"Socioeconomic, Demographic and Environmental Factors and COVID-19 Vaccination: Interactions Affecting Effectiveness"

Kargı, Bilal, Coccia, Mario, Uçkaç, Bekir Cihan


This study analyses the relation between people fully vaccinated and mortality to assess the effectiveness of this health policy to cope with COVID-19 pandemic between a sample of 150 countries. Statistical analyses show a positive correlation between share of people fully vaccinated and total COVID-19 mortality in early 2022 (r= 0.65, p-value <.01). These results suggest that COVID-19 vaccinations cannot be a sufficient policy response to eradicate the overall negative impact of the new infectious disease in society. Although high levels of vaccinations in some countries, many demographic (density of population), environmental (air pollution), technological (equipment of non-invasive ventilators), biological (new variants), socioeconomic (health expenditures) factors, etc., influence the diffusion and negative effects of COVID-19 pandemic society. This study can provide new knowledge to improve crisis management and the preparedness of countries to cope with or prevent future pandemic crisis and negative effects in socioeconomic systems.

Keywords: COVID-19 pandemic; Vaccination campaign; Health policy; Innovative technology; Fatality rate; Policy responses; Air pollution; Temperature; Wind speed; Variants; Health expenditures; Density of people; Crisis management.

Full text PDF

  1. Abbasi, J. (2020). COVID-19 and mRNA vaccines-first large test for a new approach. JAMA, 324(12), 1125-1127. doi.
  2. Ackley, C.A., Lundberg, D.J., Ma, L., (...), Preston, S.H., Stokes, A.C. (2022). County-level estimates of excess mortality associated with COVID-19 in the United States, SSM - Population Health, 17, 101021. doi.
  3. Aldila, D., Samiadji, B.M., Simorangkir, G.M., Khosnaw, S.H.A., Shahzad, M. (2021). Impact of early detection and vaccination strategy in COVID-19 eradication program in Jakarta, Indonesia, BMC Research Notes, 14(1),132-150. doi.
  4. Anderson, R.M., Vegvari, C., Truscott, J., Collyer, B.S. (2020). Challenges in creating herd immunity to SARS-CoV-2 infection by mass vaccination. Lancet (London, England), 396(10263), 1614-1616. doi.
  5. Angelopoulos, A.N., Pathak, R., Varma, R., Jordan, M.I. (2020). On identifying and mitigating bias in the estimation of the COVID-19 case fatality rate. Harvard Data Science Review. doi.
  6. Ardito, L., Coccia M., Messeni, P.A. (2021). Technological exaptation and crisis management: Evidence from COVID-19 outbreaks. RD Management, 51(4), 381-392.
  7. Barnard, S., Chiavenna, C., Fox, S., Charlett, A., Waller, Z., Andrews, N., Goldblatt, P., (...), De Angelis, D. (2021). Methods for modelling excess mortality across England during the COVID-19 pandemic, Statistical Methods in Medical Research, 31(9), 1790-1802. doi.
  8. Bontempi, E., Coccia, M. (2021). International trade as critical parameter of COVID-19 spread that outclasses demographic, economic, environmental, and pollution factors, Environmental Research, 201, 111514. doi.
  9. Bontempi, E., Coccia, M., Vergalli, S., Zanoletti, A. (2021). Can commercial trade represent the main indicator of the COVID-19 diffusion due to human-to-human interactions? A comparative analysis between Italy, France, and Spain, Environmental Research, 201, 111529. doi.
  10. Caliskan B., zengin, N., Cindoruk, S.S. (2020). Air quality level, emission sources and control strategies in Bursa/Turkey. Atmospheric Pollution Research, 11(12), 2182-2189. doi.
  11. Coccia, M. (2020). Factors determining the diffusion of COVID-19 and suggested strategy to prevent future accelerated viral infectivity similar to COVID. Science of The Total Environment, 729, 138474. doi.
  12. Coccia, M. (2020a). How (un)sustainable environments are related to the diffusion of COVID-19: The relation between coronavirus disease 2019, Air Pollution, Wind Resource and Energy. Sustainability, 12, 9709. doi.
  13. Coccia, M. (2021). Evolution and structure of research fields driven by crises and environmental threats: the COVID-19 research. Scientometrics, 126(2), 9405-9429. doi.
  14. Coccia, M. (2021a). Evolution of technology in replacement of heart valves: Transcatheter aortic valves, a revolution for management of valvular heart diseases, Health Policy and Technology, 10(2), 100512.
  15. Coccia, M. (2022). Preparedness of countries to face COVID-19 pandemic crisis: Strategic positioning and underlying structural factors to support strategies of prevention of pandemic threats, Environmental Research, 203, 111678. doi.
  16. Davies, N.G., Jarvis, C.I., van Zandvoort, K., Clifford, S., Sun, F.Y., Funk, S., Medley, G., (...), Keogh, R.H. (2021). Increased mortality in community-tested cases of SARS-CoV-2 lineage B.1.1.7, Nature, 593(7858), 270-274. doi.
  17. de Vlas, S.J., Coffeng, L.E. (2021). Achieving herd immunity against COVID-19 at the country level by the exit strategy of a phased lift of control. Scientific Reports, 11(1), 4445.
  18. Fontanet, A., Autran, B., Lina, B., Kieny, M.P., Karim, S.S.A., Sridhar, D. (2021). SARS-CoV-2 variants and ending the COVID-19 pandemic, The Lancet, 397(10278), 952-954. doi.
