In early 2021, in a nation battered by a devastating pandemic, the prognosis was suddenly upbeat:
Science had delivered a miracle.
Not just one, but several effective vaccines against the novel coronavirus SARS-CoV-2 were produced, tested and approved in record time. Vaccinations, history has shown, save lives. They can make lockdowns, masks, physical distancing and other pandemic response measures unnecessary. Within days of availability, Americans started lining up to get vaccinated and move forward.
More than 18 months later, this optimism has vanished. Millions of Americans got vaccinated and boosted, but too many did not. The United States, a nation that had access to the most vaccine doses the earliest, quickly fell behind other Western democracies in vaccination rates. Meanwhile, more contagious variants continue to emerge, leading to new surges of cases, hospitalizations and deaths.
In 2020—year one of the Covid-19 pandemic—thousands of Americans died every day from a novel disease that scientists knew little about and healthcare workers had few tools to treat or prevent.
In 2021—year two of the pandemic—thousands of Americans still died every day from what by then had become largely preventable complications from Covid-19—in one of the richest nations in the world, despite unprecedented federal, state, city and community efforts to inoculate people against it.
At least 318,000 Covid-19 deaths could have been prevented between January 1, 2021 and April 30, 2022, according to modeling research by our team at Brown University in collaboration with Microsoft AI for Health. The number of vaccine-preventable deaths keeps climbing as severe illness and death from the disease are predominantly affecting unvaccinated and undervaccinated Americans who are not up to date on their vaccines.
It is a tragedy beyond what many thought possible in the United States (U.S.), a nation that scores highly on pandemic preparedness and global security indexes. The U.S. vaccination rollout is at once a remarkable public health success and a striking public health failure. It reveals challenges far beyond vaccinations and urges investigation into why current models for delivering and building confidence in life-saving public health measures are failing to reach and protect all Americans equally.