The Growing Covid Hospitalization Gap Between Vaccinated and Unvaccinated

Those who are vaccinated and, especially, boostered have little chance of being hospitalized due to Covid. Those who unvaccinated have a significantly greater chance of becoming infected, hospitalized and dying - and that gap is growing. JL

David Leonhardt and Ashley Wu report in the New York Times:

Some experts believe that the hospitalization gap between the vaccinated and unvaccinated is even larger than these charts suggest. What vaccination does is radically reduce the chance of covid illness. The data on deaths from New York and Seattle underscores the relatively low risks for vaccinated people. These numbers show a starker gap between the vaccinated and the unvaccinated than the hospitalization data. (And) Omicron is still severe enough that it will lead to debilitating illness and death for many unvaccinated people.

Some of the timeliest data on Covid-19 outcomes by vaccination status comes from New York City and the Seattle area, and the two are telling a consistent story.

Cases for vaccinated and unvaccinated residents alike are rising. They’re rising because vaccination often does not prevent infection from the Omicron variant. It reduces the chances substantially — as you can see above — but vaccinated people still face a meaningful chance of infection. What vaccination does is radically reduce the chance of severe Covid illness.

(The number of Americans hospitalized with Covid has surpassed last winter’s peak.)

Some experts believe that the hospitalization gap between the vaccinated and unvaccinated is even larger than these charts suggest. The official data on Covid hospitalizations includes many people who are hospitalized for other reasons — say, a heart condition or a bicycle crash — and who test positive for the virus while being treated.

About one-third of Covid hospitalizations fall into this category, according to a recent analysis at the University of California, San Francisco. In New York State, 43 percent of people hospitalized with Covid were admitted for other reasons.

It’s true that some of these incidental Covid hospitalizations still cause problems. The virus can harm people whose bodies are weakened by other medical conditions, and all Covid cases put added stress on hospitals, because patients must be isolated. (“Hospitals are in serious trouble,” Ed Yong writes in The Atlantic.)

Still, many incidental Covid cases in hospitals do not present much risk to the infected person. And Omicron is so contagious that it has infected many vaccinated people, likely inflating the hospitalization numbers more than previous variants have.

The death gap

The data on deaths from New York and Seattle underscores the relatively low risks for vaccinated people. These numbers show a starker gap between the vaccinated and the unvaccinated than the hospitalization data.

One caveat is death trends tend to lag case trends by about three weeks. In coming weeks, deaths among the vaccinated will almost certainly rise, given how sharply cases have risen. These deaths will likely be concentrated among people in vulnerable health, including the elderly and those with a serious underlying medical condition like a previous organ transplant — especially if they’re not boosted.

This likelihood — along with the problem of overwhelmed hospitals — is one of the strongest arguments for taking steps to reduce the size of the current Omicron wave. More vaccine mandates and indoor mask wearing can help reduce cases and, by extension, deaths, experts say.

But the early data raises the possibility that the increase in deaths among the vaccinated will remain relatively modest. The gap in the mortality charts above can’t merely be a reflection of the lag between the cases and deaths. After all, deaths among unvaccinated New Yorkers and Seattleites had already begun to surge in December. Deaths among the vaccinated had not.

(In Boston and Chicago, Covid deaths have also risen, these charts show.)

The bottom line

Vaccination remains highly effective at preventing severe Covid illnesses. And Omicron is milder than earlier versions of the virus. The combination means that most Americans — including children and vaccinated adults — face little personal risk from Omicron.

The risk is not zero, to be clear, even among people who are generally healthy. But it is very small. Every day, people live with small risks, be they from the seasonal flu and other illnesses or from riding in a vehicle, playing sports or other activities.

For the unvaccinated, the situation is very different. Omicron is still severe enough that it will lead to debilitating illness and death for many unvaccinated people. In much of the U.S., a large number of adults — including older adults — remain unvaccinated.