COVID-19 vaccines saved 20 million lives in 1 year

• A new study estimates that COVID-19 vaccines helped avert 19.8 million deaths across the globe during the first year after vaccination campaigns were initiated.
• The study found that vaccine inequity resulted in a disproportionately higher number of deaths prevented by vaccination in high-income nations than in lower-income nations.
• Several low-income nations failed to meet the World Health Organization (WHO) target of vaccinating 40% of their populations and achieving this target could have doubled the number of lives saved in those regions.

A recent study published in the journal Lancet Infectious Disease estimates that COVID-19 vaccines helped reduce the global death toll by 63% during the first year they became available. The study also found that a more equitable distribution of COVID-19 vaccines could have prevented a significant number of deaths in low-income nations.

Dr. Oliver Watson, a researcher at Imperial College London, said, “Our findings offer the most complete assessment to date of the remarkable global impact that vaccination has had on the COVID-19 pandemic. […] Our findings show that millions of lives have likely been saved by making vaccines available to people everywhere, regardless of their wealth.”

“However, more could have been done. If the targets set out by the WHO had been achieved, we estimate that roughly 1 in 5 of the estimated lives lost due to COVID-19 in low-income countries could have been prevented,” he added.

Impact of COVID-19 vaccines

The first dose of a COVID-19 vaccine was delivered outside a clinical trial setting on December 8, 2020.

Since the approval of the first COVID-19 vaccine, nearly 62% of the global population has been fully vaccinated with two doses of the vaccine.

The approved COVID-19 vaccines are highly effective in preventing severe disease and reducing mortality and have changed the trajectory of the pandemic. Studies examining the impact of COVID vaccines in reducing mortality so far have been restricted to specific regions and have only assessed the direct effects of vaccination in preventing deaths in individuals.

Researchers at Imperial College London recently assessed the global impact of COVID-19 vaccination by quantifying the deaths prevented by these vaccines during the first year of vaccination.

In addition to the direct effects of vaccines on mortality, the researchers also accounted for the indirect benefits conferred by vaccines such as reducing the transmission of the virus in the community, including unvaccinated individuals.

Quantifying the lives saved

The researchers used mathematical models of SARS-CoV-2 transmission to estimate the number of lives that would have been lost in an alternative scenario involving the lack of COVID-19 vaccines.

They incorporated data on variables such as vaccination rates, vaccine rollout dates, COVID-19 deaths, variants in circulation, and demographic data for each country in the model to arrive at estimates of deaths averted due to vaccination.

Based on the number of COVID-19 deaths officially reported by each country, the researchers estimated that vaccines helped prevent 14.4 million deaths across the globe during the first year of COVID-19 vaccination.

However, studies suggest that official reports have significantly underestimated the actual number of deaths attributed to COVID-19.

Hence, the researchers assessed excess all-cause deaths during the COVID-19 pandemic, which is the difference between the number of deaths observed during a year of the pandemic and the expected deaths in a non-pandemic year.

The researchers used national vital registration systems that maintain records on deaths and births to obtain data on excess deaths due to COVID-19. However, these registries are incomplete in many developing countries. Hence, the researchers used models to predict the excess deaths in these countries.

Based on estimates of excess deaths during the pandemic, the researchers found that vaccinations helped avert 19.8 million deaths, lowering the death toll by 63% during the first year of vaccinations.

Global disparities in vaccination rates

Vaccination coverage in low- and middle-income countries has lagged behind that in high-income countries due to inequities in access to COVID-19 vaccines.

The COVID Vaccine Global Access (COVAX) initiative was launched to facilitate more equitable distribution of the vaccines, including through the donation of vaccines by wealthier nations. The COVAX initiative’s Advanced Market Committee (AMC) helps finance the purchase of vaccines and their distribution to low- and middle-income countries.

COVAX AMC had set a target of immunizing 20% of the population in developing countries by the end of 2021. Likewise, the World Health Organization had set a target of immunizing 40% of the global population in the same time period.

However, numerous developing countries failed to reach these targets. The inadequate vaccine supply and hoarding of vaccine doses by wealthier countries meant that low-and middle-income countries had limited access to vaccines.

The lack of necessary infrastructure for the storage of vaccines and vaccine hesitancy has also contributed to lower vaccination rates in some nations.

In the present study, the researchers assessed the number of lives that could have been saved if the distribution of vaccines was more equitable. They found that the number of deaths prevented due to vaccination was greater in high-income nations than in low and middle-income nations.

Nevertheless, COVID-19 vaccines reduced the death toll by an estimated 41% (7.4 million) in 83 COVAX AMC countries. Among these COVAX AMC participants, 41 countries failed to reach the target of vaccinating 20% of their population. This included 25 low-income countries and achieving the 20% vaccination target could have reduced the death toll by an additional 45% in these countries.

Moreover, 96 countries failed to meet the WHO target of vaccinating 40% of the population. The majority of these were low-income countries and achieving the WHO target in those countries could have prevented more than twice (111%) as many deaths in these countries.

Equitable vaccine distribution

These results highlight the need for mechanisms to achieve a more equitable distribution of vaccines.

Dr. Ingrid Katz, a professor at Harvard Medical School, said, “There are many measures that could help achieve global vaccine equity. At the core of any proposal, we need a strong intergovernmental body that can help establish a convention or agreement to strengthen pandemic prevention, preparedness, and response.”

“This must be embedded in global health equity and a commitment for the international community to work together and ensure the strengthening of healthcare at the community level. This must be backed by sustained funding for pandemic preparedness and oversight mechanisms that can ensure accountability and transparency while ensuring trust,” she said.

“We can begin by empowering national sovereignty, promoting bilateral donations to programs such as COVAX, ensuring financial and operation support to low- and middle-income nationals to support scale-up of effective vaccine programs, sharing intellectual property and technology transfers for vaccine manufacturing, and support development of a generation of researchers and institutions that can provide regulatory support.”
— Dr. Ingrid Katz

“All of this can and should be done now, not as a global pandemic is being unleashed. It is the only way we can ensure that we can effectively address this and all future pandemics,” added Dr. Katz.

Dr. Watson noted that combatting misinformation and improving the infrastructure for vaccine delivery and distribution could also help achieve vaccine equity.

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