COVID-19 preventable mortality and leading cause of death ranking

Note: This brief was originally published on October 13, 2021 and was updated in December 2021. 

This brief examines how deaths from COVID-19 rank among other leading causes of death in the U.S. We find that COVID-19 was the third leading cause of death in November 2021. We also find that in October, COVID-19 was the number 1 cause of death for people age 45-54 and in the top 7 leading causes of death for other age groups, aside from infants.

We also estimate that 163,000 COVID-19 deaths could have been prevented by vaccination since June 2021, when safe and effective COVID-19 vaccines were widely available to all adults in the U.S.

COVID-19 was the 3rd leading cause of death in the U.S. in November 2021


Looking at the most recent data available on deaths from COVID-19 and other causes, we estimate that COVID-19 is the number 3 leading cause of death in the U.S. in November 2021. Deaths from other causes represent the daily average deaths from January through June of 2021. (Average daily deaths from accidents and suicides in the chart above are from 2020, as 2021 data are not yet available.)

The number of daily deaths from COVID-19 had decreased remarkably from the once staggering 3,118 deaths per day in January 2021 but started increasing again, in August 2021, with the spread of the Delta variant. In November 2021, COVID-19 took the lives of 1,110 people per day on average. By comparison, heart disease, which is typically the number one cause of death in the U.S. each year, leads to the death of about 2,000 people per day, and cancer claims about 1,600 lives per day, on average.

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As of December 2021, COVID-19 deaths are on the rise again. An average of almost 1,600 people per day continued to die of COVID-19 in the first eight days of December 2021. An overwhelming majority of COVID-19 deaths in the U.S. have been among unvaccinated people.

COVID-19 rank fell to number 7 among leading causes of death in July but is back up to number 3 in November 2021


The chart above combines data on COVID-19 mortality rates from KFF’s tracker with data from the Centers for Disease Control and Prevention (CDC) to examine weekly counts of death by jurisdiction and cause of death and monthly provisional counts of deaths by select causes. Deaths from COVID-19 and other causes in the chart above are the average daily deaths in each month of 2020 and 2021.

COVID-19 was the number 1 leading cause of death for people ages 45-54 years in October 2021


To rank COVID-19 among other leading causes of death by age groups, we looked at COVID-19 deaths for each age group in 2021 and the most recent available data for other “rankable” age-specific leading causes, including congenital disorders and perinatal conditions that mostly affect children.

COVID-19 was among the top 7 leading causes of death for all non-infant age groups in October 2021. In October 2021, COVID-19 ranked as the number 1 above cancer for people age 45-54, number 2 above suicide for people ages 25-34, number 2 above cancer for people ages 35-44, and number 2 above heart diseases for people ages 55-64.

Even among children age 1-14, who are at relatively low risk of severe illness compared to older adults, COVID-19 was in the top 10 leading causes of death from August through October 2021. Among children age 5-14, COVID-19 ranked as the number 6 leading cause of death in August and the number 5 leading cause of death in September. Among children ages 1-4, COVID-19’s rank rose from number 13 to number 7 among leading causes of death in August 2021 and held there in September.

Approximately 163,000 COVID-19 deaths since June 2021 likely would have been prevented with vaccinations   


As of November 30, 2021, the cumulative number of deaths attributed to COVID-19 in the U.S. from the start of the pandemic is 780,561. COVID-19 vaccines that are free, safe, and highly effective have been widely available to all adults in the U.S. since early May 2021. Older and higher-risk adults in the U.S. had access to these vaccines months earlier. Therefore, by June 2021, adults in the U.S. generally could have been fully vaccinated and protected from most cases of severe illness or death due to COVID-19.

To estimate the number of COVID-19 deaths that could have been prevented with vaccines, we looked at COVID-19 deaths among unvaccinated people in the months after vaccines were widely available (June through November 2021). We summed COVID-19 deaths in each month since June and subtracted COVID-19 deaths among children age 0-17 years.

Then, we subtracted COVID-related deaths among vaccinated people with a symptomatic breakthrough COVID-19 infection from total COVID-19 deaths among adults in each month. Deaths among vaccinated people with a symptomatic breakthrough COVID-19 infection were available from CDC through September 2021; for October-November, we assumed a conservative rate of 4% of total COVID-19 deaths were among those fully vaccinated based on CDC reports of COVID-19 deaths with symptomatic breakthrough infections.

Even if all of the unvaccinated people who died of COVID-19 had chosen to get vaccinated, some of those deaths may not have been preventable, as vaccines are not 100% effective. A recent CDC study showed age-standardized vaccine effectiveness against deaths of 91% in the June 20–July 17 period and 94% in the April 4–June 19 period. Based on this study, we assume 91% of COVID-19 deaths likely would have been prevented with COVID-19 inoculations.

We find that since June 2021 approximately 163,000 lives would have been saved with vaccinations. Most of these preventable deaths occurred well after vaccines became available. In September 2021 alone, approximately 51,000 people’s lives likely would have been saved if they had chosen to get vaccinated. In November 2021, over 29,000 COVID-19 deaths likely would have been averted with vaccines.

The overwhelming majority of COVID-19 hospitalizations and deaths continue to be preventable. COVID-19 vaccines have proven to be effective against the COVID-19 Delta variant. Preliminary studies are showing COVID-19 vaccines with booster doses are effective against the newly emerging Omicron variant. At this time, the CDC does not require a booster shot to be considered fully vaccinated, but that may change.

Methods

We used the KFF COVID-19 Tracker data for average daily and monthly total COVID-19 deaths in the United States using data as of December 8, 2021. For data on deaths due to other leading causes, we used monthly provisional counts of death by select causes, 2020-2021.  For other leading causes, we used CDC data for weekly counts of death by select underlying causes of death. For other leading causes from the weekly counts CDC file, only MMWR weeks 1-25 are included in average daily deaths for 2021. The average daily deaths for accidents and suicides are from 2020. Heart disease deaths were combined for all circulatory disease except stroke. Stroke represents cerebrovascular disease. In the second chart, respiratory disease represents chronic lower respiratory disease and the 2020 average daily deaths for accidents are reported.

For age-specific rank of COVID-19 deaths among other leading causes of death, we used CDC provisional COVID-19 deaths data by age and CDC provisional death counts for other leading causes for January – June 2021. For age-specific leading causes for which 2021 monthly provisional death counts were not available, we used CDC Wonder data for 2019 for age-specific average monthly death counts. Infants were excluded from this analysis as the 15th leading cause of death based on 2019 CDC Wonder data had a monthly average greater than the highest COVID-19 death count for this age group in most month in 2021; For infants, COVID-19 ranked as the number 13 leading cause of deaths in August and September.

 

The Peterson Center on Healthcare and KFF are partnering to monitor how well the U.S. healthcare system is performing in terms of quality and cost.

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