This file contains COVID-19 death counts and rates by month and year of death, jurisdiction of residence (U.S., HHS Region) and demographic characteristics (sex, age, race and Hispanic origin, and age/race and Hispanic origin). United States death counts and rates include the 50 states, plus the District of Columbia. Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1. Number of deaths reported in this file are the total number of COVID-19 deaths received and coded as of the date of analysis and may not represent all deaths that occurred in that period. Counts of deaths occurring before or after the reporting period are not included in the file. Data during recent periods are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction and cause of death. Death counts should not be compared across jurisdictions. Data timeliness varies by state. Some states report deaths on a daily basis, while other states report deaths weekly or monthly. The ten (10) United States Department of Health and Human Services (HHS) regions include the following jurisdictions. Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont; Region 2: New Jersey, New York; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin; Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, Texas; Region 7: Iowa, Kansas, Missouri, Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming; Region 9: Arizona, California, Hawaii, Nevada; Region 10: Alaska, Idaho, Oregon, Washington. Rates were calculated using the population estimates for 2021, which are estimated as of July 1, 2021 based on the Blended Base produced by the US Census Bureau in lieu of the April 1, 2020 decennial population count. The Blended Base consists of the blend of Vintage 2020 postcensal population estimates, 2020 Demographic Analysis Estimates, and 2020 Census PL 94-171 Redistricting File (see https://www2.census.gov/programs-surveys/popest/technical-documentation/methodology/2020-2021/methods-statement-v2021.pdf). Rate are based on deaths occurring in the specified week and are age-adjusted to the 2000 standard population using the direct method (see https://www.cdc.gov/nchs/data/nvsr/nvsr70/nvsr70-08-508.pdf). These rates differ from annual age-adjusted rates, typically presented in NCHS publications based on a full year of data and annualized weekly age-adjusted rates which have been adjusted to allow comparison with annual rates. Annualization rates presents deaths per year per 100,000 population that would be expected in a year if the observed period specific (weekly) rate prevailed for a full year. Sub-national death counts between 1-9 are suppressed in accordance with NCHS data confidentiality standards. Rates based on death counts less than 20 are suppressed in accordance with NCHS standards of reliability as specified in NCHS Data Presentation Standards for Proportions (available from: https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf.).

Reporting of new Aggregate Case and Death Count data was discontinued May 11, 2023, with the expiration of the COVID-19 public health emergency declaration. This dataset will receive a final update on June 1, 2023, to reconcile historical data through May 10, 2023, and will remain publicly available.

Aggregate Data Collection Process Since the start of the COVID-19 pandemic, data have been gathered through a robust process with the following steps:

• A CDC data team reviews and validates the information obtained from jurisdictions’ state and local websites via an overnight data review process.
• If more than one official county data source exists, CDC uses a comprehensive data selection process comparing each official county data source, and takes the highest case and death counts respectively, unless otherwise specified by the state.
• CDC compiles these data and posts the finalized information on COVID Data Tracker.
• County level data is aggregated to obtain state and territory specific totals.

This process is collaborative, with CDC and jurisdictions working together to ensure the accuracy of COVID-19 case and death numbers. County counts provide the most up-to-date numbers on cases and deaths by report date. CDC may retrospectively update counts to correct data quality issues.

Methodology Changes Several differences exist between the current, weekly-updated dataset and the archived version:

• Source: The current Weekly-Updated Version is based on county-level aggregate count data, while the Archived Version is based on State-level aggregate count data.
• Confirmed/Probable Cases/Death breakdown:  While the probable cases and deaths are included in the total case and total death counts in both versions (if applicable), they were reported separately from the confirmed cases and deaths by jurisdiction in the Archived Version.  In the current Weekly-Updated Version, the counts by jurisdiction are not reported by confirmed or probable status (See Confirmed and Probable Counts section for more detail).
• Time Series Frequency: The current Weekly-Updated Version contains weekly time series data (i.e., one record per week per jurisdiction), while the Archived Version contains daily time series data (i.e., one record per day per jurisdiction).
• Update Frequency: The current Weekly-Updated Version is updated weekly, while the Archived Version was updated twice daily up to October 20, 2022.

Important note: The counts reflected during a given time period in this dataset may not match the counts reflected for the same time period in the archived dataset noted above. Discrepancies may exist due to differences between county and state COVID-19 case surveillance and reconciliation efforts.

Confirmed and Probable Counts In this dataset, counts by jurisdiction are not displayed by confirmed or probable status. Instead, confirmed and probable cases and deaths are included in the Total Cases and Total Deaths columns, when available. Not all jurisdictions report probable cases and deaths to CDC.* Confirmed and probable case definition criteria are described here:

Council of State and Territorial Epidemiologists (ymaws.com).

Deaths CDC reports death data on other sections of the website: CDC COVID Data Tracker: Home, CDC COVID Data Tracker: Cases, Deaths, and Testing, and NCHS Provisional Death Counts. Information presented on the COVID Data Tracker pages is based on the same source (to

Data on drug overdose death rates, by drug type and selected population characteristics. Please refer to the PDF or Excel version of this table in the HUS 2019 Data Finder (https://www.cdc.gov/nchs/hus/contents2019.htm) for critical information about measures, definitions, and changes over time. SOURCE: NCHS, National Vital Statistics System, numerator data from annual public-use Mortality Files; denominator data from U.S. Census Bureau national population estimates; and Murphy SL, Xu JQ, Kochanek KD, Arias E, Tejada-Vera B. Deaths: Final data for 2018. National Vital Statistics Reports; vol 69 no 13. Hyattsville, MD: National Center for Health Statistics.2021. Available from: https://www.cdc.gov/nchs/products/nvsr.htm. For more information on the National Vital Statistics System, see the corresponding Appendix entry at https://www.cdc.gov/nchs/data/hus/hus19-appendix-508.pdf.

