Study Finds Large Gap in Excess Deaths Along Partisan Lines After COVID-19 Vaccines Introduced

A team of Yale researchers has found that Republican voters in two U.S. states had more excess deaths than Democratic voters after vaccines for COVID-19 became widely available to counter the disease. The discrepancy didn’t exist prior to the vaccines.

Jacob Wallace, assistant professor of public health (health policy); Jason L. Schwartz, associate professor of public health (health policy); and Paul Goldsmith-Pinkham, assistant professor at the Yale School of Management conducted the research using a novel linkage of political party affiliation and mortality data to assess whether there were differences in COVID-19 excess death rates between Republican and Democratic voters. The authors estimated excess death rates as the percentage increase in deaths above expected deaths due to seasonality, geographic location, party affiliation, and age.

The study found that overall, the excess death rate for Republican voters was 5.4 percentage points, or 76%, higher than the excess death rate for Democratic voters. After COVID-19 vaccines became widely available, the excess death rate gap between Republicans and Democrats widened from 1.6 percentage points to 10.4 percentage points.

“The gap in excess death rates between Republicans and Democrats is concentrated in counties with low vaccination rates and only materializes after vaccines became widely available,” the authors said in the study.

The study’s findings were recently released as a working paper by the researchers in collaboration with the National Bureau of Economic Research. The findings have been reported extensively in national media including The New York Times, The Washington Post, and NBC News.

Schwartz said the findings amplify the critical importance of vaccines.

“Even as we continue to hear and talk a lot about booster campaigns, the updated booster, and trying to reach folks with their third or fourth or fifth dose, there are still over 70 million Americans who have yet to receive even their first dose of a COVID vaccine, who have rejected it all this time,” Schwartz said. “Those individuals remain at dramatically increased risk of severe outcomes, including death.”

The findings should also serve as a rallying cry for public health professionals to continue their push to make sure people are vaccinated to protect themselves from the ongoing threat of COVID-19, Schwartz said.

“The public health community can't give up on the hard work of trying to continue to make progress with those who are unvaccinated — hard as it is, intractable as many of those individuals appear to be at this point,” said Schwartz. “It will prolong and worsen the future of the pandemic if we continue to have this large segment of the population unvaccinated — particularly given the clusters of unvaccinated individuals in certain communities, certain regions, certain states — who remain highly susceptible to those severe outcomes.”

In conducting the research, the research team compared individual voter registration records from 2017 with death records from 2018 to 2021 for Ohio and Florida, Goldsmith-Pinkham said. They then calculated excess death rates controlling for differences in mortality rates pre-COVID.

The research showed that the gap between Republican and Democratic excess death “increased significantly after COVID vaccinations were readily available,” Goldsmith-Pinkham said.

A Very Sad Story

Wallace said the paper tells “a very sad story” because many of the deaths may have been avoidable. And as a public health policy professional, he finds it particularly troubling because the data suggest that, with higher vaccination rates, deaths could potentially have been averted at a low cost.

“It’s possible that thousands of deaths that could have been averted,” he said.

Despite this, Wallace said he and the other researchers are glad the study has received widespread attention because the coverage focuses on what still needs to be done to address the gap in vaccination rates and to continue probing the risk factors that drive COVID-19 mortality and determine which ones are amenable to intervention.

Some of these interventions include identifying trusted messengers in certain populations and, if needed, going door-to-door to get science-based vaccine information to communities with the aim of increasing vaccination rates.

Further study, such as linking the death rates to party affiliation on a national level as well as measuring the impact of masking and other COVID initiatives, will help show a more complete picture, he said.

Schwartz said the study highlights the ongoing struggle of convincing people of the importance and safety of vaccines in fighting not just COVID-19 but other illnesses as well.

“All of us in vaccine policy are very concerned that the controversy and contentious atmosphere that has surrounded COVID vaccines — much of it along party lines — is going to have negative consequences for pediatric vaccination ­— measles and polio and pertussis and so on — in the years ahead,” Schwartz said. “We’re already seeing indications to that effect. That would present a serious threat to children’s health, so we have to redouble our collective efforts to improved public understanding and public support for vaccines across the board, not just for COVID-19.”