Human mobility increased with vaccine coverage and attenuated the protection of COVID-19 vaccination: A longitudinal study of 107 countries

BACKGROUND: The World Health Organization has raised concerns that vaccinated people may reduce physical and social distancing more than necessary. With imperfect vaccine protection and the lifting of mobility restrictions, understanding how human mobility responded to vaccination and its potential consequence is critical. We estimated vaccination-induced mobility (VM) and examined whether it attenuates the effect of COVID-19 vaccination on controlling case growth. METHODS: We collected a longitudinal data set of 107 countries between 15 February 2020 and 6 February 2022 from Google COVID-19 Community Mobility Reports, the Oxford COVID-19 Government Response Tracker, Our World in Data, and World Development Indicators. We measured mobility in four categories of location: retail and recreational places, transit stations, grocery stores and pharmacies, and workplaces. We applied panel data models to address unobserved country characteristics and used Gelbach decomposition to evaluate the extent to which VM has offset vaccination effectiveness. RESULTS: Across locations, a 10-percentage-point (pp) increase in vaccine coverage was associated with a 1.4-4.3 pp increase in mobility (P < 0.001). VM was greater in lower-income countries (up to 7.9 pps; 95% confidence interval (CI) = 5.3 to 10.5, P < 0.001) and in earlier stages of vaccine rollouts (up to 19.2 pps; 95% CI = 15.1 to 23.2%, P < 0.001). VM decreased the effectiveness of vaccines in controlling case growth by 33.4% in retail and recreation places (P < 0.001), 26.4% in transit stations (P < 0.001), and 15.4% in grocery stores and pharmacies (P = 0.002). CONCLUSIONS: VM provides support for the Peltzman effect; it attenuates but does not completely counter vaccine effectiveness. Our study findings suggest strategies for mitigating the unintended consequences of VM, including reducing short-term mobility responses after vaccination, prioritizing mobility in grocery-type places and workplaces, and accelerating rollouts at earlier stages of vaccination, especially in lower-income countries.