Unvaccinated individuals now account for the vast majority of COVID-19 hospitalizations and deaths in the U.S., according to available data

Key takeaway

COVID-19 vaccines authorized by the U.S. Food and Drug Administration have proved highly effective at preventing severe disease and death in vaccinated individuals. Over 95% of COVID-19 hospitalizations and deaths from the past few months occurred among unvaccinated people and could have been avoided by vaccination.

Reviewed content

Verdict:

Accurate

Claim:

“99.2% of U.S. COVID deaths in June were unvaccinated people”

Verdict detail

Accurate: The U.S. Centers for Disease Control and Prevention (CDC) doesn’t provide official estimates of the percentage of COVID-19 hospitalizations and deaths in fully vaccinated individuals due to data limitations. However, the claim that over 99% of current COVID-19 hospitalizations and deaths occur in unvaccinated people is accurate, according to preliminary CDC data and statements from its director.

See our method of evaluation

Full Claim

“99.2% of U.S. COVID deaths in June were unvaccinated people”

Global COVID-19 vaccination received a great deal of public attention for being the largest global rollout of vaccines to date. COVID-19 vaccines authorized by the U.S. Food and Drug Administration (FDA) demonstrated high efficacy in large clinical trials^[1-3]. But how effective they would be at preventing infection, disease, and death in the real world still remained an object of study.

As more and more people are getting vaccinated in many countries, more data about COVID-19 vaccines’ effectiveness in real-world conditions are becoming available. As of 6 July 2021, an estimated 24% of the world population had received at least one dose of one of the 12 COVID-19 vaccines listed by the World Health Organization as having full approval or emergency use authorization. In the U.S., 55% of the population have received at least one dose of a COVID-19 vaccine, and more than 157 million people (47.5%) have been fully vaccinated.

This tweet published on 4 July 2021 claimed that 99.2% of the COVID-19 deaths in June 2021 in the U.S. occurred among unvaccinated people, implying that vaccination might prevent most COVID-19 deaths. The tweet was later shared on Facebook by the political commentator Brian Tyler Cohen, receiving thousands of interactions in one day.

Although the tweet didn’t cite its source, Anthony Fauci, the director of the U.S. National Institute of Allergy and Infectious Diseases, mentioned the same 99.2% figure during a 4 July 2021 interview hosted by Chuck Todd on the NBC program “Meet the Press”:

“Well, if you look at the number of deaths, about 99.2% of them are unvaccinated. About 0.8% are vaccinated. No vaccine is perfect. But when you talk about the avoidability of hospitalization and death, Chuck, it’s really sad and tragic that [al]most all of these are avoidable and preventable.”

Indeed, a growing body of evidence indicates that FDA-authorized COVID-19 vaccines are highly effective at preventing hospitalization and death. Yet, COVID-19 vaccines aren’t 100% effective, and a small percentage of people who are fully vaccinated may still get COVID-19. These cases of infection among vaccinated people are known as vaccine breakthrough cases.

As of 30 April 2021, the CDC received 10,262 reports of vaccine breakthrough infections, one-third of them asymptomatic^[4]. On 1 May 2021, the CDC stopped monitoring asymptomatic and mild cases in fully vaccinated individuals to focus only on hospitalized and fatal cases. As of 28 June 2021, 4,427 patients with COVID-19 vaccine breakthrough infections were hospitalized, and 879 died. As the CDC website explains, these reports included all patients who tested positive for COVID-19, even if their hospitalization or death was unrelated to COVID-19.

Due to these and other data limitations, the CDC doesn’t officially estimate the percentage of COVID-19 cases, hospitalizations, and deaths occurring in fully vaccinated people. Still, the director of the U.S. CDC, Rochelle Walensky, said at a 1 July 2021 White House briefing that preliminary data from January to June 2021 suggested that about 99.5% of COVID-19 deaths in the U.S. occurred in unvaccinated people.

An Associated Press analysis of data from the CDC arrived at a similar conclusion. In May 2021, fully vaccinated people accounted for fewer than 1,200 (1.1%) hospitalizations and 150 (0.8%) deaths of the more than 100,000 total hospitalizations and 18,000 COVID-19 deaths reported in the U.S. This means that a high proportion of COVID-19 deaths might be preventable by vaccination, as the tweet implied.

In addition to preventing severe disease and death, the results from a June 2021 CDC study published in the New England Journal of Medicine indicated that full vaccination with mRNA COVID-19 vaccines might also reduce the risk of infection by 91%^[5]. Finally, FDA-authorized COVID-19 vaccines also reduce the risk of infection with all known variants of the virus, according to a 2 July 2021 weekly review from the CDC’s COVID Data Tracker.

Similar studies in other countries also found that most COVID-19 deaths occurred in unvaccinated individuals, and COVID-19 vaccines could prevent them.

For example, one study including surveillance data from the first four months of the vaccination campaign in Israel showed that two doses of the Pfizer-BioNTech mRNA COVID-19 were more than 91% effective at preventing infection, and more than 96% at preventing hospitalization, and death^[6].

Likewise, a 25 June 2021 preliminary study from the U.K.’s Public Health England in 3,975 essential workers found that fully vaccinated people were about 90% protected against infection. Partially vaccinated people were still 78% less likely to become infected than unvaccinated people. Full COVID-19 vaccination was also 96% effective at preventing hospitalization with the Delta variant of the virus, first identified in India.

In summary, the claim that most COVID-19 deaths occurred among unvaccinated individuals is accurate, according to available evidence. No vaccine is 100% effective, and therefore a small number of hospitalizations and deaths are expected among fully vaccinated individuals. However, recent data from the U.S. and other countries suggest that COVID-19 vaccines are highly effective and might prevent most COVID-19 severe cases and deaths in the U.S.

REFERENCES

• 1 – Polack et al. (2020) Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. New England Journal of Medicine.
• 2 – Baden et al. (2020) Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine. New England Journal of Medicine.
• 3 – Sadoff et al. (2021) Interim Results of a Phase 1–2a Trial of Ad26.COV2.S Covid-19 Vaccine. New England Journal of Medicine.
• 4 – CDC COVID-19 Vaccine Breakthrough Case Investigations Team (2021) COVID-19 Vaccine Breakthrough Infections Reported to CDC — United States, January 1–April 30, 2021. Morbidity and Mortality Weekly Report.
• 5 – Thompson et al. (2021) Prevention and Attenuation of COVID-19 by BNT162b2 and mRNA-1273 Vaccines. New England Journal of Medicine.
• 6 – Haas et al. (2021) Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data. The Lancet.