This file contains COVID-19 death counts, death rates, and percent of total deaths by jurisdiction of residence. The data is grouped by different time periods including 3-month period, weekly, and total (cumulative since January 1, 2020). United States death counts and rates include the 50 states, plus the District of Columbia and New York City. New York state estimates exclude New York City. Puerto Rico is included in HHS Region 2 estimates.

Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1. Number of deaths reported in this file are the total number of COVID-19 deaths received and coded as of the date of analysis and may not represent all deaths that occurred in that period. Counts of deaths occurring before or after the reporting period are not included in the file.

Data during recent periods are incomplete because of the lag in time between when the death occurred and when the death certificate is completed, submitted to NCHS and processed for reporting purposes. This delay can range from 1 week to 8 weeks or more, depending on the jurisdiction and cause of death.

Death counts should not be compared across states. Data timeliness varies by state. Some states report deaths on a daily basis, while other states report deaths weekly or monthly.

The ten (10) United States Department of Health and Human Services (HHS) regions include the following jurisdictions. Region 1: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont; Region 2: New Jersey, New York, New York City, Puerto Rico; Region 3: Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia; Region 4: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee; Region 5: Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin; Region 6: Arkansas, Louisiana, New Mexico, Oklahoma, Texas; Region 7: Iowa, Kansas, Missouri, Nebraska; Region 8: Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming; Region 9: Arizona, California, Hawaii, Nevada; Region 10: Alaska, Idaho, Oregon, Washington.

Rates were calculated using the population estimates for 2021, which are estimated as of July 1, 2021 based on the Blended Base produced by the US Census Bureau in lieu of the April 1, 2020 decennial population count. The Blended Base consists of the blend of Vintage 2020 postcensal population estimates, 2020 Demographic Analysis Estimates, and 2020 Census PL 94-171 Redistricting File (see https://www2.census.gov/programs-surveys/popest/technical-documentation/methodology/2020-2021/methods-statement-v2021.pdf).

Rates are based on deaths occurring in the specified week/month and are age-adjusted to the 2000 standard population using the direct method (see https://www.cdc.gov/nchs/data/nvsr/nvsr70/nvsr70-08-508.pdf). These rates differ from annual age-adjusted rates, typically presented in NCHS publications based on a full year of data and annualized weekly/monthly age-adjusted rates which have been adjusted to allow comparison with annual rates. Annualization rates presents deaths per year per 100,000 population that would be expected in a year if the observed period specific (weekly/monthly) rate prevailed for a full year.

Sub-national death counts between 1-9 are suppressed in accordance with NCHS data confidentiality standards. Rates based on death counts less than 20 are suppressed in accordance with NCHS standards of reliability as specified in NCHS Data Presentation Standards for Proportions (available from: https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf.).

Data for CDC’s COVID Data Tracker site on Rates of COVID-19 Cases and Deaths by Vaccination Status. Click 'More' for important dataset description and footnotes

Dataset and data visualization details: These data were posted on October 21, 2022, archived on November 18, 2022, and revised on February 22, 2023. These data reflect cases among persons with a positive specimen collection date through September 24, 2022, and deaths among persons with a positive specimen collection date through September 3, 2022.

Vaccination status: A person vaccinated with a primary series had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after verifiably completing the primary series of an FDA-authorized or approved COVID-19 vaccine. An unvaccinated person had SARS-CoV-2 RNA or antigen detected on a respiratory specimen and has not been verified to have received COVID-19 vaccine. Excluded were partially vaccinated people who received at least one FDA-authorized vaccine dose but did not complete a primary series ≥14 days before collection of a specimen where SARS-CoV-2 RNA or antigen was detected. Additional or booster dose: A person vaccinated with a primary series and an additional or booster dose had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after receipt of an additional or booster dose of any COVID-19 vaccine on or after August 13, 2021. For people ages 18 years and older, data are graphed starting the week including September 24, 2021, when a COVID-19 booster dose was first recommended by CDC for adults 65+ years old and people in certain populations and high risk occupational and institutional settings. For people ages 12-17 years, data are graphed starting the week of December 26, 2021, 2 weeks after the first recommendation for a booster dose for adolescents ages 16-17 years. For people ages 5-11 years, data are included starting the week of June 5, 2022, 2 weeks after the first recommendation for a booster dose for children aged 5-11 years. For people ages 50 years and older, data on second booster doses are graphed starting the week including March 29, 2022, when the recommendation was made for second boosters. Vertical lines represent dates when changes occurred in U.S. policy for COVID-19 vaccination (details provided above). Reporting is by primary series vaccine type rather than additional or booster dose vaccine type. The booster dose vaccine type may be different than the primary series vaccine type. ** Because data on the immune status of cases and associated deaths are unavailable, an additional dose in an immunocompromised person cannot be distinguished from a booster dose. This is a relevant consideration because vaccines can be less effective in this group. Deaths: A COVID-19–associated death occurred in a person with a documented COVID-19 diagnosis who died; health department staff reviewed to make a determination using vital records, public health investigation, or other data sources. Rates of COVID-19 deaths by vaccination status are reported based on when the patient was tested for COVID-19, not the date they died. Deaths usually occur up to 30 days after COVID-19 diagnosis. Participating jurisdictions: Currently, these 31 health departments that regularly link their case surveillance to immunization information system data are included in these incidence rate estimates: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, New York, New York City (New York), North Carolina, Philadelphia (Pennsylvania), Rhode Island, South Dakota, Tennessee, Texas, Utah, Washington, and West Virginia; 30 jurisdictions also report deaths among vaccinated and unvaccinated people. These jurisdictions represent 72% of the total U.S. population and all ten of the Health and Human Services Regions. Data on cases

Data for CDC’s COVID Data Tracker site on Rates of COVID-19 Cases and Deaths by Vaccination Status. Click 'More' for important dataset description and footnotes

Dataset and data visualization details: These data were posted on October 21, 2022, archived on November 18, 2022, and revised on February 22, 2023. These data reflect cases among persons with a positive specimen collection date through September 24, 2022, and deaths among persons with a positive specimen collection date through September 3, 2022.

