Washington, DC—How much difference did pharmacy staff and other healthcare professionals providing COVID-19 vaccines make in saving the health and lives of older Americans during the pandemic?

County-level COVID-19 vaccination rates were significantly associated with reductions in the odds of COVID-19 infections and severe outcomes among Medicare beneficiaries, according to population-level regression analysis.

Without COVID-19 vaccinations, according to the study led by U.S. Department of Health and Human Services researchers, more than half a million Medicare fee-for-service beneficiaries in the study cohort might have had a COVID-19 infection between January and May 2021, with almost 203,000 of those hospitalized because of that. An estimated one-third of those patients, about 71,000, might have died.

“Projected to the full Medicare population, our study estimated vaccinations were associated with approximately a quarter of a million (265,000) fewer Medicare beneficiaries with COVID-19 infection, 107,000 fewer COVID-19 hospitalizations, and 39,000 fewer COVID-related deaths among all Medicare beneficiaries by the end of May 2021,” the authors noted.

One interesting finding was that the strong negative linear relationship between county-level vaccination rates and COVID-19 outcomes among Medicare beneficiaries appeared to taper off at higher vaccination rates. Researchers said that data suggest that “initial increases in vaccination rates are likely very effective and even a modest increase in vaccination rates has a large payoff; accordingly, increasing vaccination rates in low vaccination rate counties may have a larger impact on mitigating COVID-19 harms than further increasing rates in counties that already have high vaccination rates.”

Another finding emphasized in the report is that “to protect Medicare beneficiaries, a high vaccination rate among those 65 and older on its own is not as effective as high vaccination rates among all adults.”

The authors reported that the largest percent reduction was shown for American Indians and Alaska Natives (AI/AN), with an estimated reduction in infections of 21%, compared with 18% among white beneficiaries, and reduction in deaths of 25% compared with 22% among white beneficiaries. White beneficiaries, who made up 81% of the study cohort, had the largest estimated number of reductions in overall COVID-19 outcomes, however.

In the total Medicare population, the study identified the following reductions of:

• 29,000 infections and nearly 4,600 deaths among black beneficiaries
• 29,000 infections and nearly 5,000 deaths among Hispanic beneficiaries
• Nearly 7,600 infections and 1,400 deaths among Asian beneficiaries
• 2,000 infections and 400 deaths among AI/AN beneficiaries.

When COVID-19 vaccinations were introduced in the United States in December 2020, 20 million people already had been infected, and 352,000 patients had died over the first 9 months of the COVID-19 pandemic. Nearly 80% of deaths were estimated to be among patients aged 65 years and older who were also Medicare eligible based on age.

“Medicare beneficiaries, therefore, are a high-risk group who are likely to see significant benefit from COVID-19 vaccinations,” the study noted. “Understanding how the initial U.S. COVID-19 vaccination effort potentially reduced COVID-19 infections, hospitalizations, and deaths in the Medicare population can help inform continued efforts to improve vaccination rates and mitigate the harms from COVID-19.”

For the period of January to May 2021, when vaccination grew from 1% to 47% among adults aged 18 to 64 years and from 1% to 80% among those aged 65 years and older, the study determined an 11% to 12% decrease in weekly COVID-19 hospitalizations and deaths among Medicare beneficiaries for every 10% increase in county vaccination rates.

Researchers also concluded that vaccines were linked to a reduction of about 5,600 deaths among nursing home Medicare beneficiaries.

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