There is evidence that, in the US, Republican-leaning counties have had higher COVID-19 death rates than Democratic-leaning counties and similar evidence of an association between political party affiliation and attitudes regarding COVID-19 vaccination. This investigation assessed political party affiliation and mortality rates for individuals during the initial 22 months of the COVID-19 pandemic.

A cross-sectional comparison of excess mortality between registered Republican and Democratic voters between March 2020 and December 2021 adjusted for age and state of voter registration was conducted. Voter and mortality data from Florida and Ohio in 2017 linked to mortality records for January 1, 2018, to December 31, 2021, were used in data analysis. The main outcome measure was the excess weekly death rates during the COVID-19 pandemic adjusted for age, county, party affiliation, and seasonality.

Between January 1, 2018, and December 31, 2021, there were 538 159 individuals in Ohio and Florida who died at the age of 25 years or older in the study sample. The median age at death was 78 years (IQR, 71-89 years). Overall, the excess death rate for Republican voters was 2.8 percentage points, or 15%, higher than the excess death rate for Democratic voters (95% prediction interval [PI], 1.6-3.7 percentage points). After May 1, 2021, when vaccines were available to all adults, the excess death rate gap between Republican and Democratic voters widened from −0.9 percentage points (95% PI, −2.5 to 0.3 percentage points) to 7.7 percentage points (95% PI, 6.0-9.3 percentage points) in the adjusted analysis; the excess death rate among Republican voters was 43% higher than the excess death rate among Democratic voters. The gap in excess death rates between Republican and Democratic voters was larger in counties with lower vaccination rates and was primarily noted in voters residing in Ohio.


The authors concluded that, in this cross-sectional study, an association was observed between political party affiliation and excess deaths in Ohio and Florida after COVID-19 vaccines were available to all adults. These findings suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been factors in the severity and trajectory of the pandemic in the US.

In light of what has been discussed repeatedly, these findings are in my view most impressive and seem to speak for themselves. The authors are nevertheless prudent and stress that their study has several limitations which mean that we ought to interpret their results with caution.

  • First, there are plausible alternative explanations for the difference in excess death rates by political party affiliation beyond the explanatory role of vaccines discussed herein.
  • Second, the mortality data, although detailed and recent, only included approximately 83.5% of deaths in the US and did not include the cause of death. Although overall excess death patterns in our data are similar to those in other reliable sources, such as the Centers for Disease Control and Prevention National Center for Health Statistics data, it is possible that the deaths that our study data did not include may disproportionately occur among individuals registered with a particular political party, potentially biasing our results. In addition, the completeness of the mortality data may vary across states or time, potentially biasing our estimates of excess death rates.
  • Third, all excess death models rely on fundamentally untestable assumptions to construct the baseline number of deaths one would expect in the absence of the COVID-19 pandemic.
  • Fourth, because no information on individual vaccination status was available, analyses of the association between vaccination rates and excess deaths relied on county-level vaccination rates.
  • Fifth, the study was based on data from 2 states with readily obtainable historical voter registration information (Florida and Ohio); hence, the results may not generalize to other states.

32 Responses to Political party affiliation is associated with excess deaths during the COVID pandemic

  • The most important bit, in my opinion:

    The authors are nevertheless prudent and stress that their study has several limitations which mean that we ought to interpret their results with caution. [list of caveats]

    Just compare this to how antivaccine people such as McCullough and many other ex-scientists do their ‘research’, which basically goes along the lines of “deaths went up, vaccines went up, so vaccines cause deaths”, or “4500 persons died within a couple of weeks after being vaccinated, so the vaccines caused 4500 deaths” and so on …

  • What a strange study! Most interesting are the parts missing: what was the rate of voters in each age group? To which amount does each age group add mortality to the overall view? Information about the differences in urban/rural relation compared with voters from each group are also missing.

    Let’s imagine that there is a very strong cohort of people being older than 88 years that votes for republicans almost 100% – the graph would be explained from simple relations we already know (age dependence of death).
    Let’s imagine that more people in rural context vote for republicans and medical support is worse in rural areas compared to urban areas where more democrats vote. Do we get the correct message from the study?

    Is there anybody out there who is able to get reliable information from that study? I failed to do.

    The paper follows an interesting question. However, it fails to give an answer by hiding data. I can’t believe that they do not have it – thus, why not give a more detailed view on the situation?

  • I was pleased that you admitted the serious limitations of this study, though many other critics provide much more harsh critique of the limitations and serious problems with this highly questionable study.

    I encourage people here to read this review of the study: “Did Republicans die more during the pandemic bc they didn’t get the vax?” Written by Vinayak K. Prasad is an American hematologist-oncologist and health researcher. He is a professor of Epidemiology and Biostatistics at the University of California, San Francisco.

