ST. PAUL — This week, some 35,000 Minnesotans age 65 and older will receive a dose of the coronavirus vaccine.

About 100 will likely be dead within a month, statistics suggest.

But not because of the vaccine. Because people die, especially older people.

There are still cancers, heart attacks and a myriad of other potential causes.

The challenge for public health officials is to avoid even a few of those inevitable deaths being seized upon as evidence that the COVID-19 vaccines are dangerous, or even killers.

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There is no evidence at this point that either the Pfizer/BioNTech or Moderna vaccines — the two that have been injected into the arms of millions of Americans — carry any hazards, except occasional allergic reactions that can be countered by common medicines on hand at vaccination sites.

Nonetheless, a portion of the public remains jittery about a brand new vaccine that has yet to undergo any long-term testing — and conceivably could cause problems that scientists aren’t yet aware of. Some health officials, intent on getting an overwhelming majority of the public inoculated, worry that the jittery group could be targeted by misinformation campaigns, especially by vaccination opponents who cling to falsehoods and often exploit a false appearance of cause-and-effect when one thing follows another.

This is especially likely now that vaccines are being widely administered to the oldest citizens, who, statistically speaking, are the most likely to die by sheer virtue of their age.

Michael Osterholm, who served on President Joe Biden’s transition COVID-19 advisory panel, has been among those warning about the scenario since December.

“If one person dies and it gets into the media, there’s a very good chance other people will see it, and they will say, ‘Wait a minute, my grandmother died a week later, too.’ And soon you have lots of deaths, and they’re all real, but they weren’t because of the vaccine,” said Osterholm, the director of the University of Minnesota’s Center for Infectious Disease Research and Policy.

It’s already started.

Misinformation starts

When baseball legend Hank Aaron died Jan. 22, 17 days after publicly being vaccinated, anti-vaccine advocates, led by Robert Kennedy Jr., sought to connect the two, based on nothing more than the two events, in widely shared social media posts.

Both the team that administered the vaccine and the medical examiner’s office issued statements saying Aaron died in his sleep for reasons unrelated to the vaccine.

Aaron was 86. Based on his age and gender alone, he had a 10 percent chance of dying within a year. On average, each year, more than 877,000 Americans over the age of 85 die, the vast majority from natural causes, according to federal death statistics from 2018 and 2019, the most recent years available — and before the pandemic. That means that, on average, in the 17 days since Aaron was vaccinated, close to 41,000 Americans his age or older could be expected to die.

And over the next few months, every American that age is supposed to get vaccinated.

Even traditional media like newspapers can add to the confusion.

Late last month, TwinCities.com ran a story from the Orange County Register about a 60-year-old California health care worker who died four days after receiving his second dose of the Pfizer vaccine. Four hours after the shot, he developed serious breathing difficulties.

The story says he was diagnosed with congestive heart failure and cites no medical reasons to suspect the vaccine, but the headline said it all: “California health care worker dies after second dose of COVID vaccine, investigations underway.”

It was the fourth-most-read story on TwinCities.com for the month, driven overwhelmingly by people sharing it on Facebook.

All deaths investigated

In fact, all deaths that appear to be premature and within a short time of receiving a COVID-19 vaccine are investigated to a degree by federal drug safety officials. It’s part of a series of standard protocols for vaccination programs that range from observations of doctors to reports by the general public.

“There are robust systems in place that are set up not just for the COVID vaccines, but for all vaccines,” said Kris Ehresmann, head of infectious diseases for the Minnesota Department of Health.

The most common mistake that the general public makes is to jump to the conclusion that because a vaccine was given, whatever followed was the result of it.

“There will be a certain number of deaths that will occur, but the sheer association in time, or temporal association, between events, does not equate to causation,” Ehresmann said.

This happened in the case of the California medical worker who died. The story quoted his wife saying, “But when someone gets symptoms 2½ hours after a vaccine, that’s a reaction. What else could have happened?”

False inferences

“Yep, I saw it,” Osterholm said when asked about the story. “This is exactly the point I was making.”

The same thing happened with autism: Some children began displaying their first symptoms of autism soon after being immunized, leading parents to believe that the shot caused the onset — a notion that has been excluded by researchers.

Scientists now suspect that many of these events happened so closely together out of coincidence: When you vaccinate enough people, odds are that some small number will have a health problem soon after, no matter what.

Osterholm is fond of telling the story of a child who suffered a seizure in front of a nurse who was holding a needle, preparing to immunize the child, who was being held in their mother’s arms. The child had a previously undetected condition.

“If that seizure had happened 30 seconds later, that mother might have assumed the vaccine caused it — and could you blame her for thinking that?” Osterholm said.

Numbers game

The vastness of the COVID-19 mass-vaccination campaign — about 1 million Americans are being vaccinated daily — almost surely means that large numbers of deaths will follow vaccinations.

Here are some examples, based on Minnesota and national death data:

  • There are almost 920,000 Minnesotans 65 and older, and they’re nearly all prioritized for getting vaccinated. Based on pre-COVID death rates, more than 39,000 would be expected to die this year anyway, about 108 per day, or between four and five each hour.
  • If you vaccinate 100,000 Minnesotans between 65 and 79 years old, statistically, you’d expect about 17 of them to die of a heart attack or other heart disease before it’s time for their second dose three weeks later. Twice that number would likely die of cancer, although cancer patients near death might not be expected to be vaccinated.
  • It’s not just older folks. If you vaccinate 10 million 35- to 44-year-olds across the nation, you’d expect about 240 to die of a heart attack or other heart disease within a week.
  • It’s not just fatal events that could cause alarm — but should be expected. If 10 million Americans between the ages of 55 and 64 were vaccinated, about 735 might be expected to suffer a stroke within a week.

Media criticized

Osterholm and others who have warned about such deaths being misinterpreted have suggested that public health officials need to be clearer with their messages so the public is prepared — and that the media needs to do a better job of vetting news stories, especially in an age when they can be spread via social media among people already skeptical of vaccines looking for “evidence” that reinforces their skepticism.

Ehresmann said she believes the core message — that the vaccines have thus far been shown to be safe — is enough.

“We hadn’t specifically thought to say that we would expect a certain number of people to die anyway post-vaccination,” she said. “I think, for the public, the important message is there are safety evaluations that took place before the vaccination was approved, and those safety evaluations continue, even after approval, so that we can make sure we have the safest and most-effective vaccines available.”

Osterholm said more can be done.

“The real fear is that more people will die because they don’t get the vaccine because they’re alarmed by all these stories.”