US Republicans more likely to die than Democrats once COVID-19 vaccines were available

Registered Republican voters in two US states were more likely to die than Democrat voters during the first year that COVID-19 vaccines were available, according to new data from half a million individuals.

A study published in JAMA Internal Medicine has found that there was a significant difference in the death rate between voters of the two major US parties from 1 May 2021 to 31 December 2021, when vaccines were available to all adults.

The researchers, who are based at Yale University, US, examined mortality data from Ohio and Florida from 1 January 2018 to 31 December 2021.

These were the only two US states with publicly available voter registration data.

The researchers looked at all individuals older than 25 who had died in this period – a total of 538,159 people – and compared this data to political parties the people were registered in in 2017.

They examined the “excess death rate”: death rates higher than would be expected, given previous mortality trends.

After the researchers had adjusted their data for age, they found that people registered in both parties had the same excess death rate up to May 2021.

But after 1 May, when any US adult could get a COVID-19 vaccine, the registered Republicans’ excess death rate jumped to 43% above that of Democrats.

These differences were largest in counties with low vaccination rates.

The researchers couldn’t get vaccination data on each individual, so they couldn’t establish the vaccination rates of the people in their study.

“Our findings suggest that political party affiliation became a substantial factor only after COVID-19 vaccines were available to all adults in the US,” write the researchers in their paper.

“Although the lack of individual-level vaccination status limited our ability to note further associations, the results suggest that well-documented differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been factors in the severity and trajectory of the pandemic.”

But the researchers point out that there could be other factors influencing their results.

“One alternative explanation is that political party affiliation is a proxy for other risk factors (beyond age, which we adjusted for) for excess mortality during the COVID-19 pandemic, such as rates of underlying medical conditions, race and ethnicity, socio-economic status, or health insurance coverage, and these risk factors may be associated with differences in excess mortality by political party, even though we only observed differences in excess mortality after vaccines were available to all adults,” write the authors.

Given there is a link between political affiliation and vaccine acceptance in the US, the researchers suggest that this mortality trend may have extended past the end of their dataset, in 2021.

They point out that 50 million adults in the US still haven’t had a primary course of COVID-19 vaccines.

While they say that “the causes of this vaccine hesitancy and refusal are varied and extend beyond political beliefs or party affiliation alone”, they also add that “engagement with conservative and Republican leaders, in particular, has been identified as a promising approach to promoting COVID-19 vaccine acceptance”.