Estimating Vaccine-Preventable COVID-19 Deaths Among Adults Under Counterfactual Vaccination Scenarios in The United States: A Modeling Study Using Observational Data

Author(s): Ming Zhong, Tamara Glazer, Meghana Kshirsagar, Richard Johnston, Rahul Dodhia, Allen Kim, Divya Michael, Santiago Salcido, Sameer Nair-Desai, Thomas C. Tsai, Stefanie Friedhoff, William B Weeks, Juan M. Lavista

Introduction: In early 2021, effective SARS-CoV-2 (COVID-19) vaccines became available in the United States; by mid-April 2021, vaccine availability outstripped demand, daily vaccination rates peaked, and COVID-19 vaccines were found highly effective in adult populations. Accurate estimates of the number of vaccine-preventable deaths had higher vaccination rates been attained could have helped local policymakers and possibly persuaded more to get vaccinated.

Methods: Because existing estimation methodologies are limited, for the period 1/1/21 – 4/30/22, we simulated the number of vaccine-preventable deaths associated with two-dose COVID-19 vaccination that incorporated state-level population, death, and vaccination numbers and three scenarios of vaccination rate achievement.

Results: Nationally, we found that had 100% of the population became fully vaccinated during the period examined, 318,979 deaths, or approximately 50% of reported COVID-19 deaths, might have been prevented; had 85% been so, 28% might have been prevented. Across states, we found substantial variation in the proportion of avoidable COVID-19 deaths that might have been avoided at the state level, from 25% in Massachusetts to 74% in Alaska.

Conclusion: Our findings are sobering when considering the number of deaths and diversion of scarce and expensive healthcare resources that might have been averted had peak vaccination administration efforts been maintained.