How many lives have the COVID vaccines saved?

 This really shouldn't be controversial.

In response to a worldwide pandemic, scientists built on decades of research in genetics and virology to design, create, test and deploy multiple COVID vaccines in record time. Three vaccines were approved for use in the US--Johnson and Johnson, Pfizer and Moderna. To date 214 million Americans--65%--are fully vaccinated and 93 million--28%--have gotten a booster. The vaccines and boosters are known to reduce COVID cases, severe illness, hospitalization and deaths.

The question is, how many deaths have the vaccines actually prevented--how many Americans are alive today who would be dead had they remained unvaccinated?

A doctor receiving a COVID vaccination

Credit: DOD

I know that many people's eyes glaze over when numbers are involved, and the next section includes a lot of numbers. For those with a numerical allergy, feel free to jump to the paragraph in bold that starts with "During the 39 weeks . . ."

The numbers:

To address the question of how many lives COVID vaccination has saved, I examined week-by-week US death rates by vaccination status between April 10, 2021 and January 1, 2022, and coordinated those with week-by-week numbers of Americans fully vaccinated.

During those 39 weeks the number of fully vaccinated Americans rose from 82.9 million to 207.4 million. As the pandemic waxed and waned, the weekly rates of COVID deaths among unvaccinated people ranged from 0.92 to 14.27 per 100,000 while the comparable rates for fully vaccinated people varied from 0.07 to 1.23 per 100,000.

The ratio of deaths per 100,000 comparing unvaccinated to vaccinated people ranged from 6.6 to 18 with an average of 11.85. That is, on average over those 39 weeks, unvaccinated Americans died from COVID at 11.85 the rate of their fully vaccinated peers.

The difference between the rate of deaths between unvaccinated and fully vaccinated people ranged from 0.85 deaths per 100,000 people during weeks when the pandemic was at a low ebb to 13.04 per 100,000 at its peak.

Knowing the number of vaccinated people in a given week and the death rate for unvaccinated people at that time, we can calculate the number of deaths that would have occurred among the vaccinated group if they had remained unvaccinated. We can calculate how many lives were saved by subtracting the actual number of deaths in the vaccinated group from the number of people in that group who would have died if unvaccinated.

Here's an example, using the week of December 18, 2021:

Number of fully vaccinated people: 205.3 million

Death rate among unvaccinated people: 92.5 per million

How many would have died at the unvaccinated rate: 205.3 x 92.5 = 18,990

Death rate among fully vaccinated: 8 per million

How many fully vaccinated people actually died: 205.3 x 8 = 1,642

Number of lives saved that week: 18,990 - 1642 = 17,348

We can then calculate that figure for each of the 39 weeks for which we have data and add them up. That gets us the answer to our question:

During the 39 weeks between April 10, 2021 and January 1, 2022, if nobody had been vaccinated we would have seen approximately 416,999 more deaths.

To put it differently, during those 39 weeks, COVID vaccinations saved approximately 417,000 American lives. That's an average of 10,692 lives saved per week, or 1527 per day.

If the COVID vaccines had not been available, the additional lives lost would have surpassed all American lives lost in World War II.

This conservative estimate of lives saved doesn't include those saved during the 20 weeks between the start of vaccinations in the US on December 14, 2020 and April 10, 2021, or the lives saved since January 1, 2022, or the additional lives saved among people who are fully vaccinated and boosted.

We can fill in those gaps at least in part. Researchers at the NIH and Rand Corporation used a modeling approach to estimate the number of lives saved by vaccines from December 14, 2020 through May 9, 2021. They arrived at a figure of 139,000 for that period. If we subtract the 10,436 deaths in the weeks where their figures overlap mine, we can add another 128,564 American lives saved by vaccines before April 10, 2021.

We don't have US COVID death rates by vaccination status after January 1, 2022, but we do have those numbers for two states, Texas and Washington. They show the same pattern, with unvaccinated people dying at between 7 and 18 times the rate of their fully vaccinated peers. It's safe to say that the number of lives saved by the COVID vaccines continues to grow.

So, even without counting the lives saved by vaccines so far in 2022, as a very conservative estimate COVID vaccinations have saved 417,000 + 128,500--more than 545,000 American lives.

What about the rest of the world?

