NPR examined COVID deaths per 100,000 people in roughly 3,000 counties across the U.S. from May 2021, the point at which most Americans could find a vaccine if they wanted one. Those living in counties that voted 60% or higher for Trump in November 2020 had 2.26 times the death rate of those that went by the same margin for Biden. Counties with a higher share of Trump votes had even higher mortality rates.

The scale of the preventable loss of life is staggering. According to a recent analysis by Brown University, nearly 320,000 lives nationwide could have been saved if more people had chosen to get vaccinated. The Brown analysis also shows a partisan split in how those preventable deaths are distributed. States that went most heavily for Trump – including Wyoming and West Virginia – have among the highest rates of preventable deaths, while states that voted heavily for Biden – such as Massachusetts and Vermont – had among the lowest.