As of April 26, 2023, around 81.3 percent of the U.S. population had received at least one dose of a COVID-19 vaccination. This statistic shows the percentage of the population in the United States who had been given a COVID-19 vaccination as of April 26, 2023, by state or territory.

As of December 23, 2022, around 80 percent of the population of the United States had been given at least one dose of a COVID-19 vaccination. This statistic shows the percentage of population in select countries and territories worldwide that had received a COVID-19 vaccination as of December 23, 2022.

Overall US COVID-19 Vaccine administration and vaccine equity data at county level. Data represents all vaccine partners including jurisdictional partner clinics, retail pharmacies, long-term care facilities, dialysis centers, Federal Emergency Management Agency and Health Resources and Services Administration partner sites, and federal entity facilities.

Note: In these datasets, a person is defined as up to date if they have received at least one dose of an updated COVID-19 vaccine. The Centers for Disease Control and Prevention (CDC) recommends that certain groups, including adults ages 65 years and older, receive additional doses.

On 6/16/2023 CDPH replaced the booster measures with a new “Up to Date” measure based on CDC’s new recommendations, replacing the primary series, boosted, and bivalent booster metrics The definition of “primary series complete” has not changed and is based on previous recommendations that CDC has since simplified. A person cannot complete their primary series with a single dose of an updated vaccine. Whereas the booster measures were calculated using the eligible population as the denominator, the new up to date measure uses the total estimated population. Please note that the rates for some groups may change since the up to date measure is calculated differently than the previous booster and bivalent measures.

This data is from the same source as the Vaccine Progress Dashboard at https://covid19.ca.gov/vaccination-progress-data/ which summarizes vaccination data at the county level by county of residence. Where county of residence was not reported in a vaccination record, the county of provider that vaccinated the resident is included. This applies to less than 1% of vaccination records. The sum of county-level vaccinations does not equal statewide total vaccinations due to out-of-state residents vaccinated in California.

These data do not include doses administered by the following federal agencies who received vaccine allocated directly from CDC: Indian Health Service, Veterans Health Administration, Department of Defense, and the Federal Bureau of Prisons.

Totals for the Vaccine Progress Dashboard and this dataset may not match, as the Dashboard totals doses by Report Date and this dataset totals doses by Administration Date. Dose numbers may also change for a particular Administration Date as data is updated.

Previous updates:

• On March 3, 2023, with the release of HPI 3.0 in 2022, the previous equity scores have been updated to reflect more recent community survey information. This change represents an improvement to the way CDPH monitors health equity by using the latest and most accurate community data available. The HPI uses a collection of data sources and indicators to calculate a measure of community conditions ranging from the most to the least healthy based on economic, housing, and environmental measures.

• Starting on July 13, 2022, the denominator for calculating vaccine coverage has been changed from age 5+ to all ages to reflect new vaccine eligibility criteria. Previously the denominator was changed from age 16+ to age 12+ on May 18, 2021, then changed from age 12+ to age 5+ on November 10, 2021, to reflect previous changes in vaccine eligibility criteria. The previous datasets based on age 16+ and age 5+ denominators have been uploaded as archived tables.

• Starting on May 29, 2021 the methodology for calculating on-hand inventory in the shipped/delivered/on-hand dataset has changed. Please see the accompanying data dictionary for details. In addition, this dataset is now down to the ZIP code level.

By August 2024, Cuba had administered the largest number of vaccines against COVID-19 per 100 inhabitants in the Latin American region, followed by Chile and Peru. According to recent estimates, the Caribbean country applied around 410 doses per 100 population, accounting for one of the largest vaccination rates observed not only in the Latin American region, but worldwide. In comparison, Haiti registered the lowest vaccination rate within the region, with only 5.87 doses administered per 100 inhabitants. Booster shots started To reinforce the immune protection against the fast spread of the SARS-CoV-2, governments began to introduce booster shots in their immunization programs aiming at strengthening people’s immune response against new contagious COVID-19 variants. In Latin America, Cuba was leading on booster shots relative to its population among a selection of countries, with around 88 percent of the population receiving the extra dose. In comparison, these numbers are higher than those for the European Union and the United States. Pharmaceutical research continues As Omicron becomes more prominent worldwide, and recombinant variants emerge, research efforts to prevent and control the disease continue to progress. As of June 2022, there were around 2,700 clinical trials to treat COVID-19 and 1,752 COVID-19 vaccines trials in clinical development. Other studies were focused on mild, moderate and severe COVID-19, complication support, and post-COVID symptoms, among others.For further information about the coronavirus (COVID-19) pandemic, please visit our dedicated Facts and Figures page.

