Since the pandemic, research based on modelling has claimed that globally 14 million Covid deaths were averted in the first year of the pandemic alone, including 120,000 in the UK alone. Yet such estimates were always implausibly high, considering real-world data on overall Covid mortality trends. Now, new research published in the journal JAMA Health Forum concludes that Covid vaccination may have averted only about 2.3 million deaths globally throughout the whole pandemic.

It is important to note that the previous and new estimates are all based on a modelling approach in which it is assumed vaccines saved lives. Theoretical scenarios are then presented of how many lives were saved based on different assumptions about vaccine effectiveness and Covid infection fatality rates. As such, the method guarantees a result that vaccines saved at least some lives among every age group and in both the pre- and post-Omicron periods. The only question is how many. Put another way, the models do not look at the impact of actual vaccination rates on real-world mortality, and cannot tell us how many deaths were averted in practice.

The new and dramatically lower estimates are not completely implausible, though their suggestion that most lives were saved during the post-Omicron period seems dubious, given the absence in real-world data of any life-saving effect from vaccinations during Omicron even among the most vulnerable groups. Yet this research provides worthwhile insights into the failure of vaccine policies followed by most governments during the pandemic.

Notably, the researchers spell out that any deaths averted would have been largely among people not previously infected with Covid and almost all in older age groups. For example, they conclude that only 2,100 deaths were averted globally among under-30s, less than 0.1% of the total. When studying those with a previous infection, the authors estimate there were less than 400 deaths averted.

The paper also estimates that around 20,000 people died globally as a direct result of vaccine side effects. That may not sound like much relative to the total estimate of lives saved, but it’s worth remembering that, unlike vaccine benefits, many side effects were actually more common in younger age groups. These are known to include serious effects sometimes leading to death. For at least some cohorts, especially healthy young people with a previous infection, it is entirely possible that more died as a result of vaccination than the numbers theoretically saved.

And here is the rub: across the world, many vaccine policies such as passports, mandates and intensive public health campaigns were targeted not at the elderly but at younger people. It is hard to forget the spectacle of Government ministers and sports authorities pressuring healthy young athletes to get vaccinated. Society pushed and cajoled into vaccination those very population groups for whom the life-saving effects — if there were any at all — were almost certainly less than the direct risks.

Vaccine policies were counterproductive even on narrow public health grounds, to say nothing about the ethics of pressuring people to accept health interventions against their will.

Nowhere is this better illustrated than with the English care home vaccine mandate. My research with Professor Sourafel Girma demonstrates that although the mandate indeed increased the proportion of care home workers vaccinated, there is no evidence it saved any lives among elderly care home residents. Even worse, the mandates led to significant numbers of care workers leaving the sector, exacerbating the staffing crisis at a critical time. When you factor in the long-term loss of trust in public health more generally caused by the mandates, it is clear that our politicians presided over an unforgivable and predictable public policy disaster.

So, what lessons can be learned for future vaccine roll-outs? The first is that, rather than just assuming more vaccination is always better than less, policymakers should examine the likely costs, benefits and — crucially — uncertainties, especially for particular population groups. Even more importantly, we need to rediscover basic public health ethical principles focused on free and informed consent and transparency. Unfortunately, the evidence so far suggests that too many politicians are unwilling even to admit to their earlier mistakes, let alone learn from them.

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David Paton is a Professor of Industrial Economics at Nottingham University Business School.

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