Vaccination, Life Expectancy, & Reader Responses

David R. Kotok
Sun Sep 17, 2023

I thank readers for their responses to our commentaries, including this one on “Life Expectancy”:
Before I get to the responses, I want to update the discussion of vaccination. I personally plan to obtain the new Covid vaccine for protection against the newer variants. I am in the age bracket of higher risk, and I have an immune-system-compromised medical condition. I’m not telling anyone else what to do or not do. I hope the information below helps you.

Vaccination, Life Expentancy, & Reader Responses


The surgeon general of my state, Dr. Joseph Ladapo, is warning that there may be safety concerns with the booster, and he is discouraging those under age 65 from receiving it. Ladapo made these remarks during a virtual roundtable on Thursday, September 13, that also featured Florida governor Ron DeSantis and several other doctors who have been critical of Covid-19 vaccination (“Florida Surgeon General Joseph Ladapo warns against COVID boosters for people under 65,”
Ladapo is controversial and accused of promulgating Covid misinformation and disinformation; he was appointed to his position by DeSantis in November 2021 (
Standing against Ladapo and DeSantis, we have the following scientifically well-grounded advice from Dr. Katelyn Jetelina, author of the “Your Local Epidemiologist” substack: “Considerations for your fall Covid-19 vaccine,” Dr. Jetelina has impeccable credentials, in my opinion.
For better or worse, the vaccine controversy is heating up again and will be an issue in the political campaigns in both the Republican and Democratic presidential primaries.
On the Democratic side we have, of course, Robert Kennedy, Jr. I’ll have more to say on both Kennedy and Ladapo/DeSantis, below. Let’s try to help with a reading list.
Here’s a curated (every citation is shown) reading list of articles on vaccination. I’ve purposely included various countries in addition to some from the United States. Some articles specifically address death from Covid vaccines. Some offer statistics, not just unsupported opinions.
“Vaccine Side Effects and Adverse Events,”
“Vaccine safety and possible side effects,”
“Childhood vaccines: Tough questions, straight answers,”
“The Freedom to Harm,” (A recent court ruling in Mississippi put children at greater risk of vaccine-preventable diseases.)
“Selected Adverse Events Reported after COVID-19 Vaccination,”

“Side effects of the coronavirus vaccines,”
“Must Know! Possible adverse reactions after getting COVID-19 vaccine,”
“A review of neurological side effects of COVID-19 vaccination,”
“COVID-19 vaccine statistics: Rare side effects,”

“Rare link between coronavirus vaccines and Long Covid–like illness starts to gain acceptance,”
“Fact check: False claim CDC official linked ‘debilitating illnesses’ to COVID-19 shots,”
“Update: Epidemiologic Characteristics of Long COVID,”
Now, let’s add some anti-vaccine discussion.
There are some antivaxxers who blame Covid vaccines for the drop in American life expectancy. One has even blamed the Covid mRNA vaccine for the rise in polio cases. I cannot fathom how a person can make that leap to polio, but this accuser did so with a totally unsupported opinion.
Not one antivaxxer critic noted how life expectancy has recovered in other countries but not in the US. Not one critic compared the vaccination responses in various jurisdictions and critically examined the observation, based on data, that antivax polices and poor public health governance have cost lives. The data are so compelling that this issue isn’t being countered by antivaxxers. But some antivaxxers instead just pronounce that the data is “untrue.” No evidence is offered.
I’ll add some evidence and opinion to this debate before I offer the responses from readers to our “Life Expectancy” commentary. Why? Because the issue of antivax has made it to the fore in the coming presidential election.
A notorious antivaxxer personality has declared himself a candidate for president in the Democratic Party primary system. He is Robert Kennedy, Jr. Here’s a link, in case you missed the declaration: Note that other prominent members of this famous American political family have disavowed the son of the Robert Kennedy, whom many older folks remember from the 1960s. Anyway, RK, Jr., is in the presidential race and is a well-funded candidate. He is likely to be on the ballot in the New Hampshire primary.
Dr. Paul Offit, professor of pediatrics at the Children's Hospital of Philadelphia and author of You Bet Your Life, has taken Kennedy severely to task: “The Irony of RFK Jr.’s Run for the Presidency,”
I’ll add these links to Paul Offit’s criticism of Robert Kennedy, Jr.:
“Robert F. Kennedy Jr. Convinced People To Distrust Vaccines. Now He’s Running For President.,” (April 7, 2023)
“Correcting Robert F. Kennedy Jr.’s vaccine ‘facts’,” (Sept. 22, 2017)
On the Republican side, Florida surgeon general Joseph Ladapo is controversial because he has promoted misleading views on vaccination data. (See “Report: Florida officials cut key data from vaccine study,”, and “US agencies debunk Florida surgeon general’s vaccine claims,
So, like it or not, politicians (Democrats and Republicans) and the public will face the vaccination-antivaccination issue in both parties’ presidential primaries. That surely presents an open field day for the disinformationistas (Democrats and Republicans).
Not all news is in the “bad” category.