Vaccination status: A person vaccinated with a primary series had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after verifiably completing the primary series of an FDA-authorized or approved COVID-19 vaccine. An unvaccinated person had SARS-CoV-2 RNA or antigen detected on a respiratory specimen and has not been verified to have received COVID-19 vaccine. Excluded were partially vaccinated people who received at least one FDA-authorized vaccine dose but did not complete a primary series ≥14 days before collection of a specimen where SARS-CoV-2 RNA or antigen was detected. Additional or booster dose: A person vaccinated with a primary series and an additional or booster dose had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after receipt of an additional or booster dose of any COVID-19 vaccine on or after August 13, 2021. For people ages 18 years and older, data are graphed starting the week including September 24, 2021, when a COVID-19 booster dose was first recommended by CDC for adults 65+ years old and people in certain populations and high risk occupational and institutional settings. For people ages 12-17 years, data are graphed starting the week of December 26, 2021, 2 weeks after the first recommendation for a booster dose for adolescents ages 16-17 years. For people ages 5-11 years, data are included starting the week of June 5, 2022, 2 weeks after the first recommendation for a booster dose for children aged 5-11 years. For people ages 50 years and older, data on second booster doses are graphed starting the week including March 29, 2022, when the recommendation was made for second boosters. Vertical lines represent dates when changes occurred in U.S. policy for COVID-19 vaccination (details provided above). Reporting is by primary series vaccine type rather than additional or booster dose vaccine type. The booster dose vaccine type may be different than the primary series vaccine type. ** Because data on the immune status of cases and associated deaths are unavailable, an additional dose in an immunocompromised person cannot be distinguished from a booster dose. This is a relevant consideration because vaccines can be less effective in this group. Deaths: A COVID-19–associated death occurred in a person with a documented COVID-19 diagnosis who died; health department staff reviewed to make a determination using vital records, public health investigation, or other data sources. Rates of COVID-19 deaths by vaccination status are reported based on when the patient was tested for COVID-19, not the date they died. Deaths usually occur up to 30 days after COVID-19 diagnosis. Participating jurisdictions: Currently, these 31 health departments that regularly link their case surveillance to immunization information system data are included in these incidence rate estimates: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, District of Columbia, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, New York, New York City (New York), North Carolina, Philadelphia (Pennsylvania), Rhode Island, South Dakota, Tennessee, Texas, Utah, Washington, and West Virginia; 30 jurisdictions also report deaths among vaccinated and unvaccinated people. These jurisdictions represent 72% of the total U.S. population and all ten of the Health and Human Services Regions. Data on cases

TABLE III. Deaths in 122 U.S. cities - 2015122 Cities Mortality Reporting System ��� Each week, the vital statistics offices of 122 cities across the United States report the total number of death certificates processed and the number of those for which pneumonia or influenza was listed as the underlying or contributing cause of death by age group (Under 28 days, 28 days ���1 year, 1-14 years, 15-24 years, 25-44 years, 45-64 years, 65-74 years, 75-84 years, and ��� 85 years).FOOTNOTE:U: Unavailable -: No reported cases * Mortality data in this table are voluntarily reported from 122 cities in the United States, most of which have populations of 100,000 or more. A death is reported by the place of its occurrence and by the week that the death certificate was filed. Fetal deaths are not included. ** Totals include unknown ages. *** Partial counts for this city.

The National Death Index (NDI) is a centralized database of death record information on file in state vital statistics offices. Working with these state offices, the National Center for Health Statistics (NCHS) established the NDI as a resource to aid epidemiologists and other health and medical investigators with their mortality ascertainment activities. Assists investigators in determining whether persons in their studies have died and, if so, provide the names of the states in which those deaths occurred, the dates of death, and the corresponding death certificate numbers. Investigators can then make arrangements with the appropriate state offices to obtain copies of death certificates or specific statistical information such as manner of death or educational level. Cause of death codes may also be obtained using the NDI Plus service. Records from 1979 through 2011 are currently available and contain a standard set of identifying information on each death. Death records are added to the NDI file annually, approximately 12 months after the end of a particular calendar year. 2012 should be available summer 2014. Early Release Program for 2013 is now available. The NDI service is available to investigators solely for statistical purposes in medical and health research. The service is not accessible to organizations or the general public for legal, administrative, or genealogy purposes.

Note: The cumulative case count for some counties (with small population) is higher than expected due to the inclusion of non-permanent residents in COVID-19 case counts.

Reporting of Aggregate Case and Death Count data was discontinued on May 11, 2023, with the expiration of the COVID-19 public health emergency declaration. Although these data will continue to be publicly available, this dataset will no longer be updated.

Aggregate Data Collection Process Since the beginning of the COVID-19 pandemic, data were reported through a robust process with the following steps:

• Aggregate county-level counts were obtained indirectly, via automated overnight web collection, or directly, via a data submission process.
• If more than one official county data source existed, CDC used a comprehensive data selection process comparing each official county data source to retrieve the highest case and death counts, unless otherwise specified by the state.
• A CDC data team reviewed counts for congruency prior to integration. CDC routinely compiled these data and post the finalized information on COVID Data Tracker.
• Cases and deaths are based on date of report and not on the date of symptom onset. CDC calculates rates in this data by using population estimates provided by the US Census Bureau Population Estimates Program (2019 Vintage).
• COVID-19 aggregate case and death data were organized in a time series that includes cumulative number of cases and deaths as reported by a jurisdiction on a given date. New case and death counts were calculated as the week-to-week change in reported cumulative cases and deaths (i.e., newly reported cases and deaths = cumulative number of cases/deaths reported this week minus the cumulative total reported the week before.

