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Routine vaccination during covid-19 pandemic response

BMJ 2020; 369 doi: (Published 16 June 2020) Cite this as: BMJ 2020;369:m2392

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Fewer American infants died in 2020. Why?

Dear Editor,

As of March 3, 2021 the latest statistics indicate that only 19,038 US infants died in 2020. ( From 2015 to 2019 US infant deaths declined from 23,462 to 20,921. (Ely et al, Infant Mortality in the US, 2018; NVSS Volume 69, Number 7, July 16, 2020. NCHS/NVSS Data Brief 395; Mortality in the US, 2019) The trend indicates that 20,286 US infant deaths would have been expected in 2020. The difference of 1248 fewer deaths in 2020 is extremely significant in a chi-square test.

Previously we have speculated about the causes of the 2020 decline in US infant mortality. ( Today there are at least three possibilities: First, is the decline in incidence of infectious diseases and fewer infection-related deaths. This is supported by trends in US pediatric hospital admissions which show a sharp decline in infectious disease admissions. (Pelletier et al, JAMA Network Open. 2021;4(2)e2037227) Second, is a trend toward fewer premature births during 2020 and fewer deaths related to prematurity. (Been et al, Lancet Public Health 2020;5:e604, Oct. 13. Handley et al, JAMA 2021;325:87) The third will seem counterintuitive but cannot be dismissed, the sharp decline in vaccinations during Covid-19 in 2020. ( November 18, 2020) It is taboo to mention this, but there are about 3500 Sudden Unexpected Infant Deaths (SUID) annually in the US. (Roehler J Pediatr 2019;212:224) It is a mystery that remains unexplained, and a causal role for vaccinations has never been excluded by properly controlled trials. Could the drop in vaccinations account for a portion of the 2020 drop in US infant deaths?

Without data about specific causes of death we can only continue to speculate about the reasons for the 2020 decline in US infant mortality. Are there data in the UK or elsewhere in Europe that could shed light on this question?


Competing interests: No competing interests

11 March 2021
Allan S. Cunningham
Retired pediatrician
Cooperstown NY 13326 USA <