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Geographic Patterns of COVID-19 Vaccination, Infection, and Mortality in the United States During Year Two of the Pandemic and the Influence of Political Orientation

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Coronavirus (COVID-19) Outbreaks, Vaccination, Politics and Society

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Abstract

The second year of the COVID-19 (SARS-CoV-2) pandemic in the United States witnessed the widespread availability of effective vaccines and a new presidential administration promising a more coherent and science-based approach. Despite this, the US in 2021 also experienced a continued series of waves in infection and mortality, driven in part by the emergence of the more transmittable Delta and Omicron variants. As was the case in 2020, the magnitude of per-capita infection and mortality varied substantially between states in 2021. State vaccination rates also showed appreciable geographic variations and were significantly negatively correlated with infection rates and strongly so with death rates. Wave severity through 2021 differed somewhat across climatic zones, consistent with weather-induced behavioral changes influencing transmission. Political orientation appears to be an important factor contributing to geographic variations in the pandemic. In particular, the percentage of voters who supported the Republican presidential candidate in the 2020 election was strongly negatively correlated with states’ vaccination rates and positively correlated with death rates. The political divide on vaccination contributes to interstate geographic differences in the outcomes of the pandemic and poses an ongoing challenge to combating COVID-19 in the United States.

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Notes

  1. 1.

    Sometimes referred to as the red/blue divide (Kates et al., 2021) because of the commonly applied informal reference to Republican leaning states as ‘red states’ and Democrat leaning states as ‘blue states’.

References

  • Abdullah, F., Myers, J., Basu, D., Tintinger, G., Ueckermann, V., Mathebula, M., Ramlall, R., Spoor, S., de Villiers, T., Van der Walt, Z., & Cloete, J. (2021). Decreased severity of disease during the first global omicron variant Covid-19 outbreak in a large hospital in Tshwane, South Africa. International Journal of Infectious Diseases, 116, 38–42.

    Article  Google Scholar 

  • Alexandar, S., Ravisankar, M., Kumar, R. S., & Jakkan, K. (2021). A comprehensive review on Covid-19 Delta variant. International Journal of Pharmacology and Clinical Research (IJPCR), 5, 83–85.

    Google Scholar 

  • Andrews, N., Stowe, J., Kirsebom, F., Toffa, S., Rickeard, T., Gallagher, E., Gower, C., Kall, M., Groves, N., O’Connell, A. M., & Simons, D., et al. (2021). Effectiveness of COVID-19 vaccines against the Omicron (B. 1.1. 529) variant of concern. MedRxiv. 2021 Dec 14. https://khub.net/documents/135939561/430986542/Effectiveness+of+COVID-19+vaccines+against+Omicron+variant+of+concern.pdf/f423c9f4-91cb-0274-c8c5-70e8fad50074

  • Bergquist, S., Otten, T., & Sarich, N. (2020). COVID-19 pandemic in the United States. Health Policy and Technology, 9, 623–638.

    Article  Google Scholar 

  • CDC (Centers for Disease Control and Prevention). (2022). COVID data tracker (CDC: https://data.cdc.gov/Case-Surveillance/United-States-COVID-19-Cases-and-Deaths-by-State-o/9mfq-cb36 ; https://covid.cdc.gov/covid-data-tracker/#trends_dailycases_totalvaccinesadministered; https://covid.cdc.gov/covid-data-tracker/#trends_dailydeaths_totalvaccinesadministered; https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-status; https://covid.cdc.gov/covid-data-tracker/#datatracker-home. Accessed January, 13–31, 2022.

  • CDC (Centers for Disease Control and Prevention) COVID-19 Response Team. (2021). SARS-CoV-2 B. 1.1. 529 (Omicron) variant—United States, December 1–8, 2021. Morbidity and Mortality Weekly Report, 70, 1731.

    Google Scholar 

  • Corcoran, K. E., Scheitle, C. P., & DiGregorio, B. D. (2021). Christian nationalism and COVID-19 vaccine hesitancy and uptake. Vaccine, 39, 6614–6621.

