Publication date: Jan 21, 2024
Objective: To investigate the relationship between vaccination rates and excess mortality during distinct waves of SARS-CoV-2 variant-specific infections, while considering a state’s GDP per capita. Methods: We ranked U.S. states by vaccination rates and GDP and employed the CDC’s excess mortality model for regression and odds ratio analysis. Results: Regression analysis reveals that both vaccination and GDP are significant factors related to mortality when considering the entire U.S. population. Notably, in wealthier states (with GDP above $65,000), excess mortality is primarily driven by slow vaccination rates, while in less affluent states, low GDP plays a major role. Odds ratio analysis demonstrates an almost twofold increase in mortality linked to the Delta and Omicron BA.1 virus variants in states with the slowest vaccination rates compared to those with the fastest (OR 1.8, 95% CI 1.7-1.9, p < 0.01). However, this gap disappeared in the post-Omicron BA.1 period. Conclusion: The interplay between slow vaccination and low GDP per capita drives high mortality.