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New research estimates the number of lives lost if US adults had not received COVID-19 vaccinations. Chip Somodevilla/Getty Images
  • The impact of the vaccination campaigns in the United States varies among states.
  • Without COVID-19 vaccinations, researchers estimate that the death toll would have been 1.2 times higher than the current level.
  • More research is necessary to promote vaccination equity among different population groups and to assess the effectiveness of the vaccines against variants.

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According to the Johns Hopkins Coronavirus Resource Center, more than 625,000 people in the U.S. have died from COVID-19 since January 2020. As of August 23, 2021, about 51.5% of the US population have been fully vaccinated to help protect them from the disease. A recent study in the journal Health Affairs estimates that the number of COVID-19 deaths that the U.S. has averted as a result of its vaccine distribution may be close to 140,000.

Researchers from the RAND Corporation and Indiana University examined the effect of state vaccination campaigns on the number of COVID-19 deaths in the U.S. The study estimates the number of lives saved during the first 5 months of the vaccination campaign in each of the 50 states and Washington, D.C.

Using Bloomberg’s COVID-19 Vaccine Tracker, the researchers measured the cumulative number of doses that each state administered weekly. They then obtained 2018 state population counts from the Surveillance, Epidemiology, and End Results program, and used them to calculate the number of doses per 100 people aged 16 years and older.

The team also obtained daily data on state-reported COVID-19 deaths from the New York Times database, using this information to calculate cumulative deaths per 100 adults in each state per week from December 21, 2020, to May 9, 2021.

The researchers statistically estimated the number of deaths that would have occurred from COVID-19 with no vaccination program and compared that number with the reported deaths from each state.

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“Our study suggests that without the vaccinations of early 2021, the cumulative number of COVID-19 deaths in the U.S. would have been nearly 1.2 times higher than their current level,” said the authors of the study.

The study also found that state-level estimates differ. New York vaccinations led to an estimated 11.7 fewer COVID-19 deaths per 10,000 adults, while Hawaii observed the smallest estimated reduction with 1.1 fewer deaths per 10,000 adults.

The authors note several limitations of the study. Firstly, the Bloomberg database does not include the age, race, ethnicity, or occupation of the person receiving the vaccine. Also, it neither separates the number of vaccines by location — for example, nursing homes vs. pharmacies — nor differentiates between the first and second doses of the two-dose vaccinations.

Other limitations include the ability to determine how many of the estimated reductions in death were due to vaccinations or natural immunity and how many were the result of a lower population-level risk of transmission.

Elitza Theel, Ph.D., director of the Infectious Diseases Serology Lab at Mayo Clinic in Rochester, MN, would like to have seen further discussion in this study about the different levels of preventive measures per individual state.

“Some were under lockdowns and mask mandates, while others had much looser restrictions,” said Theel in an interview with MNT. “These differential control measures, likewise, also impacted death tolls.”

The researchers conclude that this study provides support for policies that further expand vaccine administration. Emerging evidence suggests that historically marginalized and low income populations have experienced disproportionately high hospitalization and death rates during the pandemic. Ensuring that these communities have an equal share of the benefits of COVID-19 vaccinations is critical.

“This study brings into focus the dramatic success of the early months of the nation’s coronavirus vaccine rollout,” said Christopher Whaley, Ph.D., senior author of the study and a policy researcher at RAND. “The findings provide support for policies that further expand vaccine administration to enable a larger proportion of the nation’s population to benefit.”

Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center in Nashville, TN, told MNT that this research will spawn future studies.

“[Future epidemiological studies] will look at not only deaths averted but [also] hospitalizations averted and admissions to intensive care units averted by vaccinations,” said Dr. Schaffner.

As the SARS-CoV-2 variants emerge, both Theel and Schaffner stressed the continued need for more research.

“I think it will be very important to determine the efficacy of the current vaccine formulations against these specific variants,” said Theel.

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