Note: In these datasets, a person is defined as up to date if they have received at least one dose of an updated COVID-19 vaccine. The Centers for Disease Control and Prevention (CDC) recommends that certain groups, including adults ages 65 years and older, receive additional doses.

On 6/16/2023 CDPH replaced the booster measures with a new “Up to Date” measure based on CDC’s new recommendations, replacing the primary series, boosted, and bivalent booster metrics The definition of “primary series complete” has not changed and is based on previous recommendations that CDC has since simplified. A person cannot complete their primary series with a single dose of an updated vaccine. Whereas the booster measures were calculated using the eligible population as the denominator, the new up to date measure uses the total estimated population. Please note that the rates for some groups may change since the up to date measure is calculated differently than the previous booster and bivalent measures.

This data is from the same source as the Vaccine Progress Dashboard at https://covid19.ca.gov/vaccination-progress-data/ which summarizes vaccination data at the county level by county of residence. Where county of residence was not reported in a vaccination record, the county of provider that vaccinated the resident is included. This applies to less than 1% of vaccination records. The sum of county-level vaccinations does not equal statewide total vaccinations due to out-of-state residents vaccinated in California.

These data do not include doses administered by the following federal agencies who received vaccine allocated directly from CDC: Indian Health Service, Veterans Health Administration, Department of Defense, and the Federal Bureau of Prisons.

Totals for the Vaccine Progress Dashboard and this dataset may not match, as the Dashboard totals doses by Report Date and this dataset totals doses by Administration Date. Dose numbers may also change for a particular Administration Date as data is updated.

Previous updates:

• On March 3, 2023, with the release of HPI 3.0 in 2022, the previous equity scores have been updated to reflect more recent community survey information. This change represents an improvement to the way CDPH monitors health equity by using the latest and most accurate community data available. The HPI uses a collection of data sources and indicators to calculate a measure of community conditions ranging from the most to the least healthy based on economic, housing, and environmental measures.

• Starting on July 13, 2022, the denominator for calculating vaccine coverage has been changed from age 5+ to all ages to reflect new vaccine eligibility criteria. Previously the denominator was changed from age 16+ to age 12+ on May 18, 2021, then changed from age 12+ to age 5+ on November 10, 2021, to reflect previous changes in vaccine eligibility criteria. The previous datasets based on age 16+ and age 5+ denominators have been uploaded as archived tables.

• Starting on May 29, 2021 the methodology for calculating on-hand inventory in the shipped/delivered/on-hand dataset has changed. Please see the accompanying data dictionary for details. In addition, this dataset is now down to the ZIP code level.

As of January 18, 2023, Portugal had the highest COVID-19 vaccination rate in Europe having administered 272.78 doses per 100 people in the country, while Malta had administered 258.49 doses per 100. The UK was the first country in Europe to approve the Pfizer/BioNTech vaccine for widespread use and began inoculations on December 8, 2020, and so far have administered 224.04 doses per 100. At the latest data, Belgium had carried out 253.89 doses of vaccines per 100 population. Russia became the first country in the world to authorize a vaccine - named Sputnik V - for use in the fight against COVID-19 in August 2020. As of August 4, 2022, Russia had administered 127.3 doses per 100 people in the country.

The seven-day rate of cases across Europe shows an ongoing perspective of which countries are worst affected by the virus relative to their population. For further information about the coronavirus pandemic, please visit our dedicated Facts and Figures page.

Data last updated 12/29/2022. Data are not currently being routinely updated. For more information about mpox, including vaccine eligibility criteria, see the DPH mpox webpage: ct.gov/dph/mpox. Table published by the Connecticut Department of Public Health that contains the cumulative number of people by county of residence who have received at least one dose of JYNNEOS vaccine reported to CT WiZ (the Connecticut Immunization Information System). Currently vaccination is prioritized for individuals at the highest risk of exposure to someone with mpox. Since the size of this population is not known, the number vaccinated is reported without the vaccine coverage percentage. This table excludes residents of other states vaccinated in Connecticut. Connecticut residents vaccinated out of state are included if they were vaccinated in a jurisdiction that has established electronic vaccination data exchange with Connecticut (as of 8/31/2022, this is NYC, RI, NJ, DE, NV, Philadelphia).