On a more positive note on the life expectancy front, here’s a post from Eric Topol, professor of molecular medicine, executive vice-president of Scripps Research, and author of the Substack Ground Truths. Here’s the lede from his April 8 issue:


Why the new RSV vaccines are a BFD
The era of rational, structure-based design of vaccines that's hitting it out of the park.
It has taken over 65 years to get to this point, but, remarkably, new major triumphs, built on decades of work, have attracted little attention to date.
This is about Respiratory Syncytial Virus (RSV):
—Each year about 120,000 children die from RSV, half are under age 6 months.
—For children younger than age 5, there are 33 million cases of bronchiolitis/ pneumonia and 3.6 million hospital admissions worldwide. A large proportion are in low and middle income countries.
—For older adults in the United States, there are about 100,000 hospitalizations and 8,000 deaths associated with RSV. It rivals seasonal influenza for morbidity and mortality in older adults.
—The pathogen was first identified in 1956 in Baltimore but we have not had a successful vaccine until now.
In the past several weeks, 4 randomized trials of RSV vaccines in pregnant women and older adults have been published in the New England Journal of Medicine.
I also want to note good news from Brian Simpson, editor of Global Health NOW, an initiative of Johns Hopkins Bloomberg School of Public Health, in an April 9 email to subscribers:
Every once in a while, we’re accused of being alarmist fear-mongers who hype bad news.
I admit the essentials tend to trend away from the good news and point toward concerning events and findings that our readers need to know to do their jobs and stay informed. That’s just how things work.
But: As I surveyed March 2023, this morning I did note a passel of good news. It seems like a good place to start on Easter morning. —Brian
This Widely Available Antibiotic Could Save Millions of Moms
Research spanning 7 low- and middle-income countries found that a dose of the inexpensive, generic antibiotic azithromycin reduced the occurrence of maternal sepsis by ~35% and could help prevent the condition in as many as 2 million pregnant women each year. Read Annalies’s interview with former CDC director Julie Gerberding.


Now let’s hear some readers’ views sent in response to my April 9 commentary on declining life expectancy in the United States (

Ed wrote,
David, this is a disheartening analysis. I hope you have many readers in DC.


Peatmoss responded on Twitter:
Jeremy Grantham discussed the dismal life expectancy in the U.S vs other countries in a recent TIP podcast ( Even the worst borough of London has a higher LE than the U.S average. He also raised the issue of toxicity and declining birth rates.


Mark added,
Maybe if young people didn’t have to give up 7 years of their life to become a doctor and have $500,000 of debt maybe more young people would study medicine. For those willing to persevere, their reward is to be called ‘fat-cat one percenters’ simply because they have a high income level. And, as you know, our nation taxes income not wealth, so young doctors face an uphill financial climb. Are there any thought leaders in Congress looking at larger societal issues like this? These days it would take courage to offer tax breaks to young physicians because they are assumed to be in a privileged class. But if your numbers are correct, we need some additional incentives for them. Perhaps Congress could be thinking about big picture issues like this instead of impeaching a President or subpoenaing the bank records of the son of a President.

Lin suggested broadening the discussion:
Lots of potentially valid points, but one very big one I didn’t see mentioned: drug overdose deaths, especially in the 20–50 age group.

Ken responded,
NPR probably would not report this…fentanyl coming across our borders is killing 100,000 plus a year not to mention additional drug-related deaths. Interesting to note 2020 departure from trend.
Kotok response:
I believe that NPR and others have reported widely about fentanyl. It is easy to blame “the border”. Much harder to get funding for and implement a revised immigration system that is decades old and broken. Thanks for the note. (

Basil focused on misinformation during the pandemic:
Wow! Thanks for another educational e-mail. It looks like the gap caused by misinformation and stupidity was not too widespread before Covid. It seems to have remained stable between 2015 and 2017. Then it even declined some for a year. I would love to see that chart extended to today, since the misinformation and stupidity got politicized with Covid.

Lindsey reflected on a broader picture:
I'm not arguing on what you presented, but Americans' lifestyle also plays a big part in life expectancy statistics. There is no doubt the rampant misinformation on vaccines, COVID and other health related subjects causes real problems with health-related issues. Yet, in general Americans are living an unhealthy lifestyle. I do a lot of educational outreaches and one of the programs I'm involved with will hand out a snack, a healthy snack, (fruit, milk, cereals, etc.). Yet many kids are not interested in these snacks. Talking to some teachers I get the feeling health hygiene is not in a kid's vocabulary. To me what the pandemic did was highlighted the erosion in a healthy U.S. society and social media misinformation and misinformation in general just helped amplify this problem. The U.S. is failing in some many fronts and health issues are just one of them. Yet, for me keeping a glass half full attitude is what keeps me.


