COVID Excess Mortality Percentage, Racial/Ethnic Disparities in COVID Mortality, and Vaccine Effectiveness: Evidence from Linked Mortality and Vaccination Records

34 Pages Posted: 14 Jul 2022 Last revised: 4 Aug 2022

See all articles by Vladimir A. Atanasov

Vladimir A. Atanasov

William and Mary - Raymond A. Mason School of Business

Paula Natalia Barreto Parra

Northwestern University

Lorenzo Franchi

Northwestern University

Jeff Whittle

Clement J. Zablocki Medical Center - Department of Medicine

John Meurer

Medical College of Wisconsin

Eric Luo

Fitzhugh Mullan Institute for Health Workforce Equity, The George Washington University

Ruohao Zhang

Centre College

Bernard S. Black

Northwestern University - Pritzker School of Law

Date Written: July 6, 2022

Abstract

COVID-19 mortality rates rise strongly with age, but so do other natural causes of death. We develop a new measure of the COVID-19 mortality burden, the COVID Excess Mortality Percentage (CEMP), defined as COVID-19 deaths as a fraction of all deaths from natural causes other than COVID. We use this measure to study COVID-19 mortality in Indiana and Wisconsin, including racial/ethnic disparities in mortality rates. We find very high disparities, especially in 2020, with CEMP ratios for Hispanics to non-Hispanic Whites as high as 9:1 for ages 50-59. We find very different CEMP patterns by age and race/ethnicity, in the pre-vaccine period (2020) and the vaccine-available period (April 2021-March 2022).

We also report data on vaccine effectiveness (VE) in Milwaukee County, where we can link individual death records to vaccination records. Measuring VE based on CEMP controls for the potential for the vaccinated to be healthier and hence face lower COVID mortality risk without vaccination. VE measured this way is substantially lower than reported in many other studies (e.g., 60% for fully vaccinated (but not boosted) adults during 1Q 2022 (Omicron-dominant period) and 71% during 4Q 2021 (Delta-dominant period). Three-vaccine-dose VE is much higher, at around 90%, and similar for Moderna and Pfizer, but COVID mortality risk after two Pfizer doses is over twice the two-dose Moderna risk. The gap between two-dose and three-dose VE implies that tens of thousands of COVID decedents would likely have survived with a faster booster rollout.

The Online Appendix for this paper is available at http://ssrn.com/abstract=3706517.

Note:
Funding Information: This project was funded by the National Institutes of Health, award 3 UL1 TR001436-06S1.

Conflict of Interests: The authors have no competing interests.

Ethical Approval: Approved by the Medical College of Wisconsin Human Research Review Board.

Suggested Citation

Atanasov, Vladimir A. and Barreto Parra, Paula Natalia and Franchi, Lorenzo and Whittle, Jeffrey and Meurer, John and Luo, Qian and Zhang, Ruohao and Black, Bernard S., COVID Excess Mortality Percentage, Racial/Ethnic Disparities in COVID Mortality, and Vaccine Effectiveness: Evidence from Linked Mortality and Vaccination Records (July 6, 2022). Northwestern Law & Econ Research Paper No. 22-10, Available at SSRN: https://ssrn.com/abstract=3706392 or http://dx.doi.org/10.2139/ssrn.3706392

Vladimir A. Atanasov

William and Mary - Raymond A. Mason School of Business ( email )

P.O. Box 8795
Williamsburg, VA 23187-8795
United States

Paula Natalia Barreto Parra

Northwestern University ( email )

2001 Sheridan Road
Evanston, IL 60208
United States

Lorenzo Franchi

Northwestern University ( email )

2001 Sheridan Road
Evanston, IL 60208
United States

Jeffrey Whittle

Clement J. Zablocki Medical Center - Department of Medicine ( email )

5000 W. National Ave.
Milwaukee, WI 53295
United States

HOME PAGE: http://www.mcw.edu/display/router.asp?DocID=10377

John Meurer

Medical College of Wisconsin ( email )

United States
4145100375 (Phone)

HOME PAGE: http://https://www.mcw.edu/departments/institute-for-health-and-equity/people/john-meurer-md-mba

Qian Luo

Fitzhugh Mullan Institute for Health Workforce Equity, The George Washington University ( email )

2175 K St NW
Washington, DC 20052
United States

Ruohao Zhang

Centre College ( email )

600 West Walnut Street
Danville, KY 40422
United States

Bernard S. Black (Contact Author)

Northwestern University - Pritzker School of Law ( email )

375 E. Chicago Ave
Chicago, IL 60611
United States
312-503-2784 (Phone)

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