Data last updated 12/29/2022. Data are not currently being routinely updated. For more information about mpox, including vaccine eligibility criteria, see the DPH mpox webpage: ct.gov/dph/mpox.

Table published by the Connecticut Department of Public Health that contains the cumulative number of people by race/ethnicity who have received at least one dose of JYNNEOS vaccine reported to CT WiZ (the Connecticut Immunization Information System). Data on vaccinations by race/ethnicity should be interpreted with caution because of the challenges of classifying race/ethnicity. Reported race and ethnicity information is used to create a single race/ethnicity variable. People with more than one race are classified as two or more races. People with Hispanic ethnicity are classified as Hispanic regardless of reported race(s). People with a missing ethnicity are classified as non-Hispanic.

Currently vaccination is prioritized for individuals at the highest risk of exposure to someone with mpox. Since the size of this population is not known, the number vaccinated is reported without the vaccine coverage percentage.

This table excludes residents of other states vaccinated in Connecticut. Connecticut residents vaccinated out of state are included if they were vaccinated in a jurisdiction that has established electronic vaccination data exchange with Connecticut (as of 8/31/2022, this is NYC, RI, NJ, DE, NV, Philadelphia).

Data last updated 12/29/2022. Data are not currently being routinely updated. For more information about mpox, including vaccine eligibility criteria, see the DPH mpox webpage: ct.gov/dph/mpox. Table published by the Connecticut Department of Public Health that contains the cumulative number of people by age group who have received at least one dose of JYNNEOS vaccine reported to CT WiZ (the Connecticut Immunization Information System). Age is age at the time of the first dose of monkeypox vaccine. Currently vaccination is prioritized for individuals at the highest risk of exposure to someone with mpox. Since the size of this population is not known, the number vaccinated is reported without the vaccine coverage percentage. This table excludes residents of other states vaccinated in Connecticut. Connecticut residents vaccinated out of state are included if they were vaccinated in a jurisdiction that has established electronic vaccination data exchange with Connecticut (as of 8/31/2022, this is NYC, RI, NJ, DE, NV, Philadelphia).

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 to verify the data submitted, as other data systems are not providing alerts for substantial increases in disease transmission or severity in the state.

May 26, 2022: COVID-19 Community Level (CCL) data released for McCracken County, KY for the week of May 5, 2022 have been updated to correct a data processing error. McCracken County, KY should have appeared in the low community level category during the week of May 5, 2022. This correction is reflected in this update.

May 26, 2022: COVID-19 Community Level (CCL) data released for several Florida counties for the week of May 19th, 2022, have been corrected for a data processing error. Of note, Broward, Miami-Dade, Palm Beach Counties should have appeared in the high CCL category, and Osceola County should have appeared in the medium CCL category. These corrections are reflected in this update.

May 26, 2022: COVID-19 Community Level (CCL) data released for Orange County, New York for the week of May 26, 2022 displayed an erroneous case rate of zero and a CCL category of low due to a data source error. This county should have appeared in the medium CCL category.

June 2, 2022: COVID-19 Community Level (CCL) data released for Tolland County, CT for the week of May 26, 2022 have been updated to correct a data processing error. Tolland County, CT should have appeared in the medium community level category during the week of May 26, 2022. This correction is reflected in this update.

June 9, 2022: COVID-19 Community Level (CCL) data released for Tolland County, CT for the week of May 26, 2022 have been updated to correct a misspelling. The medium community level category for Tolland County, CT on the week of May 26, 2022 was misspelled as “meduim” in the data set. This correction is reflected in this update.

June 9, 2022: COVID-19 Community Level (CCL) data released for Mississippi counties for the week of June 9, 2022 should be interpreted with caution due to a reporting cadence change over the Memorial Day holiday that resulted in artificially inflated case rates in the state.

July 7, 2022: COVID-19 Community Level (CCL) data released for Rock County, Minnesota for the week of July 7, 2022 displayed an artificially low case rate and CCL category due to a data source error. This county should have appeared in the high CCL category.

