Fact check: How does the Covid mRNA vaccine death toll compare to the flu vaccine?

1. Why some studies say mRNA shots look safer than the flu vaccine — and what they measured

A pharmacovigilance analysis using the WHO international adverse event database concluded that mRNA COVID-19 vaccines showed a lower risk of serious adverse events and fewer reported deaths compared with influenza vaccines, suggesting a possible protective effect in spontaneous reporting systems (published March 2022). That study compared reporting patterns and signal strength rather than calculating population-level mortality rates, which means its headline finding reflects differences in reported events, not a randomized mortality comparison. The study’s reliance on passive surveillance influences both which events are captured and how death reports are attributed, so the result indicates relative reporting patterns rather than definitive causal death-rate differences. ^[1]

2. Large cohort evidence that flags increased risks for specific serious outcomes

A multinational cohort study of about 99 million vaccinated individuals published in April 2024 documented higher risks of certain adverse events of special interest after COVID-19 vaccines, notably myocarditis, pericarditis, and Guillain-Barré syndrome, while characterizing overall absolute risks as relatively low. That study used active surveillance and cohort methods to estimate event incidence, which is stronger for estimating risk than passive reporting, but it still focused on specific adverse events rather than total deaths linked to vaccination, so it cannot be used alone to compute a vaccine-attributed death toll or to directly compare all-cause mortality with influenza vaccination. ^[2]

3. Pharmacovigilance detects different cardiovascular and neurological signals — context matters

A separate pharmacovigilance analysis found higher reporting of some cardiovascular complications—for example hypertensive crisis and supraventricular tachycardia—after mRNA COVID-19 vaccines versus influenza vaccines, while neurological complications were reportedly lower in COVID vaccine reports (published December 2022). Pharmacovigilance comparisons can reveal differential signal patterns across vaccine types, but they are vulnerable to reporting bias, differential vaccine uptake across age groups, and temporal changes in surveillance intensity. These methodological constraints limit pharmacovigilance studies’ ability to determine whether observed differences translate into net excess deaths. ^[3]

4. Independent reviews underline serious harms but stop short of a death tally

A National Academies evidence review (April 2024) summarized serious harms associated with COVID-19 vaccination, including Guillain-Barré syndrome, myocarditis, and pericarditis, but explicitly did not provide a direct comparison of COVID vaccine deaths versus influenza vaccine deaths. An independent systematic review by Gøtzsche and Demasi (March 2023) argued that serious harms may have been downplayed or omitted in some sponsor-run studies and called for further randomized trials to clarify risks, highlighting concerns about incomplete reporting and the need for stronger trial data rather than delivering a comparative mortality estimate. These reviews point to unresolved evidence gaps around rare but serious outcomes and data transparency. ^{[4] [5]}

5. What the evidence collectively does — and does not — prove about death tolls

Putting these studies together shows a consistent theme: researchers have documented increased risks for certain rare serious events after COVID-19 vaccination and different reporting patterns versus influenza vaccines, but the available analyses do not present a definitive population-level comparison of vaccine-attributed deaths. Pharmacovigilance reports highlight reporting differences, cohort studies quantify event risk for specific conditions, and reviews call for better randomized data; none of the cited pieces supplies a matched, all-cause mortality comparison across comparable populations for mRNA COVID-19 versus flu vaccines. ^{[1] [2] [3] [4] [5]}

6. Key limitations and why headlines about a “death toll” are premature

The body of evidence is constrained by varied methods: passive reporting systems can under- or overstate signals, cohort studies focus on pre-specified adverse events rather than all-cause mortality, and reviews point to incomplete sponsor reporting. Age, sex, baseline health, infection risk, and calendar time differ between vaccine recipient groups and affect death counts; none of the cited sources adjusts all these factors to produce a definitive death-toll comparison. The systematic-review call for new randomized trials underscores that current observational and pharmacovigilance data cannot conclusively settle a head-to-head death-rate question. ^{[1] [2] [3] [5]}

7. Bottom line for readers seeking a straightforward comparison

Based on the referenced literature, the factual conclusion is that the evidence is mixed on adverse-event patterns and clear that certain rare serious events are increased after COVID-19 vaccination, but there is no conclusive, peer-reviewed, population-level estimate in these sources comparing all-cause deaths from mRNA COVID-19 vaccines directly to influenza vaccines. Policymakers and clinicians must weigh known benefits in preventing COVID-19 morbidity and mortality against the documented rare risks, and researchers must prioritize transparent, comparative mortality analyses to answer the “death toll” question definitively. ^{[1] [2] [3] [4] [5]}