This process was collaborative, with CDC and jurisdictions working together to ensure the accuracy of COVID-19 case and death numbers. County counts provided the most up-to-date numbers on cases and deaths by report date. Throughout data collection, CDC retrospectively updated counts to correct known data quality issues. CDC also worked with jurisdictions after the end of the public health emergency declaration to finalize county data.

• Source: The weekly archived dataset is based on county-level aggregate count data
• Confirmed/Probable Cases/Death breakdown: Cumulative cases and deaths for each county are included. Total reported cases include probable and confirmed cases.
• Time Series Frequency: The weekly archived dataset contains weekly time series data (i.e., one record per week per county)

Important note: The counts reflected during a given time period in this dataset may not match the counts reflected for the same time period in the daily archived dataset noted above. Discrepancies may exist due to differences between county and state COVID-19 case surveillance and reconciliation efforts.

The surveillance case definition for COVID-19, a nationally notifiable disease, was first described in a position statement from the Council for State and Territorial Epidemiologists, which was later revised. However, there is some variation in how jurisdictions implement these case classifications. More information on how CDC collects COVID-19 case surveillance data can be found at FAQ: COVID-19 Data and Surveillance.

Confirmed and Probable Counts In this dataset, counts by jurisdiction are not displayed by confirmed or probable status. Instead, counts of confirmed and probable cases and deaths are included in the Total Cases and Total Deaths columns, when available. Not all jurisdictions report

This data presents national-level provisional maternal mortality rates based on a current flow of mortality and natality data in the National Vital Statistics System. Provisional rates which are an early estimate of the number of maternal deaths per 100,000 live births, are shown as of the date specified and may not include all deaths and births that occurred during a given time period (see Technical Notes).

A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. In this data visualization, maternal deaths are those deaths with an underlying cause of death assigned to International Statistical Classification of Diseases, 10th Revision (ICD-10) code numbers A34, O00–O95, and O98–O99.

The provisional data include reported 12 month-ending provisional maternal mortality rates overall, by age, and by race and Hispanic origin. Provisional maternal mortality rates presented in this data visualization are for “12-month ending periods,” defined as the number of maternal deaths per 100,000 live births occurring in the 12-month period ending in the month indicated. For example, the 12-month ending period in June 2020 would include deaths and births occurring from July 1, 2019, through June 30, 2020. Evaluation of trends over time should compare estimates from year to year (June 2020 and June 2021), rather than month to month, to avoid overlapping time periods. In the visualization and in the accompanying data file, rates based on death counts less than 20 are suppressed in accordance with current NCHS standards of reliability for rates. Death counts between 1-9 in the data file are suppressed in accordance with National Center for Health Statistics (NCHS) confidentiality standards.

Provisional data presented on this page will be updated on a quarterly basis as additional records are received. Previously released estimates are revised to include data and record updates received since the previous release. As a result, the reliability of estimates for a 12-month period ending with a specific month will improve with each quarterly release and estimates for previous time periods may change as new data and updates are received.

This dataset includes all infant deaths that were linked to their corresponding birth certificate and includes all items released in the public-use file. Additional information in this file includes state and county of residence and exact dates of birth and death (which includes day of month, month, and year).

This dataset includes all fetal deaths for a given year and includes all items released in the public-use file. Additional information in this file includes state and county of residence (cities with a population of 250,000 or greater) and exact date of delivery (which includes day of month, month, and year).

The Public Health Emergency (PHE) declaration for COVID-19 expired on May 11, 2023. As a result, the Aggregate Case and Death Surveillance System will be discontinued. Although these data will continue to be publicly available, this dataset will no longer be updated.

On October 20, 2022, CDC began retrieving aggregate case and death data from jurisdictional and state partners weekly instead of daily.

This dataset includes the URLs that were used by the aggregate county data collection process that compiled aggregate case and death counts by county. Within this file, each of the states (plus select jurisdictions and territories) are listed along with the county web sources which were used for pulling these numbers. Some states had a single statewide source for collecting the county data, while other states and local health jurisdictions may have had standalone sources for individual counties. In the cases where both local and state web sources were listed, a composite approach was taken so that the maximum value reported for a location from either source was used. The initial raw data were sourced from these links and ingested into the CDC aggregate county dataset before being published on the COVID Data Tracker.

This file contains the complete set of data reported to 122 Cities Mortality Reposting System. The system was retired as of 10/6/2016. While the system was running each week, the vital statistics offices of 122 cities across the United States reported the total number of death certificates processed and the number of those for which pneumonia or influenza was listed as the underlying or contributing cause of death by age group (Under 28 days, 28 days - 1 year, 1-14 years, 15-24 years, 25-44 years, 45-64 years, 65-74 years, 75-84 years, and - 85 years). U:Unavailable. - : No reported cases.* Mortality data in this table were voluntarily reported from 122 cities in the United States, most of which have populations of >100,000. A death is reported by the place of its occurrence and by the week that the death certificate was filed. Fetal deaths are not included. Total includes unknown ages.
More information on Flu Activity & Surveillance is available at http://www.cdc.gov/flu/weekly/fluactivitysurv.htm.

Data for CDC’s COVID Data Tracker site on Rates of COVID-19 Cases and Deaths by Updated (Bivalent) Booster Status. Click 'More' for important dataset description and footnotes

Webpage: https://covid.cdc.gov/covid-data-tracker/#rates-by-vaccine-status

Dataset and data visualization details:

These data were posted and archived on May 30, 2023 and reflect cases among persons with a positive specimen collection date through April 22, 2023, and deaths among persons with a positive specimen collection date through April 1, 2023. These data will no longer be updated after May 2023.