Ten other countries report COVID deaths by vaccination status. You can find the details here. On average across those countries unvaccinated people died from COVID at 9.5 times the rate of vaccinated people, quite comparable to the 11.85 ratio seen in the U.S. over time. The average difference between the death rates per 100,000 for unvaccinated vs fully vaccinated people was actually greater than the comparable figure for the US. Thus it seems reasonable to use the lives saved in the U.S. to estimate lives saved worldwide.

This is supported by data from Europe. A study jointly published by WHO and the European Centre for Disease Prevention and Control estimates that between the beginning of vaccination in Europe in December, 2020 through November of 2021, vaccines saved nearly 470,000 lives just in those aged 60 and older.

The 214 million Americans who are fully vaccinated represent slightly less than one-twentieth of the number of fully vaccinated people worldwide, currently estimated at 4.355 billion. If we multiply 545,000 lives saved in the US by a factor of 20, we get an admittedly rough estimate of how many lives the vaccines have saved worldwide--10,900,000.

That's a lot of mothers and fathers, grandparents and grandchildren, husbands and wives, workers and homemakers, friends and lovers, regular people who are still alive because they chose to get vaccinated.

Perhaps we should be thanking Anthony Fauci and other public figures and leaders who have encouraged and advocated vaccination rather than calling them mass murderers who should be jailed or executed-- tropes that far too frequently appear on right-wing news sources and saturate social media.

 

Who shouldn't get vaccinated? The informed part of informed consent.

 Ten months after the vaccines became available, we now have meaningful data that can guide people deciding if they should or shouldn't get themselves or their children vaccinated against covid.

The best available data about the actual risks of the mRNA vaccines--specifically the Pfizer/BioNTech shots--come from a joint Israeli-Harvard Medical School study evaluating the medical records of more than 1.6 million people, half of whom received two Pfizer jabs while half remained unvaccinated. I reported on this study here, and you can find the peer-reviewed paper itself, published in the New England Journal of Medicine, here.

Of course. But what are the actual risks and benefits?

Credit: Nick Youngson

The study found that just five side-effects occurred more frequently in the vaccinated groups in the six weeks following vaccination relative to a comparable time period for the unvaccinated group. These included swollen lymph nodes (78.4 additional cases per 100,000 people), shingles (15.8 extra cases per 100,000), appendicitis (5 additional cases per 100,000), Bell's palsy (3.5 additional cases per 100,000) and myocarditis (2.7 additional cases per 100,000, almost all in young men).

If we add all those side-effects together we find an incidence of 105.4 per 100,000 fully vaccinated people.

It's worth noting that those symptoms vary in seriousness. The most frequent--swollen lymph nodes--is a predictable, rarely serious, reaction to vaccination, while the remaining four potentially more serious conditions represent a total of just 27 additional cases per 100,000 vaccinated people.

To keep things simple and clear, you can safely estimate that if you get two rounds of the Pfizer vaccine, your risk of suffering any reaction worse than a sore arm is around 1 in 1000, and your risk of a serious side-effect such as shingles or appendicitis is around 1 out of 3700.

We can compare these risks to the risks from covid itself in a variety of ways. Here are several that readers may find helpful:

Risks from covid in the Israeli-Harvard study: Among the 800,000 participants who remained unvaccinated, a significant number contracted covid. As is typical of covid, not all of those developed serious symptoms. However, far more did experience significant symptoms and sequelae from covid than were seen in their vaccinated peers. These included cardiac arrythmia (166 extra cases per 100,000), acute kidney injury (125.4 extra cases per 100,000), pulmonary embolism--a blood clot in the lung--(61.7 extra cases per 100,000), deep-vein thrombosis (43 extra cases per 100,000), myocardial infarction--a heart attack--(25 extra cases per 100,000), myocarditis (11 extra cases per 100,000), pericarditis (10.9 extra cases per 100,000) and intracranial bleeding (7.6 extra cases per 100,000).

So, in the same 6 week period, the unvaccinated group suffered serious, very serious or potentially fatal symptoms such as acute kidney injury, pulmonary blood clots or heart attacks at a combined rate of 443 per 100,000. That's more than four times the rate of all the vaccine side-effects combined, and 16 times the rate of the potentially serious vaccine side-effects.