    Here are just a small part of this doctor’s problems with this study:
    “Of course, the paper is hopelessly flawed.


    It linked 2017 voting registration to people — but this does not account for people who turned on Trump in 2020. It doesn’t reflect being a Republican during the pandemic.

    Just 500k people were linked, out of 30 million. This is a huge selection bias. The authors have no evidence the finding is generalizable to millions and millions they could not link, and did not study.

    They don’t seem to adjust for age as a discrete value, but use age ranges. A 25 year old and 64 year old are in the same range. A 66 year old is the same as a 74 year old? Do they get the same adjustment? Is this even possible? If so, it is insane. If Republican voters are more likely to be 57 than 27, or 74 than 66, that is a big difference with respect to COVID outcomes that is essentially unadjusted for.

    They don’t have vaccination records. Are you crazy? How are you going to make such an allegation without individual vaccine records to prove that it is indeed vaccination that resulted in the increase in death?

    They don’t adjust for BMI, socioeconomic status, race, gender, education or other medical conditions. This is an unacceptable omission! Just because excess mortality is not imbalanced pre-covid does not mean there are not huge differences here that COVID exploits. COVID obliterates poor, overweight, older people. It hit people of lower SES harder. These authors don’t even consider that Republicans might be hit harder just because the party has more people lower down the socioeconomic ladder, particularly in the rust belt and in places like Florida. These differences can be preferentially exploited by COVID.

    The method of matching people accepted 57% matches. WTF! so low. (yes this will merely attenuate the link, theoretically. *** a wise reader notes that is only true if poor accuracy is at random. It might not be. Some names Vinayak much more easy to match than John. This could bias results systematically based on names/ origins/ frequency ***)”

    Is it really worthwhile to post information about such a poor study? GIGO!

    • @Dana Ullman

      Just 500k people were linked, out of 30 million. This is a huge selection bias.

      No it isn’t. As long as the sample is random and representative, your sample can even be as small as a couple of hundred subjects to say something about a population of 30 million. This is statistics 101.

      If you don’t believe me: just look for ‘sample size calculator’. Or better: get a simple undergraduate statistics textbook. You might even learn something.

      • being so full of bias, Dullman does not understand bias because he is too biased.

      • For statistics like these, you should give a hint on “random and representative”. I would have liked to see a table with numbers for age cohorts and party voted as well as if these people lived in rural or urban regions.
        As voting is usually linked to a lot of other parameters like age, income, lifestyle, maybe even nutrition, at least the most important and known factors should have been published and taken into consideration for the statistical model. Maybe mixed model would have been a good approach to get rid of the impact of influences that don’t have anything to do with voting.

        It looks like thy did several statistical tests on the data. Did they correct for alpha inflation?

        With the information given by the authors, the information is nearly useless.

    • Mr Ullman, please explain why you told an outrageous lie in this blog.

      You claimed to have “many times” identified a laboratory that can distinguish homeopathic water from other water, though you have not once done so.

      Also please now do so. Sixty-ninth time of asking.

  • lol… nice trolling Edzard

    Giving the benefit of all the doubts raised by Dana Ullman to assume that the study is fair and valid, I can believe that the vaccines saved some lives. The vaccines had a strong degree of efficacy, but only for a few months without repeated jabs. So it was either get a jab every four months, or risk facing the virus.
    Now that the virus is endemic, my question is how many that took the jab are still experiencing detrimental effects of repeated injections of mRNA spike protein.
    Evidently quite a few. It is estimated that the Moderna vaccine is responsible for 1 heart problem (among other ill effects) in every thirty-five covid vaccine patients.

    • sorry, but you do not understand the meaning of ‘trolling’

    • Now that the virus is endemic, my question is how many that took the jab are still experiencing detrimental effects of repeated injections of mRNA spike protein.

      I see that you don’t understand what a mRNA vaccine is either.

    • @John

      Now that the virus is endemic, my question is how many that took the jab are still experiencing detrimental effects of repeated injections of mRNA spike protein.

      No-one that we know of.

      Evidently quite a few. It is estimated that the Moderna vaccine is responsible for 1 heart problem (among other ill effects) in every thirty-five covid vaccine patients.

      This is EXACTLY what I refer to in my first comment: antivaxxers who claim that the vaccine causes all sorts of problems based on no or tentative evidence at best, without any cautions and disclaimers.

      One serious cardiac problem in every 35 vaccinated people? And in all the world there is only one ‘brave researcher’ who noticed this – after global administration of billions of those vaccines? Do you have any idea how utterly preposterous this sounds? No, you clearly have no idea. Just like you clearly have no idea about vaccines or medicine or even science in general. All you do is brainlessly parrot whatever crap you can find without ever actually understanding anything. Sorry John, but your lack of any discernible personal intelligence is getting rather boring.

