Unvaccinated people died of COVID-19 at a higher rate than vaccinated people; vaccines prevented hundreds of thousands of deaths

A series of Facebook posts from December 2024 questioned how “Billions of Unvaxxed people with NO Boosters are still alive”. This kind of loaded question is a typical example of the “just asking questions” tactic, which involves framing accusations as questions to make them sound more acceptable and to avoid having to provide supporting evidence for those accusations.

These posts contain two assumptions: firstly, that unvaccinated people should all have died by now; and secondly, the fact that unvaccinated people haven’t all died is evidence that COVID-19 vaccines aren’t necessary.

However, these assumptions are incorrect, as epidemiological data that we discuss below will show.

The claim hinges on incorrect assumptions about COVID-19 mortality risks

The claim misunderstood the concept of risk, which refers to the probability of an event occurring, not a certainty. This is a classical example of a fallacy called survivorship bias, in which the part of a population that survived is mistaken as the entire group, ignoring the fate of all those who died.

To die of COVID-19, a person must first become infected, and then develop severe disease that leads to death. Being unvaccinated increases the likelihood of both infection and severe outcomes. However, this doesn’t mean that being unvaccinated guarantees infection and death.

The posts assume that everyone has already contracted COVID-19 and that anyone who gets COVID-19 will die unless they’re vaccinated. But not everyone got the disease and COVID-19 doesn’t have a 100% mortality rate. According to the World Health Organization, the majority of the world population didn’t get COVID-19. Even before the vaccines were available, the highest case mortality rate for COVID-19 was estimated at around 5%. Therefore, this assumption is incorrect.

Using the same flawed logic, one could argue that the fact some people who never wore seat belts are still alive today proves that seat belts are unnecessary. This reasoning ignores the role of seat belts—and vaccines—in reducing the likelihood of harm, even if they don’t guarantee specific outcomes for every individual.

Moreover, it’s important to stress that death isn’t the only negative outcome of COVID-19. Severe COVID-19 may increase the risk of heart attack and stroke in the long term. Furthermore, many people who recovered from the initial onset of COVID-19 still suffer from long COVID.

Research has shown that being vaccinated reduces the risk of post-COVID cardiovascular complications and of long COVID^[1-3]. Thus, we can see that not being vaccinated can expose a person to life-threatening risks.

Unvaccinated people died at a higher rate from COVID-19 than vaccinated individuals

On top of the flawed reasoning that we highlighted in the section above, the claim is inconsistent with available data on mortality of unvaccinated individuals.

First, and contrary to what the claim suggests, many unvaccinated people died from COVID-19. Crude mortality figures from the U.S. Centers for Disease Control and Prevention (CDC) showed that more than 180,000 unvaccinated people died of COVID-19 in the U.S. between April 2021 and August 2022. In the U.K., around 6,800 unvaccinated people died of COVID-19 between April 2021 and May 2023.

Therefore, the claim drew an incomplete and misleading picture as it ignores the fact that many unvaccinated people did die from COVID-19.

But crude mortality figures provide limited information as they are influenced by the total number of unvaccinated people in the population and how old and vulnerable to COVID-19 these people were, as Science Feedback previously explained.

To understand whether getting vaccinated reduces COVID-19 mortality, one needs to look at the mortality rate after adjusting for the proportion of vaccinated and unvaccinated people in the population and for the age of individuals.

The data aggregator Our World in Data provided such data for the U.S., Switzerland, and Chile. Data unambiguously showed that unvaccinated people died in a much higher proportion than vaccinated people. Vaccinated people who received boosters showed the lowest COVID-19 mortality (Figure 1).

Data from the Canada Communicable Disease Report also showed that “unvaccinated individuals were much more likely to be hospitalized or to die” compared to vaccinated people during the first two years of the country’s vaccination campaign (December 2020 to January 2022)^[4].

Therefore, while many unvaccinated individuals are still alive today, that doesn’t change the fact that unvaccinated people died at a higher rate from COVID-19 than vaccinated people.

Mortality estimates suggest that many unvaccinated people who died from COVID-19 could still be alive today had they been vaccinated

Now that we have established that unvaccinated people died from COVID-19 at a higher rate than vaccinated people, we can ask whether being vaccinated could have prevented deaths that occurred in the unvaccinated population.

One model—not yet peer-reviewed—using real-world data on infections, deaths, and vaccinations in U.S. states estimated that about 318,000 COVID-19 deaths could have been avoided in the U.S. between January 2021 and April 2022 (19,000 deaths per month) if 100% of the population had been vaccinated^[5]. Another study estimated that 232,000 deaths that occurred in the U.S. between June 2021 and August 2022 could have been prevented if those people had been vaccinated (15,300 deaths per month)^[6]. Both studies used slightly different methodologies but yielded comparable results, lending strength to their conclusions.

Conclusion

Death reports clearly showed that unvaccinated people died from COVID-19 in a higher proportion than vaccinated individuals. While the posts are correct in saying that many unvaccinated people still remain alive, this isn’t evidence that COVID-19 vaccines don’t work or aren’t needed.

It’s unsurprising that many unvaccinated people survived the pandemic because not everybody in the world contracted COVID-19 and because COVID-19 doesn’t have a 100% mortality rate even for unvaccinated people. That said, analyses showed that not getting vaccinated raised one’s risk of dying from COVID-19 and that hundreds of thousands of deaths could have been prevented by vaccination, demonstrating the benefit of COVID-19 vaccines.

REFERENCES

• 1 – Martí Català et al. (2024) The effectiveness of COVID-19 vaccines to prevent long COVID symptoms: staggered cohort study of data from the UK, Spain, and Estonia. The Lancet Respiratory Medicine.
• 2 – Trinh et al. (2024) Effectiveness of COVID-19 vaccines to prevent long COVID: data from Norway. The Lancet Respiratory Medicine.
• 3 – Mercadé-Besora et al. (2023) The role of COVID-19 vaccines in preventing post-COVID-19 thromboembolic and cardiovascular complications. Heart.
• 4 – Dam et al. ( 2024) COVID-19 outcome trends by vaccination status in Canada, December 2020–January 2022. Canada Communicable Disease Report.
• 5 – Zhong et al. (2022) Estimating Vaccine-Preventable COVID-19 Deaths Under Counterfactual Vaccination Scenarios in the United States. MedRXiv.
• 6 – Jia et al. (2023) Estimated preventable COVID-19-associated deaths due to non-vaccination in the United States. European Journal of Epidemiology.