{"id":2824,"date":"2023-10-02T10:08:24","date_gmt":"2023-10-02T10:08:24","guid":{"rendered":"https:\/\/repo.epiprev.it\/?p=2824"},"modified":"2023-11-16T14:39:04","modified_gmt":"2023-11-16T14:39:04","slug":"covid-19-vaccination-all-cause-and-non-covid-19-mortality-in-an-italian-province-data-updated-re-presented-biases","status":"publish","type":"post","link":"https:\/\/repo.epiprev.it\/index.php\/2023\/10\/02\/covid-19-vaccination-all-cause-and-non-covid-19-mortality-in-an-italian-province-data-updated-re-presented-biases\/","title":{"rendered":"COVID-19 vaccination, all-cause and non-COVID-19 mortality in an Italian Province. Data updated, re-presented biases"},"content":{"rendered":"\n<p class=\"has-small-font-size\"><strong>Publication date:<\/strong> 02\/10\/2023 &#8211;  <strong>E&amp;P Code:<\/strong>  <a aria-label=\" (opens in a new tab)\" rel=\"noreferrer noopener\" href=\"https:\/\/repo.epiprev.it\/2824\" target=\"_blank\">repo.epiprev.it\/2824<\/a>   <br><strong>Authors:<\/strong> Giovanni Malatesta<sup>1<\/sup>, Alberto Donzelli<sup>2<\/sup>, Marco Alessandria<sup>3<\/sup>, Franco Berrino<sup>4<\/sup><\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>Abstract<\/strong>: The SARS-CoV-2 pandemic has led to an unprecedented effort to generate real evidence on the safety and effectiveness of various treatments, mRNA vaccines included. We can now welcome with great interest the publication of a new article on mortality in the general population of the Italian province of Pescara, divided by vaccination status, with a follow-up of two years (1).<br>Already in articles published during the pandemic (2, 3) it has been argued that, in observational cohort studies, an incorrect management of follow-up times may introduce the so-called Immortal-Time Bias (ITB) in favour of the exposed group. Nevertheless, ITB still appears to be present in several cohort studies. As highlighted in an article (Intervention) recently published in Epidemiologia&amp;Prevenzione (4), a study on the safety of COVID-19 vaccines in the population of an Italian province is no exception (5). A possible explanation that the ITB is still largely prevalent in such cohort studies may be that the structure of the ITB is still poorly understood (3). A new study on the effectiveness of COVID-19 vaccines (1) in the same Italian province as that examined in the article (5) we have previously considered (4) repeats the aforementioned bias, along with others, similarly common, that we have discussed before.<br><em>Errata corrige: nel grafico a pagina 3 la cifra 1,896,676 \u00e8 stata coretta in 186,676 (11 ottobre 2023)<\/em><\/p>\n\n\n\n<!--more-->\n\n\n\n<p class=\"has-small-font-size\"><strong>Cite as<\/strong>: Elenco autori, Giovanni Malatesta, Alberto Donzelli, Marco Alessandria, Franco Berrino (2023). COVID-19 vaccination, all-cause and non-COVID-19 mortality in an Italian Province. Data updated, re-presented biases. E&P Repository <a href='https:\/\/repo.epiprev.it\/2824'>https:\/\/repo.epiprev.it\/2824<\/a><button title=\"Copia citazione\" id=\"copyTextCite\"><span class=\"far fa-copy\"><\/span><\/button><\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>Topic<\/strong>: <a href='\/index.php\/category\/COVID-19'>COVID-19<\/a><\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>Key words<\/strong>: <a href=\"https:\/\/repo.epiprev.it\/index.php\/tag\/all-cause-mortality-in-province-of-pescara\/\" rel=\"tag\">all-cause mortality in province of Pescara<\/a>, <a href=\"https:\/\/repo.epiprev.it\/index.php\/tag\/calendar-bias\/\" rel=\"tag\">calendar bias<\/a>, <a href=\"https:\/\/repo.epiprev.it\/index.php\/tag\/covid-19-vaccination-status-and-all-cause-mortality\/\" rel=\"tag\">COVID-19 vaccination status and all-cause mortality<\/a>, <a href=\"https:\/\/repo.epiprev.it\/index.php\/tag\/covid-19-vaccination-status-and-non-covid-19-mortality\/\" rel=\"tag\">COVID-19 vaccination status and non-COVID-19 mortality<\/a>, <a href=\"https:\/\/repo.epiprev.it\/index.php\/tag\/immortal-time-bias\/\" rel=\"tag\">immortal-time bias<\/a>, <\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>AVVERTENZA. GLI ARTICOLI PRESENTI NEL REPOSITORY NON SONO SOTTOPOSTI A PEER REVIEW.