The first study to model the impact of COVID vaccines on the pandemic on a worldwide scale has found that 19.8 million deaths out of a possible 31.4 million were prevented in the first year after vaccines were first introduced in December 2020.
It's understandable to feel disappointed in the various COVID-19 vaccines, even, perhaps especially, for people who are in no way anti-vaccine. The speed and success with which they were developed and rolled out was impressive but the hope the vaccines would put a stop to the pandemic entirely has not panned out.
However, a study published in The Lancet Infectious Diseases looks at the donut, not at the hole. Without vaccines the numbers dying from COVID-19 would have more than doubled, the authors conclude. These were among the most life-saving developments of all time, an astounding feat given the exceptional time pressure everyone was under.
Estimates of how many people died from COVID-19 are disturbingly vague. Tracking of reported deaths provides figures of a little over 6 million. However, in countries where testing was not widely available this is an immense under-estimate. Looking at the number of excess deaths compared to ordinary years produces figures of 15 million in 2020 and 2021.
If it is hard to be precise about how many died it is inevitably harder still to know how many might have in an alternate reality. Dr Oliver Watson of Imperial College London has made an effort, however, restricting the task to 365 days after December 8, 2020, the day the first person got the first vaccine.
“Our findings offer the most complete assessment to date of the remarkable global impact that vaccination has had on the COVID-19 pandemic,” Watson said in a statement.
Watson and co-authors estimate 12.2 million deaths were prevented in high and upper-middle income countries over that time, representing the countries able to pay for the vaccines they needed themselves, even if acquisition proved painfully slow. Despite reports the COVID-19 Vaccine Access initiative (COVAX) program was a failure thanks to wealthy nations hogging supply, another 7.5 million lives were saved in beneficiary countries.
Factoring in country-level death rates prior to vaccines becoming available, and varying vaccination rates thereafter, the authors estimate that 15.5 million of the lives saved were from direct protection from the vaccine. Another 4.3 million were from interrupted transmission, making the unvaccinated less likely to become infected, or reduced pressure on healthcare systems.
Most of the initial lives saved were in India, despite vaccination rates there lagging the West at first. Later in 2021, the primary beneficiaries were developed countries with older populations that eased restrictions on movements and mask mandates.
Despite the numerous delays in rolling out vaccinations to low-income countries, two-thirds of the world's population have received at least one vaccine dose. The World Health Organization (WHO) goal of 70 percent by mid-2022 is almost in reach.
The world could still have done better, however. Another 600,000 lives would have been saved if the WHO target of vaccinating 40 percent of even the most underserved countries had been met, for example. The authors note that vaccine hesitancy, powered by misinformation, has cost lives worldwide. They don't attempt to quantify this number, but an accompanying commentary notes almost 100,000 lives could have been saved in Nigeria if WHO goals had been met, with widespread anti-vax myths being a contributing factor to the failure.
The Imperial College COVID-19 modeling became a favorite target for those opposed to government interventions early in the pandemic when they predicted large numbers of deaths if the virus was allowed to spread unchecked. While their work continues to be critiqued by other epidemiologists, the much-mocked estimate of 2 million COVID-19 deaths in America without action looks tragically credible now the death toll has passed a million.