The political maelstrom swirling around coronavirus vaccines may be to blame for a higher rate of excess deaths among registered Republicans in Ohio and Florida during the coronavirus pandemic, according to a study published Monday.
The report in the journal JAMA Internal Medicine underscores the partisan divide over coronavirus vaccines that have saved lives but continued to roil American politics even as the pandemic has waned.
Yale University researchers found that registered Republicans had a higher rate of excess deaths than Democrats in the months following when vaccines became available for all adults in April 2021. The study does not directly attribute the deaths to covid-19. Instead, excess mortality refers to the overall rate of deaths exceeding what would be expected from historical trends.
The study examined the deaths of 538,139 people 25 years and older in Florida and Ohio, between January 2018 and December 2021, with researchers linking them to party registration records. Researchers found the excess death rate for Republicans and Democrats was about the same at the start of the pandemic in March 2020.
Both parties experienced a sharp but similar increase in excess deaths the following winter. But after April 2021, the gap in excess death rates emerged, with the rate for Republicans 7.7 percentage points higher than the rate for Democrats. For Republicans, that translated into a 43 percent increase in excess deaths.
Researchers said the gap in excess death rates was larger in counties with lower vaccination rates and noted that the gap was primarily driven by voters in Ohio. The results suggest that differences in vaccination attitudes and the uptake among Republican and Democratic voters "may have been factors in the severity and trajectory of the pandemic" in the United States.
In their paper, Yale researchers Jacob Wallace, Jason L. Schwartz and Paul Goldsmith-Pinkham cautioned the data did not include individual causes of death or whether someone had been vaccinated. The data did not look at voters who had no party affiliation and was limited to Florida and Ohio, which aren't neat comparisons to other states.
The excess death rates between groups could be affected by other factors, such as differences in education, race, ethnicity, underlying conditions and access to health care, said Wallace, an assistant professor at the Yale School of Public Health and the lead author.
"We're not saying that if you took someone's political party affiliation and were to change it from the Democratic Party to the Republican Party that they would be more likely to die from covid-19," Wallace said.
Researchers also pointed out that more than 50 million Americans have yet to get an initial coronavirus vaccine, and reasons often extend "beyond political beliefs or party affiliation alone." Surveys have shown Republicans lagged in vaccination rates, including for booster shots. KFF estimated that between June 2021 and March 2022, at least 234,000 covid-19 deaths could have been prevented if people had received a primary series of vaccinations.
The Yale study adds to a growing body of research indicating that Republican messaging on vaccines and other public health measures such as mask-wearing, limiting crowds and social distancing may have led to preventable deaths.
Last year, a study from researchers at the University of Maryland and University of California at Irvine published in Health Affairs concluded that Republican-majority counties experienced nearly 73 additional deaths per 100,000 people relative to majority Democratic counties through October 2021. The study suggested that vaccine uptake accounted for only 10 percent of the Republican-Democrat gap in deaths.
"We have all these data points that really highlight the relevance of sound public health policy," said Neil Jay Sehgal, who led the Maryland study and is now an associate professor at the University of Washington School of Public Health.
The release of the Yale study comes as the vaccine rollout and policies under President Biden have faced criticism by some Republicans, including members of the Republican-led House Select Subcommittee on the Coronavirus Pandemic.
In Florida, Gov. Ron DeSantis (R) pushed the rollout of vaccines early in the pandemic. But as he prepared to mount a bid for the Republican presidential nomination, DeSantis displayed increased hostility toward vaccines, petitioning for a state grand jury to investigate supposed wrongdoing related to vaccines. Florida's health department even issued a "health alert" on mRNA vaccine safety, which drew sharp rebukes.
Public health officials fear mixed messaging on coronavirus vaccines by Republicans is shaping attitudes toward the vaccine in dangerous ways.
In a nationwide survey published in March by the University of South Florida, only 49 percent of Republicans said they were "very" or "somewhat confident" that coronavirus vaccines are safe, contrasted with 88 percent of Democrats. Stephen R. Neely, a professor at USF's School of Public Affairs who conducted the survey, said the Yale study was important because it highlighted how sharply partisanship over coronavirus vaccine safety and efficacy has led to unnecessary deaths.
"It's one of the most telling metrics I've seen in how the politicization of the pandemic has played out in the real world," Neely said.