My own crude estimate: Vaccine refusal has likely killed 180K - 235K Americans to date

A few days ago, Peter Hotez MD PhD, Dean of the National School of Tropical Medicine and Professor of Pediatrics and Molecular Virology & Microbiology at Baylor College of Medicine where he is also the Co-director of the Texas Children’s Center for Vaccine Development (CVD) and Texas Children’s Hospital Endowed Chair of Tropical Pediatrics, estimated that a stunning 250,000 U.S. COVID-19 deaths have been caused specifically due to people refusing to get vaccinated.

There's a lot of different ways to measure this, of course, and other estimates vary depending on when the study was conducted and what methodology they used. For instance, back in October, the Kaiser Family Foundation estimated that at least 90,000 deaths were preventable due to vaccine refusal. They updated this in December to put their estimate at 163,000. In KFF's case, they used June 1st as their start date.

The decision on when to "start" a vaccine-based estimate can be tricky for several reasons.

First, it's not like everyone became eligible to get vaccinated at the same time. Besides participants in the clinical trials, the first U.S. resident to get vaccinated was a New York nurse named Sandra Lindsay, on December 14th, 2020. Throughout January & February 2021, the vast majority of those vaccinated in the U.S. were senior citizens, healthcare workers and a few other select populations. Over 26.5 million Americans had gotten their first dose by February 1st, and over 50 million doses had been administered as of February 26th.

On March 19th, the federal government reported having administered its 100 millionth COVID-19 vaccination shot...and ten days later, on March 29th, 6 states opened the floodgates and started allowing all adults to get vaccinated. By April 18th, 50% of all U.S. adults had gotten at least their first doses, and on April 19th, 2021, the last U.S. states (as well as Puerto Rico and Washington DC) started allowing all adults to #GetVaxxed.

Now, it wasn't until May 10th that the Pfizer vaccine was given emergency use authorization by the FDA for adolsecents 12-15 years old, and children age 5-11 wouldn't become eligible until early November, but every adult was eligible as of mid-April. Of course, it's now mid-March, which means that every U.S. child age 5-17 could theoretically have gotten their 2nd vaccination dose by now (and those 12 and older could have gotten boosted as well).

The other thing to keep in mind is that someone isn't considered "fully" vaccinated until they receive their second shot, which isn't administered until 3 or 4 weeks after the first one...and even then, it's supposed to be another 2 weeks before the vaccine is supposed to be fully effective.

So, what's the best start date to use given all of this? I could see arguments being made for May 1st, June 1st or July 1st depending on your POV. I was using July 1st for a long time but more recently decided to move back to May 1st.

WIth that in mind, here's my own crude attempt to estimate just how many COVID-19 deaths could have been prevented if as many people as possible had simply gotten vaccinated as soon as they were able to do so.

According to data from Johns Hopkins University, the CDC and various state health departments:

• Since May 1st, 2021, over 381,000 Americans have died of COVID...a national death rate of around 115 per 100,000 residents (115/100K).

• Of the 3,114 U.S. Counties (or county equivalents) nationally, 2,176 of them have had a COVID death rate higher than the national average since 5/01/21.

• The highest-vaccinated tenth of the U.S. consists of 100 counties where the average total population vaccination rate is over 80%.

• In those 100 counties, the average COVID death rate since 5/01/21 is 60.9/100K. Total COVID deaths since 5/1/21: ~21,000.

• In the other 3,014 counties, the death rate is 121/100K, or twice as high. Total COVID deaths since 5/1/21: ~360,000.

• This means that if the other 90% of the U.S. had the same death rate as the most-vaccinated 100 counties, only around ~180,000 Americans would have died in those counties since May.

In other words, if the entire U.S. population had gotten vaccinationed at the same pace as the top tenth did, at least 180,000 fewer people likely would have died of COVID since last May.

Of course, as noted above, adolescents have been able to get vaccinated since mid-May, and children 5 and older since last November. It's now mid-March 2022. This means that over 312 million Americans could have gotten their first and second shots by now, or over 94% of the total U.S. population.

Now, 94% is probably too much to ask under any circumstances, but what about 85 or 90%?

Well, the 30 most-vaccinated counties as of this writing (average 2-dose vaccination rate: 87%) have a combined population of just over 5 million people...and a COVID death rate since 5/1/21 of just 44/100K.

If the rest of the country matched that death rate, we would've seen around ~146,000 since May 1st of last year, instead of the ~381,000 who actually died since then. That's a difference of 235,000 people.

Does this mean that Dr. Hotez' 250K figure is overstated? Not at all; again, my estimated range above is a back-of-the-envelope-math sort of thing. I obviously haven't adjusted for things like age, income, education, geography, population density, race and probably several other factors. The actual number could be somewhat higher than 235K.

I should also note that it's not just vaccination refusal which has had such an impact: Those who refuse to get vaccinated are also those who've been most likely to refuse to wear a mask...or to socially distance, or to take any other precautions against getting infected (or spreading the virus).

Having said that, given that the Kaiser Family Foundation's far more stringent analysis put the figure at 163,000 between June and December (starting a month later and ending nearly 3 months earlier), I'm pretty damned sure it isn't any lower than this range. After all, an additional ~162,000 Americans have died of COVID since KFF's last update on December 10th, 2021.

Bottom line: Get vaccinated, get boosted, and keep wearing a mask indoors in public for awhile longer...because you never know who HASN'T gotten vaccinated.