<\/strong><\/p>\n\n\n\n<div class='w3eden'><!-- WPDM Link Template: Default Template -->\n\n\n<div class=\"link-template-default card mb-2\">\n    <div class=\"card-body\">\n        <div class=\"media stack-xs\">\n            <div class=\"media-body\">\n                <div class=\"media\">\n                    <div class=\"mr-3 img-48\"><img decoding=\"async\" class=\"wpdm_icon\" alt=\"Icona\" src=\"https:\/\/repo.epiprev.it\/wp-content\/plugins\/download-manager\/assets\/file-type-icons\/pdf.svg\" onError='this.src=\"https:\/\/repo.epiprev.it\/wp-content\/plugins\/download-manager\/assets\/file-type-icons\/unknown.svg\";' \/><\/div>\n                    <div class=\"media-body\">\n                        <h3 class=\"package-title\"><a href='https:\/\/repo.epiprev.it\/index.php\/download\/covid-19-vaccination-all-cause-and-non-covid-19-mortality-in-an-italian-province-data-updated-re-presented-biases\/'>COVID-19 vaccination, all-cause and non-COVID-19 mortality in an Italian Province. Data updated, re-presented biases<\/a><\/h3>\n                        <div class=\"text-muted text-small\"><i class=\"fas fa-file-download\"><\/i> 595 Download <i class=\"fas fa-hdd ml-3\"><\/i> 278.46 KB<\/div>\n                    <\/div>\n                <\/div>\n            <\/div>\n            <div class=\"ml-3 wpdmdl-btn\">\n                <a class='wpdm-download-link btn btn-primary ' rel='nofollow' href='#' onclick=\"location.href='https:\/\/repo.epiprev.it\/index.php\/download\/covid-19-vaccination-all-cause-and-non-covid-19-mortality-in-an-italian-province-data-updated-re-presented-biases\/?wpdmdl=2822&refresh=69e903744f1be1776878452';return false;\">Scarica<\/a>\n            <\/div>\n        <\/div>\n\t\t\n    <\/div>\n<\/div>\n\n\n<\/div>\n\n\n\n<p><em><strong>Errata corrige: nel grafico a pagina 3 la cifra 1,896,676 \u00e8 stata coretta in 186,676 (11 ottobre 2023)<\/strong><\/em><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Info<\/h4>\n\n\n\n<p class=\"has-small-font-size\"><strong>Affiliations<\/strong>: <br><sup>1 <\/sup>Physics Graduate, Scientific Committee Foundation \u201cAllineare Sanit\u00e0 e Salute\u201d, Pistoia, Italy.<br><sup>2<\/sup> M.D., Specialist in Hygiene and Preventive Medicine, independent Medical-Scientific Commission; President of Foundation \u201cAllineare Sanit\u00e0 e Salute\u201d, Milan, Italy.<br><sup>3<\/sup> Ph.D., Department of Life Sciences and Systems Biology, University of Turin, Turin (Italy).<br><sup>4<\/sup> M.D., past Director, Department of Predictive and Preventive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy<\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>Authors&#8217; contributions: <\/strong>Conceptualization, F.B., A.D., M.A. and G.M.; methodology, F.B., A.D., M.A. and G.M.; validation, F.B., A.D., M.A. and G.M.; formal analysis, F.B., A.D., M.A. and G.M.; resources, A.D. and G.M.; data curation, F.B., A.D., M.A. and G.M.; writing\u2014original draft preparation F.B., A.D. and G.M.; writing\u2014review and editing, F.B., A.D., M.A. and G.M.; supervision, F.B., A.D., M.A. and G.M. All authors have read and agreed to the published version of the manuscript.<\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>Competing interests: <\/strong>The authors declare no conflict of interests.<\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>Funding disclosure:<\/strong> This research received no external funding.<\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>Ethics committee approval: <\/strong>The study was based on publicly available aggregate data. No Ethics committee approval was necessary. <\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>Copyright<\/strong>:  Il detentore del copyright \u00e8 l\u2019autore\/finanziatore, che ha concesso a \u201cE&amp;P Repository\u201d una licenza per rendere pubblico questo preprint. The copyright holder for this preprint is the author\/funder, who has granted E&amp;P Repository a license to display the preprint in perpetuity.