Risk of contracting covid in the US as a whole. As of 10/18/21, there have been 45,798,599 recorded covid cases in the US. That's a case rate of 13,733 per 100,000 people, accumulated over 22 months. It's not possible to predict the exact course of the pandemic going forward, but for the average American the risk of contracting covid, say in the next 12 months, is probably 50 or 60 times higher than the risk of any side-effect from the vaccine, and several hundred times higher than the risk of any of the more serious side-effects.

As critics of covid vaccination point out, many covid cases are relatively mild. However, in the US over the course of the pandemic so far, about one out of every 20 people who contracted covid got sick enough to require hospitalization.

Risk of covid hospitalization in the US as a whole. As of 10/18/21, the cumulative covid hospitalization rate in the US reached 694 per 100,000. That implies that the average US resident is 6.6 times more likely to have been hospitalized because of covid than they would have been at risk for any negative reaction to the vaccine, and 26 times more likely to have been hospitalized from covid than to have risked a serious reaction to the vaccine.

Again, the first 22 months of the pandemic don't tell us what the next 22 months will bring, but the risk continues, especially among the unvaccinated.

Again, vaccination critics point out that "covid has a 99 percent survival rate." That's not quite true. In the US so far, 1.6 percent of recorded covid cases have resulted in recorded covid deaths. We can now compare that to the risks from vaccination.

Risk of death from covid in the US as a whole. As of 10/18/21 the cumulative rate of deaths from covid hit 224.5 per 100,000 people. That means that on average, a US resident is 2.1 times more likely to have died from covid since the start of the pandemic to date than to have risked any negative reaction to a vaccine, and 8.3 times more likely to have died as a result of covid than to have risked one of the serious reaction to the vaccine.

Risk of covid deaths state by state. As of 10/18/21, five states had cumulative covid death rates less than 105 deaths per 100,000 population. Those are Oregon (99), Utah (96), Hawaii (87), Alaska (59) and Vermont (55). For residents in those states, which comprise just three percent of the US population, the odds of having died from covid so far in the pandemic are somewhat less than the risk of having any negative reaction to the vaccine, but still two to three times higher than the risk of one of the serious vaccine side-effects. Even in those states, however, the risk of hospitalization from covid is significantly higher than any of the risks from the vaccine.

The remaining 97 percent of Americans live in states where the risks of contracting covid, becoming seriously ill, being hospitalized or dying from covid are greater than the risks of any negative sequelae from the vaccines.

Risk of covid deaths county by county. You can check your county's cumulative covid death rate on this map. If you're in one of the darker blue counties--most of which have very small populations--the cumulative death rate per 100,000 people is less than the risk of side-effects from the vaccine. Still, unless your county's cumulative death rate is less than 12 per 100,000, as it is in Orange County, Vermont (population 29,000) or Skamania County, Washington (population 11,066), your risk of hospitalization from covid is higher than any risk from the vaccine.

Risk of covid deaths from breakthrough infections: We now know that vaccine-induced immunity fades over time, and that the delta variant in particular is causing a significant number of fully vaccinated people to fall ill. However, the vaccines are still highly protective against severe illness and death. Perhaps the most striking statistic is that out of 187,000,000 fully vaccinated Americans, 7,178 have died from covid, or just 3.8 per 100,000. That's less than 6 percent of the 124,000 Americans who have died from covid since mid-July, when the delta variant became predominant.

In summary, for the large majority of Americans, the risks of getting covid, suffering one or more of the serious impacts of covid, having to be hospitalized because of covid, or dying from covid are all far higher than the risks of any side-effect of the mRNA vaccines, and, even against the delta variant, the vaccines remain highly protective against severe illness or death.

What about children?

There is one group, however, for whom this may not be true. As many critics of covid vaccination have pointed out, the risks from covid are significantly lower for young people. For example, the cumulative covid death rate for children under 15 is less than 5 per 100,000, comparable to the death rate for fully vaccinated adults. For 16 and 17 year-olds it's 9 per 100,000, and from 18 through 29, 16 per 100,000. If we were just comparing the risk of dying from covid to the much less serious but documented risks from the mRNA vaccines, one could potentially come down on the side of not vaccinating young children and teenagers.

The picture changes if we include the risk of children needing to be hospitalized because of covid. The cumulative covid hospitalization rate for children 0 through 4 is 87 per 100,000, and from 5 through 18, 51.8 per 100,000. These are less than the risk of any side effects of the vaccines, but higher than the risks of serious side effects. Luckily, young children are less likely to be severely sickened or to die from covid than adults, but a significant number do need to be hospitalized.