      • Richard

        Don’t shoot the messenger, click on the link to Wiley.

        I’ve got other reports that indicate much higher rates.

        • @John
          You are not a messenger. You’re a dim antivaxx troll who repeats any crap you stumble upon (or should I say: step in) in order to spread as much fear, uncertainty and doubt (FUD) about vaccines as possible – causing the deaths of people who listen to you and forego vaccination as a result. Yes, you are killing people with your antivaxx propaganda, which is why you deserve no respect at all.

          About this latest study: all your previous ‘messages’ turned out to be duds at best and lies at worst, and no doubt, this one will be no different. There are several big red flags already, together with some reservations mentioned in the study – none of which you even mention in what you spread. Which again supports my point.

        • John a.k.a RG,

          I’ve got reports.of chupacabra sighting and I am planning to catch one and become famous. Did you know that no one has caught one before? You can come along with me if you want. We can share the fame and fortune.

        • ……

          What a telling domain name.

        • Golly. That study assumes that a certain level of troponin means that myocarditis is present. Normally, troponin levels are assessed when people present with symptoms of myocarditis as part of diagnostics work up. Even though nearly all those assessed with myocarditis were asymptomatic and ecg’s revealed no issues they were still “diagnosed ” with myocarditis. The MOST that study can say is that certain covid vaccinations MIGHT lead to a temporary increase in troponin levels but not detectable myocarditis, and the mechanism for this is worthy of further research. I think it very appropriate that the source for that study is a web site called “hot air’

          • @Stephen Hicks
            Some more huge problems with this study:
            – No control group
            – No baseline levels established
            – Limited follow-up after only 1 day – and for only part of the cohort.

            And, most importantly, as Dr Susan Oliver mentions (from dave’s link: ), troponin levels will also increase as a result of exercise. After all, muscle development through exercise in fact happens when muscle is slightly damaged, with the body not just restoring the muscle, but ‘overdoing’ it in order to prepare for more strenuous activity to come.

            So those people with elevated troponin levels may just as well have had a serious work-out in the days prior to their vaccination. We simply don’t know – and what we do know is that actual myocarditis was NOT diagnosed in any of these people.

            But trust antivaxx idiots like John Campbell and our own ‘John’ to start screaming bloody murder right away … and showing by the comment section under Campbell’s video, there are literally tens of thousands of sheeple who believe them, many of whom indicating that they will no longer take any vaccines, no matter what. At which point the name of Darwin comes to mind …

  • Dr Susan Oliver has done an excellent take on the swiss study already. As always excellent accurate science rather than antivax nonsense.

    • @Dave
      I suspect you pasted the wrong YT link?
      The one in your comment is to a nurse-Campbell video.

      • Hi Bjorn

        If you fast forward to about 2mins 50secs then Dr Oliver starts to discuss the study. Its not obvious initially that this is going to be the case when you first begin watching. I did have to check a couple of times to make sure I’d got it right.

        If you dont know Campbell he has gone down the antivax rabbithole and Dr Oliver has posted several excellent videos debunking his BS.

        • Oh,my… I clicked the link, which induced an immediate bout of nausea so I killed it after a minute or so, when nurse Campbell pulled up a well known textbook of medicine and started to make a fool of himself. You should have either chosen to not have the link start at this point with the nurse waffling on, or warned those of us with acute nurse-Campbell-intolerance.
          I haven’t stumbled over Dr. Oliver before. Thanks for the link.
          My own go-to debunker of “Dr.” Campbell, and many other Covidiots, is “Dr. Wilson” a PhD – molecular biologist who has been an ardent Youtuber correcting Covid nonsense, including this formerly admirable nurse-educator turned Covid-disinformation dastard. I recommend his series on the “Disinformation dozen” among many good products of his.
          Wilson has made a few films on nurse Campbell’s uncontrolled descent into the abyss of Youtube monetising. He used to be a fairly respected nurse educator. I had recently started watching his YT posts about Covid matters when he rather suddenly found that he could make loads of money by dabbling in FUD and before long, the Ivermectin hype had pulled him off the edge – literally. Here’s Dr. Wilson’s latest pull-down of nurse Campbell’s many fallacies. He has evidently had enough of the bloke.

  • ‘acute nurse-cambell-intolerance’ LOL. Quote of the day. Hope the nauseau has subsided I believe campbell induced sickness can persist. The first 2 and half minutes are well worth watching just to see Dr Olivers parody of campbells use of the textbook. Priceless piss take.

    Thanks for the heads up re ‘Dr Wilson’

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