Miguel added this on Twitter:
Good article, but you didn't address that the US diet is one of the worst in the world from a health standpoint. Granted, this isn't new, but it has worsened and the effects take a few decades to show their faces. The ludicrous recent pop diets are even more concerning.

Larry suggested,
While your email yesterday provides considerable evidence of our declining life expectancy, there was also an excellent article by John Abramson, M.D. which recently appeared in Imprimis, a publication of Hillsdale College. It provides yet another frightening argument for our failing health care system. This link will get you to article. You will find it an interesting and persuasive read.


Frank offered a physician’s perspective:
I’ve read this through a number of times. I agree that exposing the overall worsening of life expectancy in the USA, as well as the wide disparity within socioeconomic groups, is important. It is however not surprising. As a physician for 40 years, the disparity in overall health status and life expectancy metrics have been obvious for many years prior to Covid and the assault on public health efforts that you describe. Indeed, the statistics of a decreasing life expectancy saw the USA white population lag significantly in 2016 and onwards, part of what has been coined “deaths of despair,” the most recent cause the opioid epidemic. I would suggest turning your focus towards the negative effects that vertical integration of the healthcare system has wrought upon the problems you describe. I would argue that the concerns regarding shortages of healthcare workers, healthcare worker “burnout” and individuals walking away from their healthcare careers has more to do with the fact that near 75–80% of physician groups are employees of corporations that have monopolized and monetized healthcare to its detriment.

Kurt added this:
You forgot to mention our porous southern border and the effect that has on ER wait times. I live in So Cal, ER filled with illegals = longer wait times. The Emergency Medical Treatment and Labor Act (EMTALA) ensures that all patients regardless of citizenship or immigration status have access to emergency medical treatment. The purpose of EMTALA is to ensure all Medicare-participating hospitals do not to turn away individuals who need lifesaving care. Undocumented immigrants use of EMTALA-related services is often covered via emergency Medicaid.

Don wrote,
Sad but important perspective. Thank you for sharing the information.


Jack contributed,
Shortage of medical workers-docs, nurses, etc. is one of my greatest concerns getting into years when really need them. But how do we solve that problem when we don't have enough people to haul the garbage? Getting the birth rate up would be great, but that won't solve the problem overnight. Technology and immigration are the two most obvious fixes, but the latter requires fixing a broken political system and we don't seem to have the Rx for that yet. I think my wait, however long, will be shorter at the ER than it will waiting for Congress to solve/fix our immigration system and start bringing in people we need. I do know at least one person who has dual citizenship and can't wait to retire and go back to Europe because of what our country has become, politically. I suspect our politics has kept at least one, if not many more, would-be immigrants, with the skills that we need, from coming to this country. Too bad we can't tow Taiwan and park it off our coast as part of US. Solve two problems at once! But, at least we should open the gates wide to immigration from Taiwan. Highly educated and skilled population. Same for Ukraine.

A knowledgeable person in the UK whose anonymity will be preserved wrote:
Although life expectancy in UK is 81.77 years, slightly higher than in US, our countries are the laggards in the G7 group of economically advanced nations. Our health systems are widely different so I guess the system and its funding is not the major factor influencing our relatively poor performance. We too have marked differences in life expectancy according to ethnicity, education, and the relative affluence of individuals. Was it here or elsewhere that I read that matters of concern that have been highlighted were accidents, drug overdoses (suicide as well as the effects of misuse), and gun crime. We have relatively little gun crime in the UK, although there is a major problem of knife crime in gangs. We certainly do not have anything resembling mass killings involving firearms except on extremely rare occasions. Your continued tolerance of the individual right to bear arms, whether or not it was written in the constitution 250 years ago, is inexplicable to us, not least when multiple fatalities in schools by the disaffected or deranged appears to be commonplace. Many of the prevailing beliefs of the political leadership in the UK in the 18th Century would be completely unacceptable now and are and should be subject to frequent review and revision.


Another David observed,
Amazing isn’t it, the ability of some members of the [species] Homo sapiens to ignore facts and choose politics over health. I will never understand the reluctance of conservatives to take the precautions with the virus and get a safe vaccination. Of course, I also can’t understand the willingness of many of the religious community in some parts of the world to embrace bigotry and injustice over justice and tolerance for all. I love to read your commentaries on Sunday, makes my Sunday morning a great way to start.
Thank you, David, from this David.

And I thank all readers for their comments and for allowing the presentation of diverse points of view.
The Covid journey is not over. Please stay safe.


David R. Kotok
Co-Founder & Chief Investment Officer
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