<\/p>\n\n\n\n<p class=\"has-small-font-size\"><strong>Terms of distribution<\/strong>: <a rel=\"noreferrer noopener\" href=\"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/deed.it\" target=\"_blank\">CC BY-NC-ND<\/a><\/p>\n\n\n\n<hr \/><img src='https:\/\/repo.epiprev.it\/wp-content\/uploads\/2023\/10\/Screenshot-2023-10-03-162330-1.png' alt=\"Screenshot-2023-10-03-162330\" class='attachment-post-thumbnail size-post-thumbnail wp-post-image' \/><p class='has-small-font-size'>Observation times for each category of vaccinated \/ unvaccinated<\/p><hr \/>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"has-background has-small-font-size has-light-gray-background-color\"><strong>References &amp; Citations<\/strong><br><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/scholar.google.com\/scholar?q=COVID-19 vaccination, all-cause and non-COVID-19 mortality in an Italian Province. Data updated, re-presented biases\" target=\"_blank\">Google Scholar<\/a><\/p>\n\n\n\n<p><a href=\"http:\/\/www.facebook.com\/sharer.php?u=https:\/\/www.repo.epiprev.it\/2824\" target=\"_blank\" rel=\"noopener noreferrer\" title=\"Condividi su Facebook\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2020\/04\/icon_facebook.png\"><\/a><a href=\"https:\/\/twitter.com\/intent\/tweet?url=https:\/\/www.repo.epiprev.it\/2824\" target=\"_blank\" rel=\"noopener noreferrer\" title=\"Condividi su Twitter\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2020\/04\/icon_twitter.png\"><\/a><a class=\"icon_whatsapp\" href=\"https:\/\/api.whatsapp.com\/send?text=https%3A%2F%2Frepo.epiprev.it\/2824&amp;attribution=AMPhtml&amp;url=https%3A%2F%2Frepo.epiprev.it\/2824\" target=\"_blank\" rel=\"noopener noreferrer\" title=\"Invia con WhatsApp\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2020\/04\/icon_whatsapp.png\"><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The SARS-CoV-2 pandemic has led to an unprecedented effort to generate real evidence on the safety and effectiveness of various treatments, mRNA vaccines included. We can now welcome with great interest the publication of a new article on mortality in the general population of the Italian province of Pescara, divided by vaccination status, with a follow-up of two years.<\/p>\n","protected":false},"author":1,"featured_media":2832,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13],"tags":[238,242,239,240,241],"class_list":["post-2824","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-covid-19","tag-all-cause-mortality-in-province-of-pescara","tag-calendar-bias","tag-covid-19-vaccination-status-and-all-cause-mortality","tag-covid-19-vaccination-status-and-non-covid-19-mortality","tag-immortal-time-bias"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>COVID-19 vaccination, all-cause and non-COVID-19 mortality in an Italian Province. Data updated, re-presented biases - E&amp;P Repository<\/title>\n<meta name=\"description\" content=\"The SARS-CoV-2 pandemic has led to an unprecedented effort to generate real evidence on the safety and effectiveness of various treatments, mRNA vaccines included. We can now welcome with great interest the publication of a new article on mortality in the general population of the Italian province of Pescara, divided by vaccination status, with a follow-up of two years (1).Already in articles published during the pandemic (2, 3) it has been argued that, in observational cohort studies, an incorrect management of follow-up times may introduce the so-called Immortal-Time Bias (ITB) in favour of the exposed group. Nevertheless, ITB still appears to be present in several cohort studies. As highlighted in an article (Intervention) recently published in Epidemiologia&amp;Prevenzione (4), a study on the safety of COVID-19 vaccines in the population of an Italian province is no exception (5). A possible explanation that the ITB is still largely prevalent in such cohort studies may be that the structure of the ITB is still poorly understood (3). A new study on the effectiveness of COVID-19 vaccines (1) in the same Italian province as that examined in the article (5) we have previously considered (4) repeats the aforementioned bias, along with others, similarly common, that we have discussed before.