Vaccination status: A person vaccinated with at least a primary series had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after verifiably completing the primary series of an FDA-authorized or approved COVID-19 vaccine. An unvaccinated person had SARS-CoV-2 RNA or antigen detected on a respiratory specimen and has not been verified to have received COVID-19 vaccine. Excluded were partially vaccinated people who received at least one FDA-authorized vaccine dose but did not complete a primary series ≥14 days before collection of a specimen where SARS-CoV-2 RNA or antigen was detected. A person vaccinated with a primary series and a monovalent booster dose had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after verifiably receiving a primary series of an FDA-authorized or approved vaccine and at least one additional dose of any monovalent FDA-authorized or approved COVID-19 vaccine on or after August 13, 2021. (Note: this definition does not distinguish between vaccine recipients who are immunocompromised and are receiving an additional dose versus those who are not immunocompromised and receiving a booster dose.) A person vaccinated with a primary series and an updated (bivalent) booster dose had SARS-CoV-2 RNA or antigen detected in a respiratory specimen collected ≥14 days after verifiably receiving a primary series of an FDA-authorized or approved vaccine and an additional dose of any bivalent FDA-authorized or approved vaccine COVID-19 vaccine on or after September 1, 2022. (Note: Doses with bivalent doses reported as first or second doses are classified as vaccinated with a bivalent booster dose.) People with primary series or a monovalent booster dose were combined in the “vaccinated without an updated booster” category.

Deaths: A COVID-19–associated death occurred in a person with a documented COVID-19 diagnosis who died; health department staff reviewed to make a determination using vital records, public health investigation, or other data sources. Per the interim guidance of the Council of State and Territorial Epidemiologists (CSTE), this should include persons whose death certificate lists COVID-19 disease or SARS-CoV-2 as the underlying cause of death or as a significant condition contributing to death. Rates of COVID-19 deaths by vaccination status are primarily reported based on when the patient was tested for COVID-19. In select jurisdictions, deaths are included that are not laboratory confirmed and are reported based on alternative dates (i.e., onset date for most; or date of death or report date, where onset date is unavailable). Deaths usually occur up to 30 days after COVID-19 diagnosis.

Participating jurisdictions: Currently, these 24 health departments that regularly link their case surveillance to immunization information system data are included in these incidence rate estimates: Alabama, Arizona, Colorado, District of Columbia, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, New York, New York City (NY), North Carolina, Rhode Island, Tennessee, Texas, Utah, and West Virginia; 23 jurisdictions also report deaths among vaccinated and unvaccinated people. These jurisdictions represent 48% of the total U.S. population and all ten of the Health and Human Services Regions. This list will be updated as more jurisdictions participate.

Incidence rate estimates: Weekly age-specific incidence rates by vaccination status were calculated as the number of cases or deaths divided by the number of people vaccinated with a primary series, overall or with/without a booster dose (cumulative) or unvaccinated (obtained by subtracting the cumulative number of people vaccinated with at least a primary series and partially vaccinated people from the 2019 U.S. intercensal population estimates) and multiplied by 100,000. Overall incidence rates were age-standardized using the 2000 U.S. Census standard population. To estimate population counts for ages 6-12 months, half of the single-year population counts for ages <12 months were used. All rates are plotted by positive specimen collection date to reflect when incident infections occurred.

Continuity correction: A continuity correction has been applied to the denominators by capping the percent population coverage at 95%. To do this, we assumed that at least 5% of each age group would always be unvaccinated in each jurisdiction. Adding this correction ensures that there is always a reasonable denominator for the unvaccinated population that would prevent incidence and death rates from growing unrealistically large due to potential overestimates of vaccination coverage.

Incidence rate ratios (IRRs): IRRs for the past one month were calculated by dividing the average weekly incidence rates among unvaccinated people by that among people vaccinated without an updated (bivalent) booster dose) or vaccinated with an updated (bivalent) booster dose.

Archive: An archive of historic data, including April 3, 2021-September 24, 2022 and posted on October 21, 2022 is available on data.cdc.gov. The analysis by vaccination status (unvaccinated and at least a primary series) for 31 jurisdictions is posted here: https://data.cdc.gov/Public-Health-Surveillance/Rates-of-COVID-19-Cases-or-Deaths-by-Age-Group-and/3rge-nu2a. The analysis for one booster dose (unvaccinated, primary series only, and at least one booster dose) in 31 jurisdictions is posted here: https://data.cdc.gov/Public-Health-Surveillance/Rates-of-COVID-19-Cases-or-Deaths-by-Age-Group-and/d6p8-wqjm. The analysis for two booster doses (unvaccinated, primary series only, one booster dose, and at least two booster doses) in 28 jurisdictions is posted here: https://data.cdc.gov/Public-Health-Surveillance/Rates-of-COVID-19-Cases-or-Deaths-by-Age-Group-and/ukww-au2k.

References

Scobie HM, Johnson AG, Suthar AB, et al. Monitoring Incidence of COVID-19 Cases, Hospitalizations, and Deaths, by Vaccination Status — 13 U.S. Jurisdictions, April 4–July 17, 2021. MMWR Morb Mortal Wkly Rep 2021;70:1284–1290.

