On Jul. 24, 2023, the Journal JAMA reported there is evidence that Republican-leaning counties 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. The study evaluated 538,159 deaths in individuals aged 25 years and older in Florida and Ohio between March 2020 and December 2021.

These differences were concentrated in counties with lower vaccination rates, and primarily noted in voters residing in Ohio.