    Article  CAS  Google Scholar 

  • Coustasse, A., Kimble, C., & Maxik, K. (2021). COVID-19 and vaccine hesitancy: A challenge the United States must overcome. The Journal of Ambulatory Care Management, 44, 71–75.

    Article  Google Scholar 

  • Del Rio, C., Malani, P. N., & Omer, S. B. (2021). Confronting the delta variant of SARS-CoV-2, summer 2021. JAMA, 326, 1001–1002.

    Article  Google Scholar 

  • Eyre, D. W., Taylor, D., Purver, M., Chapman, D., Fowler, T., Pouwels, K. B., Walker, A. S., & Peto, T. E. (2022). Effect of Covid-19 vaccination on transmission of Alpha and Deltavariants. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa2116597

    Article  PubMed  Google Scholar 

  • Federal Elections Commission. (2020). Official 2020 presidential general election results. https://www.fec.gov/resources/cms-content/documents/2020presgeresults.pdf

  • Fridman, A., Gershon, R., & Gneezy, A. (2021). COVID-19 and vaccine hesitancy: A longitudinal study. PLoS ONE, 16, e0250123.

    Article  CAS  Google Scholar 

  • Gao, J., & Radford, B. J. (2021). Death by political party: The relationship between COVID-19 deaths and political party affiliation in the United States. World Medical & Health Policy, 13, 224–249.

    Article  Google Scholar 

  • Garibaldi, B. T., Wang, K., Robinson, M. L., Zeger, S. L., Bandeen-Roche, K., Wang, M. C., Alexander, G. C., Gupta, A., Bollinger, R., & Xu, Y. (2021). Comparison of time to clinical improvement with vs without Remdesivir treatment in hospitalized patients with COVID-19. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2021.3071

    Article  PubMed  PubMed Central  Google Scholar 

  • Gollwitzer, A., Martel, C., Brady, W. J., Pärnamets, P., Freedman, I. G., Knowles, E. D., & Van Bavel, J. J. (2020). Partisan differences in physical distancing are linked to health outcomes during the COVID-19 pandemic. Nature Human Behaviour, 4(11), 1186–1197.

    Article  Google Scholar 

  • Gupta, S., Cantor, J., Simon, K. I., Bento, A. I., Wing, C., & Whaley, C. M. (2021). Vaccinations against COVID-19 may have averted up to 140,000 deaths in the United States: Study examines role of COVID-19 vaccines and deaths averted in the United States. Health Affairs, 40, 1465–1472.

    Article  Google Scholar 

  • Hoffmann, M., Krüger, N., Schulz, S., Cossmann, A., Rocha, C., Kempf, A., Nehlmeier, I., Graichen, L., Moldenhauer, A. S., Winkler, M. S., & Lier, M. (2021). The Omicron variant is highly resistant against antibody-mediated neutralization–implications for control of the COVID-19 pandemic. Cell. https://doi.org/10.1016/j.cell.2021.12.032

    Article  PubMed  PubMed Central  Google Scholar 

  • Hsiehchen, D., Espinoza, M., & Slovic, P. (2020). Political partisanship and mobility restriction during the COVID-19 pandemic. Public Health, 187, 111–114.

    Article  CAS  Google Scholar 

  • Jayk Bernal, A., Gomes da Silva, M. M., Musungaie, D. B., Kovalchuk, E., Gonzalez, A., Delos Reyes, V., Martín-Quirós, A., Caraco, Y., Williams-Diaz, A., Brown, M. L., & Du, J. (2022). Molnupiravir for oral treatment of Covid-19 in nonhospitalized patients. New England Journal of Medicine, 386, 509–520.

    Article  Google Scholar 

  • Johns Hopkins University. (2022). Understanding vaccination progress. https://coronavirus.jhu.edu/vaccines/international. Accessed January 13, 2022.

  • Johnson, A. G. (2022). COVID-19 incidence and death rates among unvaccinated and fully vaccinated adults with and without booster doses during periods of Delta and Omicron variant emergence—25 US Jurisdictions, April 4–December 25, 2021. MMWR. Morbidity and Mortality Weekly Report, 71, 132–138.