Johnson AG, Amin AB, Ali AR, et al. COVID-19 Incidence and Death Rates Among Unvaccinated and Fully Vaccinated Adults with and Without Booster Doses During Periods of Delta and Omicron Variant Emergence — 25 U.S. Jurisdictions, April 4–December 25, 2021. MMWR Morb Mortal Wkly Rep 2022;71:132–138

Johnson AG, Linde L, Ali AR, et al. COVID-19 Incidence and Mortality Among Unvaccinated and Vaccinated Persons Aged ≥12 Years by Receipt of Bivalent Booster Doses and Time Since Vaccination — 24 U.S. Jurisdictions, October 3, 2021–December 24, 2022. MMWR Morb Mortal Wkly Rep 2023;72:145–152

On October 20, 2022, CDC began retrieving aggregate case and death data from jurisdictional and state partners weekly instead of daily. This dataset contains archived historical community transmission and related data elements by county. Although these data will continue to be publicly available, this dataset has not been updated since October 20, 2022. An archived dataset containing weekly historical community transmission data by county can also be found here: Weekly COVID-19 County Level of Community Transmission Historical Changes | Data | Centers for Disease Control and Prevention (cdc.gov).

Related data CDC has been providing the public with two versions of COVID-19 county-level community transmission level data: this historical dataset with the daily county-level transmission data from January 22, 2020, and a dataset with the daily values as originally posted on the COVID Data Tracker. Similar to this dataset, the original dataset with daily data as posted is archived on 10/20/2022. It will continue to be publicly available but will no longer be updated. A new dataset containing community transmission data by county as originally posted is now published weekly and can be found at: Weekly COVID-19 County Level of Community Transmission as Originally Posted | Data | Centers for Disease Control and Prevention (cdc.gov).

This public use dataset has 7 data elements reflecting historical data for community transmission levels for all available counties and jurisdictions. It contains historical data for the county level of community transmission and includes updated data submitted by states and jurisdictions. Each day, the dataset was updated to include the most recent days’ data and incorporate any historical changes made by jurisdictions. This dataset includes data since January 22, 2020. Transmission level is set to low, moderate, substantial, or high using the calculation rules below.

Methods for calculating county level of community transmission indicator The County Level of Community Transmission indicator uses two metrics: (1) total new COVID-19 cases per 100,000 persons in the last 7 days and (2) percentage of positive SARS-CoV-2 diagnostic nucleic acid amplification tests (NAAT) in the last 7 days. For each of these metrics, CDC classifies transmission values as low, moderate, substantial, or high (below and here). If the values for each of these two metrics differ (e.g., one indicates moderate and the other low), then the higher of the two should be used for decision-making.

CDC core metrics of and thresholds for community transmission levels of SARS-CoV-2

Total New Case Rate Metric: "New cases per 100,000 persons in the past 7 days" is calculated by adding the number of new cases in the county (or other administrative level) in the last 7 days divided by the population in the county (or other administrative level) and multiplying by 100,000. "New cases per 100,000 persons in the past 7 days" is considered to have transmission level of Low (0-9.99); Moderate (10.00-49.99); Substantial (50.00-99.99); and High (greater than or equal to 100.00).

Test Percent Positivity Metric: "Percentage of positive NAAT in the past 7 days" is calculated by dividing the number of positive tests in the county (or other administrative level) during the last 7 days by the total number of tests resulted over the last 7 days. "Percentage of positive NAAT in the past 7 days" is considered to have transmission level of Low (less than 5.00); Moderate (5.00-7.99); Substa

On October 20, 2022, CDC began retrieving aggregate case and death data from jurisdictional and state partners weekly instead of daily. This dataset contains archived community transmission and related data elements by county as originally displayed on the COVID Data Tracker. Although these data will continue to be publicly available, this dataset has not been updated since October 20, 2022. An archived dataset containing weekly community transmission data by county as originally posted can also be found here: Weekly COVID-19 County Level of Community Transmission as Originally Posted | Data | Centers for Disease Control and Prevention (cdc.gov).

Related data CDC has been providing the public with two versions of COVID-19 county-level community transmission level data: this dataset with the daily values as originally posted on the COVID Data Tracker, and an historical dataset with daily data as well as the updates and corrections from state and local health departments. Similar to this dataset, the original historical dataset is archived on 10/20/2022. It will continue to be publicly available but will no longer be updated. A new dataset containing historical community transmission data by county is now published weekly and can be found at: Weekly COVID-19 County Level of Community Transmission Historical Changes | Data | Centers for Disease Control and Prevention (cdc.gov).

This public use dataset has 7 data elements reflecting community transmission levels for all available counties and jurisdictions. It contains reported daily transmission levels at the county level with the same values used to display transmission maps on the COVID Data Tracker. Each day, the dataset is appended to contain the most recent day's data. Transmission level is set to low, moderate, substantial, or high using the calculation rules below.

Methods for calculating county level of community transmission indicator The County Level of Community Transmission indicator uses two metrics: (1) total new COVID-19 cases per 100,000 persons in the last 7 days and (2) percentage of positive SARS-CoV-2 diagnostic nucleic acid amplification tests (NAAT) in the last 7 days. For each of these metrics, CDC classifies transmission values as low, moderate, substantial, or high (below and here). If the values for each of these two metrics differ (e.g., one indicates moderate and the other low), then the higher of the two should be used for decision-making.

CDC core metrics of and thresholds for community transmission levels of SARS-CoV-2

Total New Case Rate Metric: "New cases per 100,000 persons in the past 7 days" is calculated by adding the number of new cases in the county (or other administrative level) in the last 7 days divided by the population in the county (or other administrative level) and multiplying by 100,000. "New cases per 100,000 persons in the past 7 days" is considered to have a transmission level of Low (0-9.99); Moderate (10.00-49.99); Substantial (50.00-99.99); and High (greater than or equal to 100.00).

Test Percent Positivity Metric: "Percentage of positive NAAT in the past 7 days" is calculated by dividing the number of positive tests in the county (or other administrative level) during the last 7 days by the total number of tests conducted over the last 7 days. "Percentage of positive NAAT in the past 7 days" is considered to have a transmission level of Low (less than 5.00); Moderate (5.00-7.99); Substantial (8.00-9.99); and High (greater than or equal to 10.00).

