Overall benefit of the COVID-19 vaccine in the U.S.
A Commonwealth Fund study estimates that, through November 2022, COVID-19 vaccines prevented more than 18.5 million U.S. hospitalizations and 3.2 million deaths, and saved the country $1.15 trillion.
The modeling study estimated hospitalizations and deaths averted through the end of November 2022, at a time when 80% of the U.S. population had received at least one dose of COVID-19 vaccine.
Approved COVID-19 vaccines have been available in the U.S. since December 2020. Since December 12, 2020, 82 million infections, 4.8 million hospitalizations, and 798,000 deaths have been reported in the United States.
“Without vaccination the U.S. would have experienced 1.5 times more infections, 3.8 times more hospitalizations, and 4.1 times more deaths,” the authors wrote. “These losses would have been accompanied by more than $1 trillion in additional medical costs that were averted because of fewer infections, hospitalizations, and deaths.”
Fall 2022 booster benefits. There has been more than ample evidence in the U.S. BA.5 wave of COVID-19 that having two boosters reduced deaths (91%) and hospitalizations for people age 50 and over, and reduced hospitalizations (72%) for people ages 18 to 49. That data adds to the marked decreases in death for people age 50 and above who received a fourth shot as compared with the third shot. And vaccines help protect against Long Covid by 30-50% in systematic reviews, an important benefit that should not be taken for granted.
Main benefits of the COVID-19 vaccination for children
Research evidence shows the value of the COVID-19 vaccination for children. The usual yardstick is the number of hospitalizations and deaths, and for children ages 11 and below, these numbers are small, thus hampering comparisons between vaccinated and unvaccinated children. Here is the available evidence:
- In New York state, through the end of January 2022, hospitalizations were nearly two times higher for unvaccinated children ages 5 to 11 than vaccinated children, and nearly 4 times higher for unvaccinated 12- to 17-year-olds. These data are encouraging and comparable to data from adults during the Omicron wave that demonstrated estimated vaccine efficacy of 65% against hospital admissions after 2 doses of vaccine and 86% after 3 doses.
- During the height of the Omicron variant, among fully vaccinated children ages 5 to 11, COVID-19 vaccine effectiveness against hospitalizations was 83%, as opposed to 42% for partially vaccinated children. This study was conducted in Singapore between January and April 2022.
- Studies from Singapore, the United States and Italy find that two shots of the Pfizer–BioNTech vaccine offer moderate to good protection against hospitalization in children ages 5 to 11 and in adolescents, reducing the risk by between 40 and 83%. Estimates of protection levels vary widely by country and region, depending on factors such as the time elapsed since participants’ vaccination, testing intensity, and previous waves of infection.
In countries that offered children, particularly adolescents, a third dose, these boosters seem to be effective, according to U.S. data: Five months after adolescents received a second dose of the Pfizer vaccine, when their protection against visits to emergency-care departments had fallen to zero, a booster restored that protection to 81%.
- The observed overall vaccine efficacy against symptomatic COVID-19 in children 6 months to 4 years was 73.2% from 7 days after dose 3 (on the basis of 34 cases).
Parents’ views of vaccine effectiveness
The Boost Up project included a statewide survey of 1,342 parents of children ages 6 months to 17 years in Massachusetts, including oversamples of Black, Latino, and Asian parents. The survey was conducted March 11-26, 2023, via live telephone and online interviewing in English and Spanish and was funded by the State of Massachusetts via the Massachusetts Bureau of Infectious Diseases and Laboratory Sciences. Major design input was provided by the Harvard T.H. Chan School of Public Health.
Vaccines as protection for grandparents, vulnerable family and community members
According to the American Lung Association, vaccination not only reduces the risk of short- and long-term health complications from COVID-19, but it also slows the spread of the disease by preventing it from being passed onto others who are at high-risk for severe COVID-19 illness, like grandparents or daycare staff or teachers with underlying medical conditions. This also means there are less likely to be disruptions in education and childcare because of COVID-19 cases within schools and daycare.
How easily does COVID-19 spread in a home? A study found that once a COVID-19 infection occurred in a household, there was a high household COVID-19 rate, with more than 57% of infected households experiencing one or more transmissions and a 41% probability of infection for at-risk household members.
An analysis of 135 studies suggests that there is increased transmissibility of emerging COVID-19 variants within a household where there is prolonged close contact between household members and COVID-19 cases. Full vaccination plays an important role in reducing infectiousness.
The Commonwealth Fund. Two Years of U.S. COVID-19 Vaccines Have Prevented Millions of Hospitalizations and Deaths. Accessed October 12,2023. https://www.commonwealthfund.org/blog/2022/two-years-covid-vaccines-prevented-millions-deaths-hospitalizationsTopol Ground Truths.
Topol Ground Truths. https://erictopol.substack.com/.
Katz SE, Edwards K. Protecting Children Against Omicron. JAMA. 2022;327(22):2195–2197. doi:10.1001/jama.2022.7315.
Tan SHX, Cook AR, Heng D, Ong B, Lye DC, Tan KB. Effectiveness of BNT162b2 Vaccine against Omicron in Children 5 to 11 Years of Age. N Engl J Med. 2022 Aug 11;387(6):525-532. doi: 10.1056/NEJMoa2203209. Epub 2022 Jul 20. PMID: 35857701; PMCID: PMC9342421.
Nature. News feature. 11 October 2022. COVID jabs for kids: they’re safe and they work — so why is uptake so patchy?
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American Lung Association. 5 Reasons Your Child Should Get the COVID-19 Vaccination.
https://www.lung.org/blog/why-children-should-get-covid-19-vaccine#:~:text=Vaccination%20not%20only%20reduces%20the,staff%20with%20underlying%20medical%20conditions.
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