used COVID-19 vaccines. This study found much lower levels of myocarditis and pericarditis associated with vaccination in young adults and no deaths. Therefore, these rare, non-fatal events in young adults could never explain the excess mortality occurring during the COVID-19 pandemic, which largely affected older adults.
Mostert et al do not dwell on the fact that COVID-19 vaccines have repeatedly been shown to be very effective: clinical trials and observational studies have shown that they prevent about 9 out of 10 cases (~90% ) serious consequences of COVID-19. (serious illness and death). A new WHO study estimates that the COVID-19 vaccine has saved 1.4 million lives in Europe and more than halved the number of deaths from COVID-19 that could have occurred. Vaccinations have mitigated the potential for mortality, and the remaining excess mortality of 2.5 million could not be avoided, either before vaccines became available in mid-2021 or due to low vaccination coverage in some contexts, particularly in Eastern Europe. Knowing and writing about it is of course important if we wish to seriously assess the excess mortality observed during COVID-19.
False statement about the seriousness of the pandemic
Mostert et al also have a long section which suggests that the pandemic was not very serious. They write that the infection fatality rate (IFR) of COVID-19 before vaccines was 0.23% globally and as low as 0.03% among adults under 60 years old. This may be misinterpreted to mean that mortality from COVID-19 in Western countries was negligible.
The authors did not cite relevant studies on IFR as it occurred in aging Western populations. A November 2020 Nature paper by O’Driscoll et al. calculates an IFR of ~0.8% in Western countries. And this may actually be a low estimate, since this analysis was published before the more deadly Alpha and Delta variants emerged in 2021 (Davies et al. (Nature March 2021) and Twohig et al. (Lancet Inf Dis August 2021)). When Mostert et al. ignore the higher IFRs for Western populations, they make the reader believe that the COVID-19 pandemic was not serious. This is simply not true, COVID-19 had great potential for illness and mortality, particularly in aging Western populations, and was a true 100-year event and serious societal threat that required a forceful response.
The authors did not cite relevant studies on IFR as it occurred in aging Western populations.
The disaster that occurred in the Lombardy region of northern Italy at the start of the pandemic (caught unprepared and before vaccines) clearly demonstrates what could have happened (Modi et al. (Nature May 2021)).
But Mostert et al state: “Although COVID-19 containment measures and COVID-19 vaccines have been so implemented to protect citizens against morbidity and mortality due to the COVID-19 virus, they may have adverse effects that also lead to inferior results. » this can be misinterpreted to mean that the cure was worse than the disease.
Plagiarism
On top of all this, serious concerns about plagiarism have also been raised, as the excess mortality data presented are taken from previously published work by Karlinsky and Kobak (2021) and their World Mortality. websitewhere the two scientists continuously provided data on excess mortality throughout the pandemic.
Why Mostert et al copy Karlinsky and Kobak’s prose and equations from their June 2021 eLIFE paper the verbatim is unclear, but it certainly doesn’t follow good citation practices. As Mostert et al. did not analyze these excess mortality estimates in more detail, the Public health BMJ This article is not really a contribution of original research.
A withdrawal is justified
Mostert et al should not ignore the most likely explanation for the excess mortality: that the emerging COVID-19 virus explains most of the excess deaths during the pandemic. Lee et al In
As of February 2023, it was calculated that 85% of excess deaths in the United States were directly explained by the COVID-19 virus. It is therefore not necessary to invoke other improbable explanations – such as the adverse effects of vaccines – to explain excess mortality in Western countries.
A retraction is required for this misleading article which is not an original contribution.
In our opinion, a retraction is appropriate for this misleading article which is not an original contribution. The publication of such work in a journal such as Public Health BMJ can, to use the words of a commentator, to be used as a figurative Trojan horse, seemingly giving unwarranted credibility to vaccine misinformation under the guise of statistical estimates of excess mortality. It is so important that scientific journals like BMJ take action and take responsibility in an unfortunate situation like this, where misinformation about vaccines and the pandemic appears credible by appearing in a leading peer-reviewed medical journal.
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Dr. Simonsen, professor of epidemiology, is director of PandemiX, a center of excellence at Roskilde University in Denmark. Dr. Pedersen is a mathematical modeler and postdoctoral fellow at PandemiX.