COVID-19 vaccination campaigns and health outcomes in Spain during 2021

ABSTRACT

We evaluate the effects of vaccines in the evolution of the epidemic in Spain during 2021. To this end, we estimate the effect of vaccination in terms of reducing infections, hospitalizations, ICU admissions, and deaths. We also compare the health impact of COVID-19 with that caused by recent influenza seasons, in a scenario where all the population had been vaccinated. The positive impact of vaccination on health indicators has been extraordinary. The non-availability of vaccines would have increased COVID-19 deaths by 571% compared to observed deaths. Moreover, the relative benefit of vaccination increases with the severity of the indicator: greater for deaths and ICU admissions, less for infections and hospitalizations. Under the assumption that the entire population had been vaccinated with the COVID-19 vaccine from the first week of April, the impact of the disease in terms of hospitalizations and deaths during 2021 would have been above a low activity flu season, but in line with a moderate/high activity flu season.

KEYWORDS:

• COVID-19
• vaccination
• influenza

JEL CLASSIFICATION:

• I10
• I18
• H12

Acknowledgments

José E. Boscá and Javier Ferri acknowledge financial support from Grant PID2020-116242RB-I00 funded by the Spanish Ministry of Science and Innovation (MCIN/AEI/10.13039/501100011033), Grant GVPROMETEO2020-083 funded by the Generalitat Valenciana, and Grant TED2021-132629B-I00 funded by MCIN/AEI/10.13039/501100011033 and the “European Union NextGenerationEU/PRTR”. José E.Boscá and Javier Ferri are also grateful for funding from the Rafael del Pino Foundation and BBVA Research. José Cano gratefully acknowledges financial support from the Spanish Ministry of Economy, Industry and Competitiveness (BES-2017-080335). We thank Judit Vall and participants at BBVA Research seminar, XXIX Encuentro de Economía Pública (Madrid), XXIV Encuentro de Economía Aplicada (Mallorca) and 15th Annual Meeting of the Portuguese Economic Journal (Azores) for helpful comments.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Notes

¹ Andrés et al. (2020) estimated a reduction of the life expectancy at birth in Spain of 1.4 years, whereas Trias-Llimós and Bilal (2020) estimated that the epidemic in Madrid reduced life expectancy at birth by 1.9 years for men and 1.6 years for women, reverting back to levels from 2009.

² See, for instance, Chen et al. (2021), Pormohammad et al. (2021) or Ling, Zhong, and Luo (2021).

³ The data on infections was obtained from the National Epidemiological Surveillance Network (Red Nacional de Vigilancia Epidemiológica 2021), while the mortality data comes from the updated bulletins released by the Center for the Coordination of Health Alerts and Emergencies in PDF format (Centro de Coordinación de Alertas y Emergencias Sanitarias 2021b). The same agency also provides open data on daily hospitalizations and ICU admissions, which were used in subplots 1c and 1d (Centro de Coordinación de Alertas y Emergencias Sanitarias 2021c).

⁴ Evidence from various methodologies supports this conclusion. For example, a meta-analysis of 32 studies by Liu et al. (2021) showed that COVID-19 vaccines can effectively reduce deaths, severe cases, symptomatic cases, and infections caused by SARS-CoV-2 worldwide. Moghadas et al. (2021) demonstrated, using an agent-based model of SARS-CoV-2 transmission and US demographic data, that vaccination can greatly impact mitigating COVID-19 outbreaks, even with more limited infection protection. Barro (2022) found that vaccines had a significant impact on health outcomes in the United States, with a greater effect on deaths than hospitalizations, and a larger effect on hospitalizations than infections. This paper estimates that each additional 248 doses of vaccine can save one life, at a cost of $55,000, which is below the typical value of a statistical life. Additionally, Arbel et al. (2022) found evidence of a negative impact of the second booster dose on deaths in Israel among adults aged 60 years and over.

Additional information

Funding

The work was supported by the Generalitat Valenciana [GVPROMETEO2020-083]; Ministerio de Ciencia e Innovación [PID2020-116242RB-I00,TED2021-132629B-I00]