Half of COVID-19 death rate differences explained by rates of elderly influenza vaccination and low vitamin D

Low Vitamin D Status and Influenza Vaccination Rates are Positive Predictors of Early Covid-19 Related Deaths in Europe - A Modeling Approach

Preprint - not yet peer reviewed

Rainer J. Klement1 rainer klement@gmx.de & Harald Walach2-3-4

1 Department of Radiation Oncology, Leopoldina Hospital Schweinfurt, Germany

2 Poznan Medical University, Dept. Pediatric Gastroenterology, Poznan, Poland

3 University Witten-Herdecke, Dept. Psychology, Witten, Germany

4 Change Health Science Institute, Berlin, Germany

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Objectives: To clarify the high variability in Covid-19 related deaths whose origin is unclear. Study Design： Modeling of available data

Methods: We used six individual- and country-specific variables to predict the number of population standardized Covid-19 related deaths in 44 European countries using generalized linear models: Percent test-standardized number of SARS-CoV-2-cases, population size, life expectancy, severity of governmental responses, influenza-vaccination coverage and vitamin D status in the elderly.

Results: We found that flu-vaccination coverage in the elderly was the most important predictor, together with test-standardized cases and vitamin D status explaining approximately 47% of the variation in Covid-19 related deaths. Higher flu vaccination coverage and low vitamin D status were associated with more Covid-19 related deaths. Life-expectancy, population size and the severity of governments’ responses to the outbreak did not emerge as significant predictors in multivariable modeling. The latter variable even appeared to be completely negligible.

Conclusion: Adequate vitamin D levels are important, while - contrary to current opinion - flu-vaccination in the elderly is a putative aggravating factor of Covid-19 related deaths.