Maine counties with low vaccination rates have experienced far more COVID-19 deaths per capita than high-vaccination counties in the seven months since the vaccines became widely available.
The disparities are stark.
A Portland Press Herald/Maine Sunday Telegram analysis found that coastal counties with high vaccine uptake – such as Cumberland, Lincoln and Sagadahoc counties – have COVID-19 death rates about three times lower than low-vaccination counties such as Somerset, Piscataquis and Franklin counties.
The widest difference in death rates is a low of 2.23 COVID-19 deaths per 10,000 population in Sagadahoc County, compared with 8.94 deaths per 10,000 population in Franklin County. That’s about four times more deaths per capita in Franklin compared with Sagadahoc.
Sagadahoc’s vaccination rate is a full 15 percentage points higher than Franklin’s – 74.4 percent in Sagadahoc versus 59.4 percent in Franklin.
The analysis uses death rates for the period when vaccination was widely available and when most population groups had a significant amount of time to get the vaccine, June 1 through Dec. 28.
Cumberland County, Maine’s most populous and home to Greater Portland, boasts a vaccination rate of 81.9 percent, the best in Maine. It also has the third-lowest death rate since June: 2.47 COVID-19 deaths per 10,000 population.
The highest vaccination rates and lowest death rates tend to converge along the southern coast and the midcoast, while high-death and low-vaccination areas are more concentrated in Maine’s interior and northern regions.
The clear patterns are not a surprise to medical professionals who are seeing firsthand the toll of the disease and the impacts on families and communities.
“It’s very clear counties that are more highly vaccinated have seen fewer deaths and fewer hospitalizations,” said Dr. Cheryl Liechty, an infectious disease physician with MaineHealth’s Pen Bay Medical Center in Rockport and Waldo County General Hospital in Belfast. “It’s a good way to illustrate the power of vaccines.”
Liechty, who works with clinicians caring for COVID-19 patients, said seeing Maine people die from what is largely a preventable disease is “just wrenching.” Each one of them is someone’s uncle, aunt, grandparent, brother, sister, son or daughter.
As of last week, more than 1,500 Maine residents have died during the pandemic. Unlike some states, Maine does not have data to show how many of those who died were vaccinated or unvaccinated.
The data from hospitals is clear, however.
Even with 70 percent of the state’s residents now fully vaccinated, about two-thirds of all hospitalized patients are unvaccinated, state health officials and hospital officials have said. The disparity between vaccinated and unvaccinated is even more clear among the patients most in danger of dying – those in intensive care – where about nine in 10 are unvaccinated.
“We continue to see that vaccination status is the most powerful predictor of who is being admitted to the hospital,” Liechty said. “Almost everybody who is really sick is not vaccinated.”
Dr. Laura Blaisdell, a South Portland pediatrician and infectious disease expert, said the correlation between COVID-19 deaths and low vaccination rates is not surprising considering all the research and clinical trials that went into developing the vaccines, plus real-world experience since they’ve been rolled out in early 2021.
“There’s no doubt in the scientific community that these vaccines have blunted the pandemic in really meaningful ways,” Blaisdell said. “The science and the data doesn’t lie. We are seeing really clear associations between survival rates and being vaccinated.”
Blaisdell said there could be other factors at play in the death disparities among counties – some counties may have older populations than others, increasing the risk of death for the older-skewing counties. But Blaisdell said, nevertheless, the connection between vaccination and preventing death is strong.
Dr. Nirav Shah, Maine CDC director, cited U.S. Centers for Disease Control and Prevention statistics in a social media post this month about the clear link between vaccines and death rates.
“The impact of vaccination on risk of death from COVID-19 is even more stark,” Shah wrote. “In October, an unvaccinated person had a 14 times higher risk of dying from COVID-19 compared to a fully vaccinated person.”
In Maine, October is when deaths from the delta wave accelerated, with 459 of the 650 deaths since June 1 occurring in October, November or December. The December deaths likely will increase when reported in January, as the Maine CDC reviews death certificates and finds more deaths caused by COVID-19.
Nationally, cases are climbing as the omicron variant takes over – it’s estimated to account for 58 percent of cases in the United States. The seven-day average of daily new cases was about 316,000 across the country, according to the U.S. CDC, the highest point of the entire pandemic.
It’s not yet clear if the pace of deaths from the pandemic is going to rise, or how much.
Dr. Anthony Fauci, the White House’s medical adviser, said in a Dec. 26 appearance on ABC News that the omicron variant may be less severe, but its contagiousness will make for a difficult winter ahead.
“If you have many, many, many more people with a less level of severity, that might kind of neutralize the positive effect of having less severity when you have so many more people,” Fauci said.
There was some hope from South Africa, where health officials there called the omicron wave a “flash flood” that peaked quickly, declined fast and did not result in a surge of deaths, as omicron is believed to cause less severe disease. The rise in deaths was “marginal” according to South African officials quoted in The New York Times.
While omicron’s death rate in the U.S. is still unknown, the correlation between vaccination rates and death during the past several months also is evident when comparing states.
States with low vaccination rates – such as West Virginia, Wyoming and Alabama – are experiencing much higher COVID-19 death rates per capita since April versus relatively high-vaccination states such as Vermont, Massachusetts and Maine, which have low death rates overall, according to a New York Times analysis.
While data is still emerging, the vaccines also are holding up against the highly transmissible omicron variant in terms of reducing the risk of hospitalization and death, even though breakthrough cases of COVID-19 among the vaccinated seem to be more common, Blaisdell said.
Early studies and real-world data from countries that have experienced an omicron surge before the U.S. are indicating that omicron may cause less-severe disease when compared with delta and previous variants. Maine is not yet seeing a spike in the omicron variant, but cases of omicron are growing, according to sequencing being done at Jackson Laboratories.
Blaisdell said even if a vaccinated person gets infected, ending up with the equivalent of the common cold – rather than being sick for weeks with the possibility of going to the hospital or dying – clearly means the vaccines are working.
Liechty said the vaccines are “amazing” and “continue to do the job that we tasked them with.”
“I think sometimes we forget what the task was,” Liechty said. “The task was to prevent hospitalizations and death.”
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