Safety and efficacy trials of covid vaccines for children from 5 through 11 are currently taking place, and the White House has announced plans to promote vaccination of children ages 5 through 11 once a children's vaccine is approved. We should have more data specific to that age group within the next few months.

Individual risks vs. social responsibility

The risk ratios discussed above refer to individual risks. That is, one could decide to be vaccinated or not based only on comparing one's own risk of contracting covid, or of requiring hospitalization, or of dying vs. the known risks from the vaccine. However, public health authorities point out that, much like choosing to wear a mask, getting vaccinated doesn't just protect the person getting the jab, it also protects others by reducing the likelihood that that person will infect others. This multiplicative factor becomes significant when large numbers of people in a population remain unvaccinated, and so provide a continuing medium for the virus.

Currently, 43 percent of the US population remain unvaccinated, or more than 143 million people. Around half of those are adults who would incur low risks from vaccination yet could protect themselves and others by doing so. As long as they choose not to get vaccinated, they remain a big, wide playing field across which the coronavirus can continue its advance.

STILL DEBATING A COVID VACCINE? HERE'S SOME CRYSTAL-CLEAR DATA FOR YOU

As of the end of August, 2021, 51 percent of the US population have been fully vaccinated for Covid-19. That means that 49 percent have not, despite the vaccine being widely available and free. Still, 61 percent have gotten at least one shot, so that leaves "only" 39 percent of the US population who have so far chosen not to seek or accept Covid-19 vaccination.

That means that more than 129 million Americans remain un-vaccinated, giving the SARS-CoV-2 virus, and especially the highly contagious delta mutant more than enough unprotected targets to continue to cause widespread illness, hospitalizations and death. Those 129 million unvaccinated people also comprise an enormous human petri dish in which the virus can continue to multiply and mutate.

Vaccination vs. hospitalization by state

Credit: NYT

Just in case some of those 129 million might be amenable to real-life, on-the-ground data about the life-saving benefits of the vaccine, here are some brand-new, nation-wide county-by-county research findings:

                                                                          Credit: Jeffrey Harris, MD

Jeffrey Harris, a physician and emeritus professor of economics at the Massachusetts Institute of Technology, gathered data on vaccination rates, Covid-19 case rates and Covid-related hospitalizations in the 112 most populated US counties, a total of 147 million people. He used vaccination data as of mid-July, 2020 and compared them to Covid cases and hospitalizations between July 30 and August 12. You can read a pre-print of the research report here.

The results are striking. 

In the 56 counties in the lower half of the vaccination range, there were 548 cases per 100,000 population during the two-week study period, but just 281 cases per 100,000 in the 56 counties in the upper half of the vaccination rates. 

People in the less-vaccinated counties suffered 1.95 times as many diagnosed Covid-19 cases than people in the more-vaccinated counties.

A ten percent increase in vaccination rate correlated with a 28.3 percent reduction in Covid-19 cases.

The difference in Covid-caused hospitalizations in less- compared to more-vaccinated counties was even more dramatic. In the 56 less-vaccinated counties there were 55.4 hospitalizations per 100,000 people during the two-week study period, compared to 20.5 per 100,000 in the more-vaccinated counties. 

That means that for every hospitalization in the more-vaccinated counties, there were 2.7 hospitalizations in the less-vaccinated ones.

A ten-percent increase in vaccination rate correlated with a whopping 44.9 percent decrease in Covid hospitalizations.

So what's the bottom line of this large, detailed nationwide study? Basically, any region that can get 10 percent more of its citizens to get vaccinated can expect to cut its Covid case rate by 28 percent and its Covid hospitalization rate by 45 percent.

Lets translate those reductions in Covid cases and hospitalizations into lives saved:

In the US to date, we've suffered 39,662,129 confirmed Covid-19 cases. Among those, 2,675,000 have been hospitalized and 654,668 people have died. 

That means that for every 100,000 US cases, we're likely to see 1650 deaths. 

Thanks to an incredibly quick learning curve within the medical profession, the percentage of Americans who survive after being hospitalized for Covid-19 increased from 78.9 percent in early 2021 to 93.5 percent in August. Still, that means that even now the death rate for hospitalized Covid patients is 6.5 percent, meaning that out of every 100,000 Americans hospitalized for Covid, 6500 are likely to die.