If

TABLE III. Deaths in 122 U.S. cities – 2016. 122 Cities Mortality Reporting System — Each week, the vital statistics offices of 122 cities across the United States report the total number of death certificates processed and the number of those for which pneumonia or influenza was listed as the underlying or contributing cause of death by age group (Under 28 days, 28 days –1 year, 1-14 years, 15-24 years, 25-44 years, 45-64 years, 65-74 years, 75-84 years, and ≥ 85 years).

FOOTNOTE: U: Unavailable. —: No reported cases. * Mortality data in this table are voluntarily reported from 122 cities in the United States, most of which have populations of 100,000 or more. A death is reported by the place of its occurrence and by the week that the death certificate was filed. Fetal deaths are not included.

† Pneumonia and influenza.

§ Total includes unknown ages.

Reporting of Aggregate Case and Death Count data was discontinued May 11, 2023, with the expiration of the COVID-19 public health emergency declaration. Although these data will continue to be publicly available, this dataset will no longer be updated.

This archived public use dataset has 11 data elements reflecting United States COVID-19 community levels for all available counties.

The COVID-19 community levels were developed using a combination of three metrics — new COVID-19 admissions per 100,000 population in the past 7 days, the percent of staffed inpatient beds occupied by COVID-19 patients, and total new COVID-19 cases per 100,000 population in the past 7 days. The COVID-19 community level was determined by the higher of the new admissions and inpatient beds metrics, based on the current level of new cases per 100,000 population in the past 7 days. New COVID-19 admissions and the percent of staffed inpatient beds occupied represent the current potential for strain on the health system. Data on new cases acts as an early warning indicator of potential increases in health system strain in the event of a COVID-19 surge.

Using these data, the COVID-19 community level was classified as low, medium, or high.

COVID-19 Community Levels were used to help communities and individuals make decisions based on their local context and their unique needs. Community vaccination coverage and other local information, like early alerts from surveillance, such as through wastewater or the number of emergency department visits for COVID-19, when available, can also inform decision making for health officials and individuals.

For the most accurate and up-to-date data for any county or state, visit the relevant health department website. COVID Data Tracker may display data that differ from state and local websites. This can be due to differences in how data were collected, how metrics were calculated, or the timing of web updates.

Archived Data Notes:

This dataset was renamed from "United States COVID-19 Community Levels by County as Originally Posted" to "United States COVID-19 Community Levels by County" on March 31, 2022.

March 31, 2022: Column name for county population was changed to “county_population”. No change was made to the data points previous released.

March 31, 2022: New column, “health_service_area_population”, was added to the dataset to denote the total population in the designated Health Service Area based on 2019 Census estimate.

March 31, 2022: FIPS codes for territories American Samoa, Guam, Commonwealth of the Northern Mariana Islands, and United States Virgin Islands were re-formatted to 5-digit numeric for records released on 3/3/2022 to be consistent with other records in the dataset.

March 31, 2022: Changes were made to the text fields in variables “county”, “state”, and “health_service_area” so the formats are consistent across releases.

March 31, 2022: The “%” sign was removed from the text field in column “covid_inpatient_bed_utilization”. No change was made to the data. As indicated in the column description, values in this column represent the percentage of staffed inpatient beds occupied by COVID-19 patients (7-day average).

March 31, 2022: Data values for columns, “county_population”, “health_service_area_number”, and “health_service_area” were backfilled for records released on 2/24/2022. These columns were added since the week of 3/3/2022, thus the values were previously missing for records released the week prior.

April 7, 2022: Updates made to data released on 3/24/2022 for Guam, Commonwealth of the Northern Mariana Islands, and United States Virgin Islands to correct a data mapping error.

April 21, 2022: COVID-19 Community Level (CCL) data released for counties in Nebraska for the week of April 21, 2022 have 3 counties identified in the high category and 37 in the medium category. CDC has been working with state officials t

Note: After May 3, 2024, this dataset will no longer be updated because hospitals are no longer required to report data on COVID-19 hospital admissions, hospital capacity, or occupancy data to HHS through CDC’s National Healthcare Safety Network (NHSN). The related CDC COVID Data Tracker site was revised or retired on May 10, 2023.

This dataset represents weekly COVID-19 hospitalization data and metrics aggregated to national, state/territory, and regional levels. COVID-19 hospitalization data are reported to CDC’s National Healthcare Safety Network, which monitors national and local trends in healthcare system stress, capacity, and community disease levels for approximately 6,000 hospitals in the United States. Data reported by hospitals to NHSN and included in this dataset represent aggregated counts and include metrics capturing information specific to COVID-19 hospital admissions, and inpatient and ICU bed capacity occupancy.

Reporting information:

• As of December 15, 2022, COVID-19 hospital data are required to be reported to NHSN, which monitors national and local trends in healthcare system stress, capacity, and community disease levels for approximately 6,000 hospitals in the United States. Data reported by hospitals to NHSN represent aggregated counts and include metrics capturing information specific to hospital capacity, occupancy, hospitalizations, and admissions. Prior to December 15, 2022, hospitals reported data directly to the U.S. Department of Health and Human Services (HHS) or via a state submission for collection in the HHS Unified Hospital Data Surveillance System (UHDSS).
• While CDC reviews these data for errors and corrects those found, some reporting errors might still exist within the data. To minimize errors and inconsistencies in data reported, CDC removes outliers before calculating the metrics. CDC and partners work with reporters to correct these errors and update the data in subsequent weeks.
• Many hospital subtypes, including acute care and critical access hospitals, as well as Veterans Administration, Defense Health Agency, and Indian Health Service hospitals, are included in the metric calculations provided in this report. Psychiatric, rehabilitation, and religious non-medical hospital types are excluded from calculations.
• Data are aggregated and displayed for hospitals with the same Centers for Medicare and Medicaid Services (CMS) Certification Number (CCN), which are assigned by CMS to counties based on the CMS Provider of Services files.
• Full details on COVID-19 hospital data reporting guidance can be found here: https://www.hhs.gov/sites/default/files/covid-19-faqs-hospitals-hospital-laboratory-acute-care-facility-data-reporting.pdf