  19. Garber, A.M. (2021). Learning from excess pandemic deaths, Journal of the American Medical Association, 325(17), 1729-1730. doi.
  20. IMARC, (2022). Mechanical Ventilators Market: Global Industry Trends, Share, Size, Growth, Opportunity and Forecast, 2021-2026.
  21. Islam, N., Shkolnikov, V. M., Acosta, R. J., Klimkin, I., Kawachi, I., Irizarry, R. A., Alicandro, G., Khunti, K., Yates, T., Jdanov, D. A., White, M., Lewington, S., Lacey, B. (2021). Excess deaths associated with covid-19 pandemic in 2020: age and sex disaggregated time series analysis in 29 high income countries. BMJ, 373, n1137.
  22. Johns Hopkins Center for System Science and Engineering, (2022). Coronavirus COVID-19 Global Cases, accessed in 14 January 2022. Retrieved from.
  23. Kapitsinis, N. (2020). The underlying factors of the COVID-19 spatially uneven spread. Initial evidence from regions in nine EU countries. Regional Science Policy and Practice, 12(6), 1027-1045. doi.
  24. Lau, H., Khosrawipour, T., Kocbach, P., Ichii, H., Bania, J., Khosrawipour, V. (2021). Evaluating the massive underreporting and undertesting of COVID-19 cases in multiple global epicenters. Pulmonology, 27(2), 110-115. doi.
  25. Liu, Z., Magal, P., Webb, G. (2021). Predicting the number of reported and unreported cases for the COVID-19 epidemics in China, South Korea, Italy, France, Germany and United Kingdom. Journal of Theoretical Biology, 509, 110501.
  26. Mayo, C. (2021). Different types of COVID-19 vaccines: How they work. accessed 6 September 2021. Retrieved from.
  27. Moore, S., Hill, E.M., Tildesley, M.J., Dyson, L., Keeling, M.J. (2021). Vaccination and non-pharmaceutical interventions for COVID-19: a mathematical modelling study, The Lancet Infectious Diseases, 21(6), 793-802. doi.
  28. Nicastro, F., Sironi, G., Antonello, E., (...), Trabattoni, D., Clerici, M. (2021). Solar UV-B/A radiation is highly effective in inactivating SARS-CoV-2, Scientific Reports 11(1), 14805. doi.
  29. Our World in Data, (2022). Coronavirus (COVID-19) Vaccinations - Statistics and Research - Our World in Data. Accessed 25 January. Retrieved from.
  30. Papanikolaou, V., Chrysovergis, A., Ragos, V., Tsiambas, E., Katsinis, S., Manoli, A., Papouliakos, S., Roukas, D., Mastronikolis, S., Peschos, D., Batistatou, A., Kyrodimos, E., Mastronikolis, N. (2022). From delta to Omicron: S1-RBD/S2 mutation/deletion equilibrium in SARS-CoV-2 defined variants. Gene, 814, 146134. doi.
  31. Prieto-Curiel, R., Gonzlez Ramrez, H. (2021). Vaccination strategies against COVID-19 and the diffusion of anti-vaccination views, Scientific Reports, 11(1), 6626. doi.
  32. Randolph, H.E., Barreiro, L.B. (2020). Herd immunity: understanding COVID-19. Immunity, 52, 737-741. doi.
  33. Ritchie, H., Ortiz-Ospina, E., Beltekian, D., Mathieu, E., Hasel, J., Macdonald, B., Giattino, C., Roser, M. (2020). Policy Responses to the Coronavirus Pandemic. Our World in Data, Statistics and Research. July 7. Retrieved from.
  34. Rosario, D.K.A., Mutz, Y.S., Bernardes, P.C., Conte-Junior, C.A. (2020). Relationship between COVID-19 and weather: Case study in a tropical country. International Journal of Hygiene and Environmental Health, 229, 113587. doi.
  35. Saadi, N., Chi, Y.-L., Ghosh, S., (...), Jit, M., Vassall, A. (2021). Models of COVID-19 vaccine prioritisation: a systematic literature search and narrative review, BMC Medicine, 19(1), 318-340. doi.
  36. Seligman B, Ferranna M, Bloom D.E. (2021). Social determinants of mortality fromCOVID-19: A simulation study using NHANES. PLoS Med, 18(1), e1003490. doi.
  37. Shattock, A.J., Le Rutte, E.A., Dnner, R.P., (...), Chitnis, N., Penny, M.A. (2022). Impact of vaccination and no n-pharmaceutical interventions on SARS-CoV-2 dynamics in Switzerland, Epidemics, 38, 100535. doi.
  38. Soo Hoo, G.W. (2010). Noninvasive ventilation in adults with acute respiratory distress: a primer for the clinician. Hospital Practice, 38(1), 1625. doi.
  39. Stokes, A. C., Lundberg, D.J., Bor, J., Bibbins-Domingo, K. (2021). Excess Deaths During the COVID-19 Pandemic: Implications for US Death Investigation Systems. American Journal of Public Health, 111(S2), S53S54.
  40. Stokes, A.C., Lundberg, D.J., Elo, I.T., Hempstead, K., Bor, J., Preston, S.H. (2021a). COVID-19 and excess mortality in the United States: A county-level analysis, PLoS Medicine, 18(5), no.e1003571. doi.
  41. The World Bank, (2022a). Data, Population, total. Accessed January 2022. Retrieved from.
  42. The World Bank, (2022). Current health expenditure (% of GDP), Accessed February 2022. Retrieved from.
  43. Vinceti, M., Filippini, T., Rothman, K.J., Di Federico, S., Orsini, N. (2021). SARS-CoV-2 infection incidence during the first and second COVID-19 waves in Italy. Environmental research, 197, 111097. doi.


Kargı, Bilal, Coccia, Mario, Uçkaç, Bekir Cihan "Socioeconomic, Demographic and Environmental Factors and COVID-19 Vaccination: Interactions Affecting Effectiveness" Bulletin Social-Economic and Humanitarian Research, Tom 19, Issue 21 P. 83 - 99. doi: 10.52270/26585561_2023_19_21_83