As of the end of August, 2021, the US is registering more than 140,000 new Covid cases per day, or 980,000 per week. We're seeing an average of 12,297 new hospitalization per day, or 86,079 per week, and 1163 deaths per day, or 8,141 deaths per week.

Looking just weeks into the future, this study tells us that if just 10 percent of the 129,000,000 un-vaccinated Americans were to get vaccinated, we could avoid approximately 275,000 new Covid-19 cases, prevent 38,650 hospitalizations, and save at least 2500 lives--every week!

Dr. Harris believes we can do this. He says that among his patients he has encountered many "reasons" for not getting vaccinated. He recognizes that some people are "encapsulated in a misinformation bubble from which there seems to be no escape." Others, however, may be reachable, especially if there are tangible, real-life consequences to not be being vaccinated, such as loss of a job or not being able to enter restaurants or other businesses. 

"I expect many will come around," he says. Let's hope he's right.

Worth getting the jabs? You decide.

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REA/8-29-21

Vaccination rates ranged from below 30 percent in three counties in Georgia to over 65 percent in several counties in Maryland, Massachusetts, California and Washington. 

EVEN THE VACCINATED NEED TO GUARD AGAINST VARIANT DELTA

Many of us who have been vaccinated against Covid-19 have at least started to lead more normal lives. Since getting my Pfizer shots, I've traveled by plane, stayed at a B&B and in friends' homes, eaten inside restaurants, and hugged (vaccinated) friends. It's felt great.

But from what I'm now reading, even if we're fully vaccinated, we may not be fully protected against the highly contagious Delta variant.

Credit: ISO-FORM LLC

From the laboratory, as reported in the prestigious journal Nature, we learn that one dose of either the Pfizer or the AstraZenaca vaccines "was poorly or not at all efficient against the Beta and Delta variants." Serum from just one person in 10 partially vaccinated people was able to neutralize the Delta variant. 

A bit more encouragingly, blood serum from 95 percent of people who'd gotten both shots of either vaccine did generate a neutralizing response. However, that response was just one-third to one-fifth as potent against Delta compared to Alpha.

And, in the outside world comes a report from Israel indicating that the Pfizer jab is just 64 percent effective in keeping vaccinated people from catching the Delta variant. The good news is that it appears to be 94 percent effective in preventing severe illness. Still, the actual numbers are not encouraging. In the recent two-week period surveyed, Israel recorded 1,528 new Covid cases. Of those, 1,271 were in fully vaccinated people. Thirty-seven people had to be hospitalized, of which 23 were fully vaccinated. Seventeen patients fell seriously ill, or which 11 had gotten both Pfizer shots.

More recent data from Israel, covering the week of June 27 through July 3 showed that a shockingly high percentage of new Covid cases--85 percent--hit fully vaccinated people. That's essentially the same percentage who are vaccinated in the whole Israeli population. At first glance this could indicate that the mRNA vaccines provide no protection against the delta variant. It's also possible that the 15 percent of the Israeli population who are nor vaccinated have already had Covid or are otherwise immune. In that case these data could indicate that vaccination provides no more protection than a prior bout with Covid. But in either case they clearly show that "breakthrough" infections from the delta variant are far from rare.

And an even more recent report from Israel finds that even two Pfizer jabs are just 39 percent effective in protecting people against the delta variant. The same report is quick to point out that the shots are 88 percent effective in preventing hospitalization and 91 percent effective against severe illness.

The Israeli numbers are described as preliminary and definitely are outliers compared to what some other countries are reporting. However, they clearly show that the Delta variant can sneak past the antibody defenses of a significant number of vaccinated individuals, corroborating what was seen in the lab.

If more proof were needed, an outbreak of the delta variant among staff and patients at a hospital in Calgary, Alberta, Canada provides it. Ten medical professionals who were fully vaccinated nonetheless came down with Covid-delta after attending a party. "It's quite a red flag, honestly," one Canadian health expert said.

It's reassuring that the vaccines still appear to be highly effective in preventing serious illness. Still, I don't want to risk even a mild case of Covid. So, until the Delta variant becomes much less prevalent, or until further data is significantly more reassuring, I'm dialing back from my more freewheeling behavior of the last few months.

"Normal" may be in sight, but, due to the highly contagious delta variant, it's not here yet.

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REA

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