Metric details:

• Time Period: timeseries data will update weekly on Mondays as soon as they are reviewed and verified, usually before 8 pm ET. Updates will occur the following day when reporting coincides with a federal holiday. Note: Weekly updates might be delayed due to delays in reporting. All data are provisional. Because these provisional counts are subject to change, including updates to data reported previously, adjustments can occur. Data may be updated since original publication due to delays in reporting (to account for data received after a given Thursday publication) or data quality corrections.
• New COVID-19 Hospital Admissions (count): Number of new admissions of patients with laboratory-confirmed COVID-19 in the previous week (including both adult and pediatric admissions) in the entire jurisdiction.
• New COVID-19 Hospital Admissions (7-Day Average): 7-day average of new admissions of patients with laboratory-confirmed COVID-19 in the previous week (including both adult and pediatric admissions) in the entire jurisdiction.
• Cumulative COVID-19 Hospital Admissions: Cumulative total number of admissions of patients with laboratory-confirmed COVID-19 (including both adult and pediatric admissions) in the entire jurisdiction since August 1, 2020.
• Cumulative COVID-19 Hospital Admissions Rate: Cumulative total number of admissions of patients with laboratory-confirmed COVID-19 (including both adult and pediatric admissions) in the entire jurisdiction since August 1, 2020 divided by 2019 intercensal population estimate for that jurisdiction multiplied by 100,000.
• New COVID-19 Hospital Admissions Rate (7-day average) percent change from prior week: Percent change in the 7-day average new admissions of patients with laboratory-confirmed COVID-19 per 100,000 population compared with the prior week.
• New COVID-19 Hospital Admissions (7-Day Total): 7-day total number of new admissions of patients with laboratory-confirmed COVID-19 (including both adult and pediatric admissions) in the entire jurisdiction.
• New COVID-19 Hospital Admissions Rate (7-Day Total): 7-day total number of new admissions of patients with laboratory-confirmed COVID-19 (including both adult and pediatric admissions) for the entire jurisdiction divided by 2019 intercensal population estimate for that jurisdiction multiplied by 100,000.
• Total Hospitalized COVID-19 Patients: 7-day total number of patients currently hospitalized with laboratory-confirmed COVID-19 (including both adult and pediatric patients) for the entire jurisdiction.
• Total Hospitalized COVID-19 Patients (7-Day Average): 7-day average of the number of patients currently hospitalized with laboratory-confirmed COVID-19 (including both adult and pediatric patients) for the entire jurisdiction.
• COVID-19 Inpatient Bed Occupancy (7-Day Average): Percentage of all staffed inpatient beds occupied by patients with laboratory-confirmed COVID-19 (including both adult and pediatric patients) within the entire jurisdiction is calculated as an average of valid daily values within the past 7 days (e.g., if only three valid values, the average of those three is taken). Averages are separately calculated for the daily numerators (patients hospitalized with confirmed COVID-19) and denominators (staffed inpatient beds). The average percentage can then be taken as the ratio of these two values for the entire jurisdiction.
• COVID-19 Inpatient Bed Occupancy absolute change from prior week: The absolute change in the percent of staffed inpatient beds occupied by patients with laboratory-confirmed COVID-19 represents the week-over-week absolute difference between the 7-day average occupancy of patients with confirmed COVID-19 in staffed inpatient beds in the past 7 days, compared with the prior week, in the entire jurisdiction.
• COVID-19 ICU Bed Occupancy (7-Day Average): Percentage of all staffed inpatient beds occupied by adult patients with confirmed COVID-19 within the entire jurisdiction is calculated as a 7-day average of valid daily values within the past 7 days (e.g., if only three valid values, the average of those three is taken). Averages are separately calculated for the daily numerators (adult patients hospitalized with confirmed COVID-19) and denominators (staffed adult ICU beds). The average percentage can then be taken as the ratio of these two values for the entire jurisdiction.
• COVID-19 ICU Bed Occupancy absolute change from prior week: The absolute change in the percent of staffed ICU beds occupied by patients with laboratory-confirmed COVID-19 represents the week-over-week absolute difference between the average occupancy of patients with confirmed COVID-19 in staffed adult ICU beds for the past 7 days, compared with the prior week, in the in the entire jurisdiction.

Note: October 27, 2023: Due to a data processing error, reported values for avg_percent_inpatient_beds_occupied_covid_confirmed will appear lower than previously reported values by an average difference of less than 1%. Therefore, previously reported values for avg_percent_inpatient_beds_occupied_covid_confirmed may have been overestimated and should be interpreted with caution.

October 27, 2023: Due to a data processing error, reported values for abs_chg_avg_percent_inpatient_beds_occupied_covid_confirmed will differ from previously reported values by an average absolute difference of less than 1%. Therefore, previously reported values for abs_chg_avg_percent_inpatient_beds_occupied_covid_confirmed should be interpreted with caution.

December 29, 2023: Hospitalization data reported to CDC’s National Healthcare Safety Network (NHSN) through December 23, 2023, should be interpreted with caution due to potential reporting delays that are impacted by Christmas and New Years holidays. As a result, metrics including new hospital admissions for COVID-19 and influenza and hospital occupancy may be underestimated for the week ending December 23, 2023.

January 5, 2024: Hospitalization data reported to CDC’s National Healthcare Safety Network (NHSN) through December 30, 2023 should be interpreted with caution due to potential reporting delays that are impacted by Christmas and New Years holidays. As a result, metrics including new hospital admissions for COVID-19 and influenza and hospital occupancy may be underestimated for the week ending December 30, 2023.