July 14, 2022: COVID-19 Community Level (CCL) data released for Massachusetts counties for the week of July 14, 2022 should be interpreted with caution due to a reporting cadence change that resulted in lower than expected case rates and CCL categories in the state.

July 28, 2022: COVID-19 Community Level (CCL) data released for all Montana counties for the week of July 21, 2022 had case rates of 0 due to a reporting issue. The case rates have been corrected in this update.

July 28, 2022: COVID-19 Community Level (CCL) data released for Alaska for all weeks prior to July 21, 2022 included non-resident cases. The case rates for the time series have been corrected in this update.

July 28, 2022: A laboratory in Nevada reported a backlog of historic COVID-19 cases. As a result, the 7-day case count and rate will be inflated in Clark County, NV for the week of July 28, 2022.

August 4, 2022: COVID-19 Community Level (CCL) data was updated on August 2, 2022 in error during performance testing. Data for the week of July 28, 2022 was changed during this update due to additional case and hospital data as a result of late reporting between July 28, 2022 and August 2, 2022. Since the purpose of this data set is to provide point-in-time views of COVID-19 Community Levels on Thursdays, any changes made to the data set during the August 2, 2022 update have been reverted in this update.

August 4, 2022: COVID-19 Community Level (CCL) data for the week of July 28, 2022 for 8 counties in Utah (Beaver County, Daggett County, Duchesne County, Garfield County, Iron County, Kane County, Uintah County, and Washington County) case data was missing due to data collection issues. CDC and its partners have resolved the issue and the correction is reflected in this update.

August 4, 2022: Due to a reporting cadence change, case rates for all Alabama counties will be lower than expected. As a result, the CCL levels published on August 4, 2022 should be interpreted with caution.

August 11, 2022: COVID-19 Community Level (CCL) data for the week of August 4, 2022 for South Carolina have been updated to correct a data collection error that resulted in incorrect case data. CDC and its partners have resolved the issue and the correction is reflected in this update.

August 18, 2022: COVID-19 Community Level (CCL) data for the week of August 11, 2022 for Connecticut have been updated to correct a data ingestion error that inflated the CT case rates. CDC, in collaboration with CT, has resolved the issue and the correction is reflected in this update.

August 25, 2022: A laboratory in Tennessee reported a backlog of historic COVID-19 cases. As a result, the 7-day case count and rate may be inflated in many counties and the CCLs published on August 25, 2022 should be interpreted with caution.

August 25, 2022: Due to a data source error, the 7-day case rate for St. Louis County, Missouri, is reported as zero in the COVID-19 Community Level data released on August 25, 2022. Therefore, the COVID-19 Community Level for this county should be interpreted with caution.

September 1, 2022: Due to a reporting issue, case rates for all Nebraska counties will include 6 days of data instead of 7 days in the COVID-19 Community Level (CCL) data released on September 1, 2022. Therefore, the CCLs for all Nebraska counties should be interpreted with caution.

September 8, 2022: Due to a data processing error, the case rate for Philadelphia County, Pennsylvania,

Percentages of COVID-19 vaccination rates among T2 parent-adolescent dyad sample.

Age-standardised mortality rates for deaths involving coronavirus (COVID-19), non-COVID-19 deaths and all deaths by vaccination status, broken down by age group.

As of April 26, 2023, one of the states with the highest percentage of adults 65 years and older who were fully vaccinated against COVID-19 was Vermont with 95 percent. This statistic shows the percentage of adults aged 65 and older in the United States who were fully vaccinated against COVID-19 as of April 26, 2023, by state or territory.

In the state of Oregon, it is estimated that only 65 percent of children have received recommended doses of DTaP, polio, MMR, Hib, hepatitis B, varicella and PCV vaccines by the age of 35 months. This statistic displays the states with the lowest percentage of children receiving recommended immunizations in the U.S. as of 2021.

Vaccine successes

Vaccines are one of the most cost- effective ways of preventing the spread of infectious diseases and reducing the health burden on healthcare systems. With immunizations, both the receiving individual is protected as well as others who cannot be vaccinated- if herd immunity is achieved, a disease may be eradicated within an area. Examples of vaccine successes include polio and diphtheria in the U.S., where reported cases of the diseases dropped to zero in recent years as a result of the effective implementation of vaccine programs.

