Covid Scotland: Death rate 25 times higher in double-jabbed than boosted

The vast majority (95 per cent) had received their second dose more than six months prior to their death and - of these patients - 96.3% "had several co-morbidities which contributed to their deaths" and an average age of 78.

According to the report from Public Health Scotland, the age-standardised Covid mortality rate in the first week of January was 0.46 per 100,000 in the triple-vaccinated population, compared to 11.89 per 100,000 in the double-jabbed and 7.62 per 100,000 among the unvaccinated.

However, once the over-70s - who are most vulnerable to waning immunity - are excluded, the mortality rate remains highest in the unvaccinated.

Source: Public Health Scotland

A Covid death is defined as any individual who has ever tested positive for Covid whose infection is "listed as an underlying or contributory cause of death on the death certificate".

Similar trends are evident in the hospitalisation rate, with the double-vaccinated now four times more likely than the triple-jabbed to be in hospital with Covid.

READ MORE: Why are Covid case rates appear to be lowest in the unvaccinated?

In the week to January 14, there were 191 double-vaccinated patients in hospital who had tested positive Covid. According to PHS, "over 60% received their second dose of vaccine more than six months prior to test".

PHS said some of the older patients who are more than six months on from their last inoculation "will have not received their next vaccine dose because of their frailty or ill health".

Meanwhile, PHS cautioned that there is "a lot of uncertainty" around who is being included in the unvaccinated population.

It comes as weekly data since Omicron became dominant in mid-December appears to show case rates as consistently lowest in the unvaccinated group - even when compared to the triple-jabbed.

In the week to January 14, for example, the age-standardised Covid case rate was 413 per 100,000 in the unvaccinated compared to 481 per 100,000 in the triple-jabbed and 866 per 100,000 in the double-vaccinated.

READ MORE: Omicron Covid restrictions to end in Scotland from Monday

However, PHS said it is likely that the size of the unvaccinated population is being overestimated - skewing the case rate downwards - because GP records are used to count this population.

Unlike those given first, second and third doses - where vaccination records can be used to accurately calculate the number of people in each group - the unvaccinated population is gauged based on people registered with a GP practice in Scotland.

However, PHS said this can be misleading if people have left Scotland, but not notified their GP.

In addition, PHS said the case rate data does not adjust for "potential biases" such as prior infection, co-morbidities, socio-economic status, and time since vaccination, or "systematic differences" between the vaccinated and unvaccinated groups, such as behaviour, which "become more evident" as the vast majority of the population is vaccinated.

The report adds: "For example, people who are vaccinated may be more likely to follow other government guidance such as regular testing and reporting for Covid-19, which makes them more likely to be identified as a case than unvaccinated people, resulting in higher case rates in the vaccinated population."

Older Scots were more likely than younger people to be in hospital 'because of' Covid

The report also provided an update on the proportion of Covid patients being admitted to hospital "because of" their infection, compared to those who test positive but were admitted for other reasons.

A full report will be published next Wednesday, but preliminary data which now includes NHS Dumfries and Galloway - in addition to Grampian and Greater Glasgow and Clyde - indicates that 63% of hospital admissions are "because of" Covid. This is down from 68% when Delta was dominant.

The percentage of positive cases which go on to result in a hospital admission has fallen from a peak of 12% to 1%

Just 1% of known cases are now leading to a admission - but the true figure will be lower once asymptomatic and undetected cases included.