Unvaccinated Texans 40 times more likely to die of covid than those fully vaccinated in 2021, study says

A medic from the Houston fire department prepares to transport a covid-19 patient to a hospital on Aug. 24. (John Moore/Getty Images)

A vast majority of Texans who have died of covid-19 since the beginning of the year were unvaccinated, according to a grim new Texas health department report released Monday.

The report from the Texas Department of State Health Services examined data from Jan. 15 to Oct. 1 and found that unvaccinated people were much more likely to get infected and die of the coronavirus than those who got their shots.

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Of the nearly 29,000 covid-linked fatalities in Texas during that period, more than 85% were unvaccinated individuals. Nearly 7% of the deaths were among partially vaccinated people, while nearly 8% were fully vaccinated.

The figures highlight just how much more at risk the unvaccinated population has been this year: In all age groups, the state's unvaccinated were 40 times more likely to die than fully vaccinated people. The study also found that the unvaccinated in all age groups were 45 times more likely to have a coronavirus infection than fully vaccinated people. It also looked closely at data from September and underlined the impact of the highly contagious delta variant, which fueled a surge in Texas, as it did in much of the country.

The report from Texas health officials underscores the risk that cases and death counts would spike among the unvaccinated, echoing the alarms that public health officials have been sounding throughout the year. The report, which Texas health officials say is the first statistical assessment of the real-world effect there of vaccines against the coronavirus, also highlights the impact in a state where Republican leaders have sharpened attacks on public health strategies throughout the pandemic. Last month, Texas Gov. Greg Abbott, R, banned any entity in the state from mandating vaccines for workers or customers.

"This analysis quantifies what we've known for months," Jennifer Shuford, the state's chief epidemiologist, said in a statement. "The COVID-19 vaccines are doing an excellent job of protecting people from getting sick and from dying from COVID-19. Vaccination remains the best way to keep yourself and the people close to you safe from this deadly disease."

Shuford's remarks backed the views of other health leaders including Rochelle Walensky, director of the Centers for Disease Control and Prevention, who has described the nation's ordeal as "a pandemic of the unvaccinated."

While Texas is still averaging more than 3,200 new daily infections and almost 110 new deaths a day, the state, like the nation overall, has seen case and death totals fall, according to data tracked by The Washington Post.

Nearly 54% of the state's population is fully vaccinated, trailing the national vaccination rate of 58.4%.

The state data "shows what we already knew - that the unvaccinated are increasing their risk of severe covid disease and death, and we have the data now to prove this," said Bhavna Lall, a clinical assistant professor at University of Houston's college of medicine.

She said she's troubled by leaders questioning public health mitigation measures and vaccination mandates, particularly in a state that's had more than 70,000 deaths since the pandemic's start - one of the highest total death counts in the country.

"By debating mitigation measures, we're not helping in any way," she said. "We know what works for decreasing the spread of covid. We know that vaccination works, we know masking works."

Recent findings from the CDC similarly highlighted risks for the unvaccinated. A CDC study published in September found that people who were not fully vaccinated in the spring and summer were more than 10 times more likely to be hospitalized and 11 times more likely to die of covid-19 than people who were fully vaccinated.

The new report from Texas also breaks out findings from the weeks between Sept. 4 and Oct. 1, which the health department said researchers wanted to analyze to measure the vaccine's effectiveness as the delta variant surged in the state.

In that time frame, unvaccinated people were 20 times more likely to die for a reason related to covid than fully vaccinated people, and were 13 times more likely to become infected with the virus than the fully vaccinated.

"The real-time data in Texas speaks to the science behind, and adds strength to the significant science and evidence-based practices recommended by the CDC, state health department, doctors and health-care systems that vaccines work," said Rama Thyagarajan, an assistant professor at the University of Texas at Austin's Dell Medical School.

She noted that the small percentage of fully vaccinated Texans who died were "most likely the oldest and sickest of the group."

The report notes that most deaths, at more than 35%, occurred among people 75 years and older, followed by about 25% of deaths among people ages 65 to 74.

While the coronavirus vaccine had a strong protective effect for all people, the report notes, the findings varied by age on the protective impact for covid-related deaths. Unvaccinated individuals in their 40s were 55 times more likely to die of covid-19 in September compared with fully vaccinated people of the same age. For people ages 75 and older, the unvaccinated were 12 times more likely to die than the vaccinated in that time frame.

The report also highlighted the severity of the impact of the delta variant overall. Regardless of vaccination status, the report says, Texans were four to five times more likely to become infected with the coronavirus or to suffer a covid-linked death in August, when the variant was prevalent in the state, than in April, before its presence was widespread.

Lall said it was "sad to see that during the time when delta was surging, we had so many people . . . dying because they just didn't get the vaccine."

She said the latest report from Texas, which shows the protection offered by vaccination, underlines the need to encourage not only more vaccinations but also public health measures that can help stop the virus from continuing to surge.

"We need to be aware that other parts of the world are surging - Europe has high covid cases right now - and if we don't get more people vaccinated in America, we're still at risk," she said, adding: "No one wants to go through these surges again and again."

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