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/repo.epiprev.it\/index.php\/2023\/10\/02\/covid-19-vaccination-all-cause-and-non-covid-19-mortality-in-an-italian-province-data-updated-re-presented-biases\/\" \/>\n<meta property=\"og:locale\" content=\"it_IT\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"COVID-19 vaccination, all-cause and non-COVID-19 mortality in an Italian Province. Data updated, re-presented biases - E&amp;P Repository\" \/>\n<meta property=\"og:description\" content=\"The SARS-CoV-2 pandemic has led to an unprecedented effort to generate real evidence on the safety and effectiveness of various treatments, mRNA vaccines included. We can now welcome with great interest the publication of a new article on mortality in the general population of the Italian province of Pescara, divided by vaccination status, with a follow-up of two years (1).Already in articles published during the pandemic (2, 3) it has been argued that, in observational cohort studies, an incorrect management of follow-up times may introduce the so-called Immortal-Time Bias (ITB) in favour of the exposed group. Nevertheless, ITB still appears to be present in several cohort studies. As highlighted in an article (Intervention) recently published in Epidemiologia&amp;Prevenzione (4), a study on the safety of COVID-19 vaccines in the population of an Italian province is no exception (5). A possible explanation that the ITB is still largely prevalent in such cohort studies may be that the structure of the ITB is still poorly understood (3). A new study on the effectiveness of COVID-19 vaccines (1) in the same Italian province as that examined in the article (5) we have previously considered (4) repeats the aforementioned bias, along with others, similarly common, that we have discussed before.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/repo.epiprev.it\/index.php\/2023\/10\/02\/covid-19-vaccination-all-cause-and-non-covid-19-mortality-in-an-italian-province-data-updated-re-presented-biases\/\" \/>\n<meta property=\"og:site_name\" content=\"E&amp;P Repository\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/epiprev\/\" \/>\n<meta property=\"article:published_time\" content=\"2023-10-02T10:08:24+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-11-16T14:39:04+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/repo.epiprev.it\/wp-content\/uploads\/2023\/10\/Screenshot-2023-10-03-162330-1.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1133\" \/>\n\t<meta property=\"og:image:height\" content=\"550\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"administrator\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Scritto da\" \/>\n\t<meta name=\"twitter:data1\" content=\"administrator\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tempo di lettura stimato\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minuti\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/repo.epiprev.it\/index.php\/2023\/10\/02\/covid-19-vaccination-all-cause-and-non-covid-19-mortality-in-an-italian-province-data-updated-re-presented-biases\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/repo.epiprev.it\/index.php\/2023\/10\/02\/covid-19-vaccination-all-cause-and-non-covid-19-mortality-in-an-italian-province-data-updated-re-presented-biases\/\"},\"author\":{\"name\":\"administrator\",\"@id\":\"https:\/\/repo.epiprev.it\/#\/schema\/person\/2a184e8c4e97508ef5111e78c8d0a59c\"},\"headline\":\"COVID-19 vaccination, all-cause and non-COVID-19 mortality in an Italian Province. 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