    Article  CAS  Google Scholar 

  • Kaiser Family Foundation. (2021). KFF COVID-19 vaccine monitor: September 2021. https://www.kff.org/coronavirus-covid-19/poll-finding/kff-covid-19-vaccine-monitor-september-2021/

  • Karim, S. S. A., & Karim, Q. A. (2021). Omicron SARS-CoV-2 variant: A new chapter in the COVID-19 pandemic. The Lancet, 398, 2126–2128.

    Article  CAS  Google Scholar 

  • Kates, J., Tolbert, J., & Orgera, K. (2021). The red/blue divide in COVID-19 vaccination rates. Kaiser Family Foundation (KFF). https://www.kff.org/policy-watch/the-red-blue-divide-in-covid-19-vaccination-rates/

  • Kreps, S. E., Goldfarb, J. L., Brownstein, J. S., & Kriner, D. L. (2021). The relationship between US adults’ misconceptions about COVID-19 vaccines and vaccination preferences. Vaccines, 9, 901. https://doi.org/10.3390/vaccines9080901

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Li, G., Niu, J., Fan, X., Chen, T., & He, D. (2021). The chilly climate may increase the chance of infecting COVID-19. Journal of Infection, 82, e16–e17.

    Article  CAS  Google Scholar 

  • Lin, R. -G., Evans, M., & Greene, S. (2021). How Florida fell so far behind California in battling the cononavirus. Los Angeles Times, September 29 edition.

    Google Scholar 

  • MacDonald, G. (2021). Geographic patterns of the pandemic in the United States: Covid-19 response within a disunified federal system. In Coronavirus (COVID-19) outbreaks, environment and human behaviour (pp. 451–467). Springer.

    Google Scholar 

  • Mayo Clinic. (2022). Vaccine tracker. https://www.mayoclinic.org/coronavirus-covid-19/vaccine-tracker

  • Merica, D. (2021). Trump met with boos after revealing he received Covid-19 booster. CNN. https://www.cnn.com/2021/12/20/politics/donald-trump-booster-shot-boos/index.html

  • Moore, J. X., Gilbert, K. L., Lively, K. L., Laurent, C., Chawla, R., Li, C., Johnson, R., Petcu, R., Mehra, M., Spooner, A., & Kolhe, R. (2021). Correlates of COVID-19 vaccine hesitancy among a community sample of African Americans living in the Southern United States. Vaccines, 9, 879. https://doi.org/10.3390/vaccines9080879

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Nanduri, S., Pilishvili, T., Derado, G., Soe, M. M., Dollard, P., Wu, H., Li, Q., Bagchi, S., Dubendris, H., Link-Gelles, R., & Jernigan, J. A. (2021). Effectiveness of Pfizer-BioNTech and Moderna vaccines in preventing SARS-CoV-2 infection among nursing home residents before and during widespread circulation of the SARS-CoV-2 B. 1.617. 2 (Delta) variant—National Healthcare Safety Network, March 1–August 1, 2021. Morbidity and Mortality Weekly Report, 70, 1163–1166.

    Article  CAS  Google Scholar 

  • Pulliam, J. R., van Schalkwyk, C., Govender, N., von Gottberg, A., Cohen, C., Groome, M. J., Dushoff, J., Mlisana, K., & Moultrie, H. (2022). Increased risk of SARSCoV-2 reinfection associated with emergence of Omicron in South Africa. Science, 376(6593), eabn4947.

    Google Scholar 

  • Pulliam, J. R., van Schalkwyk, C., Govender, N., von Gottberg, A., Cohen, C., Groome, M. J., Dushoff, J., Mlisana, K., & Moultrie, H. (2021). Increased risk of SARS-CoV-2 reinfection associated with emergence of the Omicron variant in South Africa. MedRxiv. https://doi.org/10.1101/2021.11.11.21266068v2

  • Ruiz, J. B., & Bell, R. A. (2021). Predictors of intention to vaccinate against COVID-19: Results of a nationwide survey. Vaccine, 39, 1080–1086.

