The COVID-19 vaccination campaign in 141 countries averted 2.4 million excess deaths by August 2021 and would have saved another 670,000 more lives had vaccines been distributed equitably, estimates a working paper from University of Southern California (USC) and Brown University researchers.
The National Bureau of Economic Research circulated the non–peer-reviewed working paper for discussion and comment this week. The researchers estimated the real-world effectiveness of the global COVID-19 vaccine rollout on all-cause death rates, including both the direct and indirect effects of the pandemic.
"Within eight months, over 2 billion people were vaccinated globally, making it the largest public health campaign in history," the study authors wrote.
"To the best of our knowledge, this is the first study that estimates the effect of COVID-19 vaccines on the global all-cause mortality using observational data. Second, unlike existing studies, this study considers the waning effect of vaccines instead of assuming a constant effectiveness of vaccines over time."
Lives saved in India, US made up 37% of total
In 43 countries included in the main regression analysis based on The Economist COVID-19 excess deaths tracker GitHub, vaccination saved an estimated 1.14 million lives from January to August 2021, a roughly 26% reduction in deaths compared with a scenario without the global vaccination campaign.
By extrapolating the results to the 141 countries, the researchers estimated that 2.36 million lives were saved in the first 8 months of the global COVID-19 vaccination campaign. The averted deaths were economically valued at $6.5 trillion, roughly equivalent to 9% of the combined gross domestic product (GDP) of the 141 countries.
In terms of absolute numbers, India and United States benefitted the most from the campaign, with 451,778 and 429,486 lives saved, respectively. Together, they made up 37% of the total lives saved in the 141 countries.
"Due to diminishing marginal health benefits of vaccination, redistributing vaccines from countries with high vaccination rates to countries with low vaccination rates can increase the number of deaths averted," the researchers wrote.
Lives saved vs economic value of those lives
Had the vaccine been equitably distributed among the 141 countries, the COVID-19 vaccination campaign would have saved 3.03 million all-cause deaths during the study period. The deaths averted had an economic value, based on country- and region-specific estimates of the value of statistical life (VSL), of about $4.69 trillion.
These findings leave us with an unanswered question at the intersection of economics and public health: should we seek to maximize the number of lives saved or maximize the economic value of lives saved?
VSL estimates ranged from $0.06 million in Afghanistan to $9.4 million in Switzerland. The average American VSL was $7.2 million, compared with the global VSL estimate of $1.3 million. While India and the United States saved similar numbers of lives with vaccination, the Indian deaths averted were valued economically at $90 billion, making up just 1.4% of the total VSL among the 141 countries.
"Therefore, relative to the status-quo, we estimate that an additional 670,000 lives would have been saved, but with a $1.8 trillion decrease in the total economic value of deaths averted," the authors wrote.
"These findings leave us with an unanswered question at the intersection of economics and public health: should we seek to maximize the number of lives saved or maximize the economic value of lives saved?" they added. "We leave answering this question as an important future endeavor for ethicists and economists."
The results suggest that COVID-19 vaccination and treatments are much more effective at preventing death than other efforts aimed to contain SARS-CoV-2, such as lockdowns and mask mandates, the researchers said.
"Our study shows the enormous health impacts of COVID-19 vaccines, which in turn have huge economic benefits," coauthor Christopher Whaley, PhD, said in a Brown University news release. "In terms of lives saved and economic value, the COVID-19 vaccination campaign is likely the most impactful public health response in recent memory."
