South African Vital Statistics, Though Incomplete, Show Unprecedented Rise in Deaths in 2021. Following Covid-19 Vaccines Rollouts a Rise in Deaths Occurred Across All Vaccinated Age Cohorts.

Birth statistics from Statistics South Africa are available up to 2023, but death statistics later than 2021 have not been released. Weekly death data to end of 2024 is available from SAMRC.

The Republic of South Africa has a current estimated population of 64.7 million. 2024 mid-year life expectancy at birth was estimated at 69.2 years for females and 63.6 years for males, with overall life expectancy estimated at 66.5 years. Death reports refer to total deaths and natural deaths, with an average of 10.4% of deaths being non-natural (ie. due to external cause: homicide, suicide, medical error, alcohol intoxication, drug overdose).

I accessed two sources of vital statistics. Statistics South Africa has provided annual birth data to 2023, and annual death data, including by age-breakdowns, up to 2021.

South African Medical Research Council (SMRC) provides epiweek death data with estimated weekly deaths from 2015 to 2019, and actual and predicted deaths, with age breakdowns from 2020 to 2024¹. All figures provided in this report reference the data source. Note that there is expected under registration of death data, however, the data is certainly adequate to show trending over the pandemic years. All data is raw counts for births and deaths with no adjustment for under registration.

Covid-19 Vaccination Rollout in South Africa

South Africa started its national vaccination program against COVID-19 on 17 February 2021. Dosing remained at < 1% of the population until 21st May 2021 before administration ramped up. Population uptake increased to 44 doses/ 100 people (25.4% of the population) by the end of December 2021. The latest available dosing data showed 67 doses / 100 people by September 2023, with some 33.72% of South Africans having been given Covid-19 vaccines.

The Covid-19 vaccination program started with healthcare and frontline workers and then expanded to those over the age of 60. Vaccines were launched for the education sector on June 23, 2021. Covid-19 vaccines were ultimately offered to all South Africans aged 12 and older. The main vaccines used in South Africa, outside of clinical trials, were Janssen (Johnson & Johnson) and Pfizer-BioNTech. 33.7% of South Africa’s population had taken primary series Covid-19 vaccines by the end of 2022.

South Africa’s 3rd wave of Covid-19 deaths exactly matched the ramping up of the Covid-19 vaccines rollout in the second half of 2021.

South Africa Vital Statistics

Annual birth and death data for StatsSA is set out. Births have been steadily declining over time with some 37% drop between 2004 and 2023. This drop may decrease with compilation of late registered births. Deaths show an undulating line, with a sharp rise in deaths in 2020 (+9.8%) and 2021 (+19.6%).

StatsSA provided by 5-years age breakdowns of deaths from 2018 - 2020. This shows a decrease in deaths in persons aged 34 and younger in 2020, but unprecedented rise in deaths across all ages in 2021.

SAMRC separates weekly deaths into total and natural. This figure sets out weekly deaths from 2020 Epiweek 1 to 2024 epiweek 52.

The data plotted by week and year makes the extraordinary deaths in 2020 and 2021 abundantly clear. Total and natural deaths are shown in separate plots. Deaths were far higher in 2021 (+19.6%) following rollout of Covid-19 vaccines than they were in 2020 (+9.8% vs. 2019), which also had death levels that were unprecedented.

Deaths by age are set out. These figures use both StatsSA and SAMRC age data to show trending since 2015 and up to 2024. While figures don’t exactly match, due to late registrations for StatsSA, the trending agrees. Lower than typical deaths in young persons in 2020, and catastrophically higher deaths in 2021. Infant and young child deaths rose above even 2021 levels in 2022, while deaths dropped off in all other age-groups.

Following are the by-Epiweek natural deaths by age-groups for 2020 to 2024. The small marker indicates the start of Covid-19 vaccination rollouts. The big marker indicates the ramp up when dosing ramped up and first exceeded 1% of the population. Note that the death spike is broader (more deaths) consecutive with Covid-19 vaccine ramp up than the first 2 Covid-19 death waves. People up to 19 years of age don’t show the distinct death spike following rollout, that is observed among older cohorts.

The correlation between Covid-19 vaccine dosing ramp up and the extreme spike in deaths in 2021, with a smaller spike extending into 2022, should be examined for causation; particularly in relation to which vaccines were administered when. The extreme peaks in deaths, across all Covid-19 vaccinated ages, raises the specter of possible vaccine-related toxicity. Similar excess deaths matching timing of Covid-19 vaccines are apparent in many of the countries whose data I have examined.

The Philippines experienced hyper-excess deaths exactly matching rollout of Covax-provided Janssen vaccines. I don’t have sufficient data to explore the possibility of any similar relationship for South Africa.

If any readers are aware of additional data that I may access to further assess South Africa’s pandemic years outcomes, please provide comments. I will continue to explore data in coming weeks and may publish an update to this report as more data comes to light.

1. SAMRC Burden of Disease Research Unit and UCT Centre for Actuarial Research