Vaccine hesitancy

Many schools in the U.S. have immunization requirements to ensure protection against preventable infectious diseases; however, reasons to avoid the requirements can range from health-related contraindications to religious or philosophical reasons. Although vaccines have been proven to be safe, myths about harms due to vaccines continue to perpetuate. For example, the proportion of U.S adults who believe that vaccinations cause autism rose between 2015 and 2019 despite the fact that the evidence on which these claims are based has long since been redacted as no causal relationship has been proven. Unfortunately, the lack of MMR vaccination has caused a resurgence of measles and mumps in recent years in the U.S. and prevented eradication of these preventable diseases.

As of March 20, 2023, around 391 doses of COVID-19 vaccines per 100 people in Cuba had been administered, one of the highest COVID-19 vaccine dose rates of any country worldwide. This statistic shows the rate of COVID-19 vaccine doses administered worldwide as of March 20, 2023, by country or territory.

Introduction

Intensive care has played a pivotal role during the COVID-19 pandemic as many patients developed severe pulmonary complications. The availability of information in pediatric intensive care (PICUs) remains limited. The purpose of this study is to characterize COVID-19 positive admissions (CPAs) in the United States and to determine factors that may impact those admissions.

Materials and Methods

This is a retrospective cohort study using data from the COVID-19 dashboard virtual pediatric system) containing information regarding respiratory support and comorbidities for all CPAs between March and April 2020. The state level data contained 13 different factors from population density, comorbid conditions and social distancing score. The absolute CPAs count was converted to frequency using the state’s population. Univariate and multivariate regression analyses were performed to assess the association between CPAs frequency and endpoints.

Results

A total of 205 CPAs were reported by 167 PICUs across 48 states. The estimated CPAs frequency was 2.8 per million children. A total of 3,235 tests were conducted with 6.3% positive tests. Children above 11 years of age comprised 69.7% of the total cohort and 35.1% had moderated or severe comorbidities. The median duration of a CPA was 4.9 days [1.25-12.00 days]. Out of the 1,132 total CPA days, 592 [52.2%] were for mechanical ventilation. The inpatient mortalities were 3 [1.4%]. Multivariate analyses demonstrated an association between CPAs with greater population density [beta-coefficient 0.01, p<0.01] and increased percent of children receiving the influenza vaccination [beta-coefficient 0.17, p=0.01].

Conclusions

Inpatient mortality during PICU CPAs is relatively low at 1.4%. CPA frequency seems to be impacted by population density while characteristics of illness severity appear to be associated with ultraviolet index, temperature, and comorbidities such as Type 1 diabetes. These factors should be included in future studies using patient-level data.

Methods This study utilized only publicly available, deidentified, state-level data. As such, no institutional review board review or approval was sought.

Endpoint identification and data collection

The following data was identified for collection regarding the CPAs themselves: number, duration, need for various ventilatory support measures, severity of comorbidities, and the total number of COVID-19 tests conducted. The following data was collected regarding US states: pediatric population, state population (pediatric and adult) density, air and drinking water quality, average temperature, average ultraviolet index, prevalence of pediatric obesity, type 1 diabetes mellitus (DM) and asthma, the proportion of children who smoke cigarettes, received the influenza vaccine, had health insurance, and received home health care, race, percent of households with children below the poverty line, highest education level of adults in homes with children, and the social distancing score by global positional satellite data (Supplementary Table 1).

The data regarding the CPAs themselves was collected from the publicly available COVID-19 dashboard provided by the Virtual Pediatric System (VPS), which collects data from several PICUs in the US. COVID-19 data was collected from March 14th through April 14th, 2020, in order to represent one full month of data. Data regarding number of centers, number of tests, and number of CPAs was captured in absolute counts. Data regarding CPAs duration was collected in days. The respiratory support modalities for which data was available were room air (RA), nasal cannula (NC) and for the advanced respiratory support modalities (i.e. other than RA and NC) there was available data for high flow nasal cannula (HFNC), non-invasive positive pressure ventilation (NIPPV), conventional mechanical ventilation (MCV), high frequency oscillatory ventilation (HFOV), and extracorporeal membrane oxygenation (ECMO), and was captured in duration (days) of their use. Data regarding severity of comorbidities is reported in the VPS dashboard and the percentage of CPAs with moderate or severe degree of comorbidities was collected.

