Writes David Wallace-Wells, in "Why Are So Many Americans Dying Right Now?" (NYT).
[A]lmost every week for more than six months, the agency has calculated that total excess mortality was 50 percent larger than and often almost twice as large as the number of official Covid-19 deaths.... What are the hypotheses?
The first is delayed care [caused by the pandemic]....
A second hypothesis is about the indirect effects of pandemic restrictions... social isolation, anxiety... unemployment, which can worsen a wide range of conditions, as well as, potentially, suicide and homicide and even car accidents and overdoses....
A third hypothesis is that Covid-19 infection does harm to the body that can linger after recovery for some people....
If you are waiting for "a fourth hypothesis, the vaccine," I can tell you it is not in this article. The vaccine is mentioned but not as a possible cause of the excess deaths. But Wallace-Wells discusses a subset of the "third hypothesis" as "another hypothesis":
Another hypothesis is that Covid infection damages immune function in some patients in a long-lasting way....
So the damage to the immune function, if any, is presumed to come from the disease and not the vaccine. Wallace-Wells notes that there is "a lot of contestation and pushback against — and contextualizing," but only about the effect of the disease. Questioning the vaccine cannot even be a hypothesis. He proceeds to talk about how our emotions drive our thinking on the subject:
Among the many lessons of the pandemic, for me, has been how much more complicated and baffling disease severity and death are.... how simplistic it often feels to apply a single cause of death.... Yet we’ve wanted stories we drew from the pandemic to be straightforward and legible, no matter how messy and nuanced so many cases turned out to be....
Does this want cause you to exclude the complicating factor that is the vaccine? As I write this, I am feeling the fear of questioning the vaccine.
Here's the parenthetical in the article where Wallace-Wells excludes the vaccine:
If long Covid or post-acute sequelae were primarily responsible [for the excess deaths], we might expect to see a spike in non-Covid excess deaths at some interval following each particular wave of infection — perhaps a few weeks or perhaps a few months later. (If vaccination risk was playing a role, it might create the same pattern, but that’s not what the curves show.)
There is also the idea that the excess mortality is really made up of deaths from Covid that were not registered as Covid deaths because they died at home and why test for Covid when the death certificate can say heart disease?
Throughout the pandemic, about 20 percent of in-hospital deaths have been attributed to Covid-19, compared to barely 2 percent of deaths at home. If you roughly triple the share of at-home deaths attributed to Covid — still well short of the share in hospitals — you make the Covid death toll a bit larger but almost entirely eliminate the excess excess gap. And if you adjust it to match the share of deaths attributed to Covid everywhere but homes — hospitals, outpatient clinics, nursing homes — you actually overshoot the gap....
That sounds quite plausible, but I note the emotion in my desire to embrace it. It's the most comforting thought. People who died were old and already in bad health, and Covid knocked them off relatively peacefully. They died at home. And they were expected to die. They'd reached the end of their life. Nothing strange is going on. Rest easy.
"Where does this leave us?," the last paragraph of the article begins. And here comes the one other mention of the vaccine:
More Americans are still dying than expected, which means at some point the United States may have to reset its expectations for how many will die in a given year at least a bit higher. The country long ago walked away from most mitigation measures beyond vaccination. (And even there, booster uptake has been quite low.)...
You can see that the reference to the vaccine is entirely positive. The only fault is only in us: We're not continuing to take it.