The uneven toll of the coronavirus pandemic

A new scientific paper out this week shows a larger increase in excess deaths among Republicans after the Covid vaccine became widely available.


WASHINGTON — The official health emergency over Covid may be over, but the effects still linger. And this week the journal JAMA Internal Medicine, published a study that supported a theory many had suspected: The pandemic didn’t hit all Americans the same — and Republicans, who lagged behind in accepting the Covid vaccine, paid a steeper price. 

In the piece, researchers from Yale wrote that they examined 538,000 deaths of people 25 and older in Florida and Ohio between March 2020 and December 2021, and they found larger increases in excess deaths in that period among Republicans, particularly after the Covid vaccine was introduced.

Overall, researchers found registered Republicans saw a 15% higher increase in excess deaths (that is, deaths beyond what would normally be expected) than Democrats over the period studied. Much of that was driven by the time period after April 1, 2021, when the Covid vaccine was readily available. In the period between April 2021 and December 31, 2021, registered Republicans saw a 43% higher increase in excess deaths than Democrats did in Ohio and Florida. Much of the difference seems to have been driven by Ohio.

While researchers could not directly tie the increased Republican deaths to vaccine hesitancy, the data showed a clear correlation. The gap in excess death rates was larger in counties with lower vaccination rates, the researchers said. And readers will remember how many Republicans said they were uneasy about the vaccine and were skeptical about getting jabbed.

To test the theory laid out in the paper further, Data Download looked at deaths over the same time periods and used county-level 2020 presidential election results as a proxy for whether a county leaned Democratic or Republican. The data showed a similar pattern, especially where the post-vaccine period was concerned.

The combination of national county-level election results with county-level Covid death data from the data research group USAFacts shows the post-vaccine period in the study was harder on counties that voted for Donald Trump than on those that voted for Joe Biden in 2020.

Overall, Biden counties experienced more deaths from Covid than Trump counties in the time period studied: 429,000 versus 353,000. Of course, more people live in Biden counties than Trump counties and Democrat-leaning counties tend to be more densely populated and were therefore more prone to Covid’s spread.

But after the vaccine became widely available in spring 2021, the numbers flipped. Republican-leaning counties saw more deaths (and a greater percentage of their deaths) after the vaccine.

There were about 104,000 Covid deaths in Biden counties in that post-vaccine period, about 24% of the total Covid deaths in those counties in the period of study. There were more than 135,000 Covid deaths in Trump counties in the post-vaccine period, about 38% of the total Covid deaths in those counties in the study’s time period.

Those numbers have torn through families and local communities — and they could even matter in the 2024 election. The last few presidential races have been remarkably close, decided by just a few thousand votes in a few states. Consider 2020, when the winner was decided by a little more than 40,000 votes in just three states, Arizona, Georgia and Wisconsin.

President Joe Biden won Arizona by a little more 10,000 votes. He captured Georgia by about 11,800. Wisconsin was Biden’s biggest win of the three states, he carried it by 20,600 votes. In each case, the margin of victory was less than half of 1 point.

In other words, it doesn’t take much to shift a close presidential race.

The Covid post-vaccine patterns look similar in those three states. Trump-voting counties saw a greater share of their Covid deaths in the post-vaccine period than Biden counties.

In Georgia and Wisconsin, Trump-voting counties experienced more Covid deaths than counties that voted for Biden, and the difference only grew in the post-vaccine period. In Georgia, 50% of all the Covid deaths in Trump-voting counties occurred post-vaccine. In Wisconsin, the figure was 30% of all Covid deaths. In Biden-voting counties the post-vaccine percentages were lower. In Georgia, 41% of all Covid deaths took place after the vaccine. In Wisconsin’s Biden counties, 25% of all Covid deaths took place after the vaccine.

In Arizona, the story is a bit more complicated. Biden-voting counties had more deaths overall, in part because Maricopa County is very big and was very close, but Trump-voting counties saw a greater percentage of their deaths after the vaccine, 35%, than Biden-voting counties did, 28%.

To be clear, there is more than a little conjecture here. There are millions and millions of Trump voters in Biden counties and vice-versa. And in a close election, a lot of factors can affect the outcome — everything from the weather to long lines at polling places.

But the combination of the county vote totals, the Covid numbers and the research from in JAMA this week suggest a partisan Covid correlation that could impact voter numbers nationally and in key states in 2024. And if the 2024 presidential race is anything like those in 2020 or 2016, every vote will count.