New estimates published in The Lancet Respiratory Medicine show that at least 1.6 million European lives have been directly saved by COVID-19 vaccinations, with 60% of those lives saved when Omicron became the dominant strain of the virus—and those numbers may be an undercount.
As of March 2023, 2.2 million COVID-19–related deaths have been reported across Europe.
The data come from The World Health Organization European Respiratory Surveillance Network, which analyzed vaccination efforts from December 2020 to March 2023, a period that encompasses both initial vaccine rollouts in the European region and booster doses. A total of 34 of 54 countries in the region were included in the study.
In the 34 countries, total vaccine overage in all adults aged 25 years or older was 87% for the primary vaccine series, 82% for the second dose, 71% for the first booster, 24% for the second booster, and 5% for the third booster by March of 2023.
The study looked at deaths divided by age-groups (25 to 49 years, 50 to 59, 60 and older, 60 to 69, 70 to 79, and 80 and older). Countries that reported weekly data for both COVID-19 vaccination and mortality by age-group for 90% or more of study weeks or more were included.
First booster dose saved most lives
Each week was also associated with a variant of concern (VOC), which accounted for 50% or more sequences per week.
In 29 countries there were 1,064,165 COVID-19–related deaths in people aged 25 years or older; of these deaths, 454,131 (43%) were in people aged 80 years or older, the authors said. By contrast, 40,788 (4%) and 19,831 (2%) of COVID-19–related deaths were in people aged 50 to 59 years and 25 to 49 years, respectively.
Most reported deaths were during the Omicron period.
"When considering each VOC mortality per variant month (PVM), regardless of age, most reported deaths were during the Omicron period (390,358 deaths); however, the Delta period had the highest number of reported deaths PVM (33,234 deaths)," the authors said.
Overall, those aged 60 years or older accounted for 96% of the total lives saved; whereas, people aged 80 years or older represented 52% of the total lives saved.
In temporal analysis, the first booster saved the most lives (51% of all lives saved) aligning with 60% of lives saved during the Omicron period. The administration of the first booster doses started around week 30 of 2021 in Europe.
In an editorial on the study, Oliver Watson, PhD, and Alexandra Hogan, PhD, of Imperial College London, write that the number of lives saved as reported by the authors is probably an underestimation.
"This study does not consider the additional herd effects of COVID-19 vaccination, whereby the population-level reduction in transmission indirectly reduces exposures, and therefore deaths, in the unvaccinated population," they write.
"Second, the estimate of averted deaths is based on the reported COVID-19 mortality by each country, which is known to underestimate the true burden of COVID-19."