State-wide data for the analyses were collected from a variety of sources with the complete list of sources provided as Supplementary Material 1. Children’s population data and pediatric comorbidity data was obtained from 2018, as these were the most recent and comprehensive data available. The sources for these other data points were generally US government-based efforts to capture state-level data on various medical issues, however, not all states reported data for all the endpoints (Supplementary Table 2).

Endpoints were assigned to the authors for collection. One author was responsible for collecting data for each state for the variables assigned. Once these data were collected a different author, who did not primarily collect data for that specific endpoint, verified the numbers for accuracy. Finally, values in the top and bottom 10th percentile were identified and verified by a third author.

Statistical analyses

As the data was collected for each state and intended for state-level analyses, and each state has a different pediatric population, the absolute numbers of CPAs for each state were not directly comparable. Thus, the absolute CPAs count for each state was first converted to a frequency of CPAs per 1,000,000 children using the specific state’s population. This CPAs frequency was then used as the dependent variable in a series of single-independent variable linear regressions to determine the univariate association between CPAs frequency and the other endpoints. Multivariate regression was conducted with CPAs frequency as the dependent variable and with other variables entered as independent variables. Forward stepwise regression was utilized with the model with greatest R-squared value being used for the analyses.

Next, a composite endpoint called “percent of PICUs days requiring advanced respiratory support” was created. This consisted of the total duration of HFNC, NIPPV, MCV, HFOV, and ECMO divided by the total PICUs admission duration. This was then modeled similarly to CPAs frequency. Next, a composite outcome called “percent of PICU days requiring intubation” was created. This consisted of the total duration of MCV and HFOV divided by the total PICU admission duration. This, too, was then modeled similarly as CPA frequency. Lastly, an endpoint called “PICUs duration per admission” was created for each state and consisted of the total CPAs PICUs duration for that specific state divided by the number of CPAs reported by that state. This was also then modeled similarly to CPA frequency.

All statistical analyses were done using the user-coded, syntax-based interface of SPSS Version 23.0. A p-value of 0.05 was considered statistically significant. All statistical analyses were done at the state-level with state-level data. Analyses were not conducted at a patient-level with patient-level data. Any use of the word significant here-on in the manuscript refers to “statistically significant” unless explicitly specified otherwise.

Between January 1, 2021 and April 30, 2022 the death rate due to COVID-19 in the United States was about 2,487 per one million population. An analysis published in May 2022 found that if 100 percent of the population in the United States had been vaccinated at this time then the death rate over this period would have been around 1,237 per one million population. It was estimated that a 100 percent vaccination rate could have prevented 318,981 of 641,305 total deaths reported over this period. As of May 2022, around 66 percent of the U.S. population had been fully vaccinated against COVID-19. This table shows the actual death rate due to COVID-19 in the United States between January 2021 and April 2022 compared to the death rate if 100 percent of the population had been vaccinated.

As of January 23, 2021, Vermont had the highest Rt value of any U.S. state. The Rt value indicates the average number of people that one person with COVID-19 is expected to infect. A number higher than one means each infected person is passing the virus to more than one other person.

Which are the hardest-hit states? The U.S. reported its first confirmed coronavirus case toward the end of January 2020. More than 28 million positive cases have since been recorded as of February 24, 2021 – California and Texas are the states with the highest number of coronavirus cases in the United States. When figures are adjusted to reflect each state’s population, North Dakota has the highest rate of coronavirus cases. The vaccine rollout has provided Americans with a significant morale boost, and California is the state with the highest number of COVID-19 vaccine doses administered.

How have other nations responded? Countries around the world have responded to the pandemic in varied ways. The United Kingdom has approved three vaccines for emergency use and ranks among the countries with the highest number of COVID-19 vaccine doses administered worldwide. In the Asia-Pacific region, the outbreak has been brought under control in New Zealand, and the country’s response to the pandemic has been widely praised.

Turkmenistan led the ranking of countries in the Commonwealth of Independent States (CIS) by number of COVID-19 vaccination doses administered per 100 population, at over 210 as of September 4, 2022. Uzbekistan ranked second, with about 204 total vaccinations per 100 people. In Russia, nearly 54 people per 100 residents were fully vaccinated.