    Article  CAS  Google Scholar 

  • Self, W. H., Tenforde, M. W., Rhoads, J. P., Gaglani, M., Ginde, A. A., Douin, D. J., Olson, S. M., Talbot, H. K., Casey, J. D., Mohr, N. M., & Zepeski, A. (2021). Comparative effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) vaccines in preventing COVID-19 hospitalizations among adults without immunocompromising conditions—United States, March–August 2021. Morbidity and Mortality Weekly Report, 70, 1337. https://doi.org/10.15585/mmwr.mm7038e1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Suthar, M. S., Arunachalam, P. S., Hu, M., Reis, N., Trisal, M., Raeber, O., Chinthrajah, S., Davis-Gardner, M. E., Manning, K., Mudvari, P., & Boritz, E. (2022). Durability of immune responses to the BNT162b2 mRNA vaccine. Med, 3, 25–27.

    Article  CAS  Google Scholar 

  • Tartof, S. Y., Slezak, J. M., Fischer, H., Hong, V., Ackerson, B. K., Ranasinghe, O. N., Frankland, T. B., Ogun, O. A., Zamparo, J. M., Gray, S., Valluri, S. R., Pan, K., Angulo, F. J., Jodar, L., & McLaughlin, J. M. (2021). Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: A retrospective cohort study. The Lancet, 398, 1407–1416.

    Article  CAS  Google Scholar 

  • Usmani, M., Jamal, Y., Gangwar, M., Magers, B., Chaves-Gonzalez, J., Wu, C. Y., Colwell, R., & Jutla, A. (2022). Asymmetric relationship between ambient air temperature and incidence of COVID-19 in the human population. The American Journal of Tropical Medicine and Hygiene. https://doi.org/10.4269/ajtmh.21-0328

    Article  PubMed  PubMed Central  Google Scholar 

  • Walter, E. B., Talaat, K. R., Sabharwal, C., Gurtman, A., Lockhart, S., Paulsen, G. C., Barnett, E. D., Muñoz, F. M., Maldonado, Y., Pahud, B. A., & Domachowske, J. B. (2022). Evaluation of the BNT162b2 Covid-19 vaccine in children 5 to 11 years of age. New England Journal of Medicine, 386, 35–46.

    Article  CAS  Google Scholar 

  • Weinberger, D. M., Chen, J., Cohen, T., Crawford, F. W., Mostashari, F., Olson, D., Pitzer, V. E., Reich, N. G., Russi, M., Simonsen, L., & Watkins, A. (2020). Estimation of excess deaths associated with the COVID-19 pandemic in the United States, March to May 2020. JAMA Internal Medicine, 180, 1336–1344.

    Article  CAS  Google Scholar 

  • White House. (2021). Path out of the pandemic: President Biden’s COVID-19 action plan. https://www.whitehouse.gov/covidplan/. Accessed January 21, 2022.

  • Willis, D. E., Andersen, J. A., Bryant-Moore, K., Selig, J. P., Long, C. R., Felix, H. C., Curran, G. M., & McElfish, P. A. (2021). COVID-19 vaccine hesitancy: Race/ethnicity, trust, and fear. Clinical and Translational Science, 14(6), 2200–2207.

    Google Scholar 

  • World Health Organizatioṇ. (2020). WHO coronavirus disease (COVID-19) dashboard. https://covid19.who.int/. Accessed November 12, 2020.

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Acknowledgements

We thank Professor Rais Akhtar for his kind invitation to submit this chapter. We thank two anonymous reviewers for their careful reading and very helpful comments and suggestions.

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  1. Department of Geography, UCLA, Los Angeles, CA, 90095-1524, USA

    Glen M. MacDonald

  2. Institute of the Environment and Sustainability, UCLA, Los Angeles, CA, 90095-1496, USA

    Travis Longcore

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Correspondence to Glen M. MacDonald .

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    Rais Akhtar

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MacDonald, G.M., Longcore, T. (2022). Geographic Patterns of COVID-19 Vaccination, Infection, and Mortality in the United States During Year Two of the Pandemic and the Influence of Political Orientation. In: Akhtar, R. (eds) Coronavirus (COVID-19) Outbreaks, Vaccination, Politics and Society. Springer, Cham. https://doi.org/10.1007/978-3-031-09432-3_21

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  • DOI: https://doi.org/10.1007/978-3-031-09432-3_21

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