Deaths in the UK from flu and COVID-19 split by position of cause on the death certificate

​FOI Ref: FOI/2022/4181

You asked

I am writing to request the following information under the Freedom of Information Act:

1. The number of deaths in the United Kingdom, broken down by year (or by month, whichever is easier), for which flu was given as a cause of death in part 1 of the death certificate (whether or not it was the sole cause), for the years 2015 to 2019 inclusive.
2. The number of deaths in the United Kingdom, broken down by year (or by month, whichever is easier) for which flu was mentioned as a contributory factor in part 2 of the death certificate (whether or not it was the only factor mentioned), for the years 2015 to 2019 inclusive.
3. The number of deaths in the United Kingdom, broken down by month, for which Covid-19 was given as a cause of death in part 1 of the death certificate (whether or not it was the sole cause), for the period February 2020 to April 2022 inclusive.
4. The number of deaths in the United Kingdom, broken down by month, for which Covid-19 was mentioned as a contributory factor in part 2 of the death certificate (whether or not it was the only factor mentioned) for the period February 2020 to April 2022 inclusive.
5. The number of deaths in paragraphs 3 and 4 above, broken down by month, when the deceased had not received three anti-Covid-19 vaccinations, for the period September 2021 to April 2022 inclusive.

We said

Thank you for your enquiry.

We are responsible for the provision of mortality statistics for England and Wales. National Records Scotland (NRS) and the Northern Ireland Statistics and Research Agency (NISRA) are responsible for statistics pertaining to Scotland and Northern Ireland. Therefore, we do not hold the requested data for the whole of the UK. Should you wish to obtain this data from NRS and NISRA, they can be contacted at foi@nrscotland.gov.uk and info@nisra.gov.uk respectively.

The medical certificate of cause of death has two parts, Part 1 contains the sequence of health conditions or events leading directly to death, while Part 2 can contain other health conditions that contributed to the death but were not part of the direct sequence. If the patient had other health conditions at the time, but they did not influence the fact that the person died at that time, those health conditions are not included on the death certificate.

1. Influenza as the underlying cause of death (Part 1)

We have published annual mortality data available by cause for the years 2013-2020, this is available as part of our explorable dataset available on our NOMIS webservice. Influenza is coded under J09-J11.

Please see the following instructions for the use of this service:

• Select the geography (England and Wales, regional or by local authority).
• Select Age -- All ages or 5 year age bands.
• Select Gender -- Total or Male/Female
• Select rates -- All deaths, rates or percentage of population for example.
• Select cause of death (ICD10 code search is available). J09-J11
• Select format (Excel or CSV for example)

2. Influenza as a secondary cause of death contributing factor (Part 2)

We can produce analysis where influenza was the secondary cause of death for you as a bespoke request. Special extracts and tabulations of mortality data for England and Wales are available to order (subject to legal frameworks, disclosure control, resources and agreements of costs, where appropriate). Such enquiries can be made to: Health.Data@ons.gov.uk.

3. COVID-19 as the underlying cause of death (Part 1)

You can find figures for COVID-19 as the underlying cause in our monthly mortality analysis update, please see table 12 deaths due to COVID-19 in England and Wales. These are deaths where COVID was listed under part 1.

4. COVID-19 as a secondary cause of death contributing factor (Part 2)

We do however hold Deaths involving COVID-19 by month of registration, UK which is produced in collaboration with NRS and NISRA. This provides a monthly break down deaths where COVID-19 was recorded as the underlying cause or mentioned on the death certificate.

Additionally, in table 12 of our monthly mortality analysis update, includes monthly data split by deaths involving (underlying cause or mentioned) and deaths due to (underlying cause only). You could subtract the due to figure from the involving figure and this would leave you with the deaths where COVID-19 was registered as a secondary cause (part 2 of the death certificate).

5. Monthly deaths due and involving COVID-19 by vaccination status

We hold data on mortality, and we receive the data on vaccinations from the National Immunisation Management Service (NIMS) who are responsible for the collection of vaccination data.

We link these datasets to people in the Public Health Data Asset (PHDA) in order to publish age-standardised mortality rates by vaccination status in our publication Deaths involving COVID-19 by vaccination status, England. The PHDA contains people enumerated in the 2011 Census and registered with a GP in 2019. This covers approximately 79% of the population in England aged 10+.

Please see Deaths by vaccination status, England which gives monthly deaths for all causes and those involving COVID by vaccination status. Please see the definitions tab for definitions of vaccination status.

Please note these figures are for deaths involving COVID and does not contain information for deaths due to COVID. This is also something that we can create as a bespoke request for you. We can only offer England data as this is all we have available via the PHDA. If you would like to obtain this also, please contact the Health Data team on health.data@ons.gov.uk.