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 among people who received additional or booster doses were reported from 31 jurisdictions; 30 jurisdictions also reported data on deaths among people who received one or more additional or booster dose; 28 jurisdictions reported cases among people who received two or more additional or booster doses; and 26 jurisdictions reported deaths among people who received two or more additional or booster doses. 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 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 months through 1 year, half of the single-year population counts for ages 0 through 1 year were used. All rates are plotted by positive specimen collection date to reflect when incident infections occurred. For the primary series analysis, age-standardized rates include ages 12 years and older from April 4, 2021 through December 4, 2021, ages 5 years and older from December 5, 2021 through July 30, 2022 and ages 6 months and older from July 31, 2022 onwards. For the booster dose analysis, age-standardized rates include ages 18 years and older from September 19, 2021 through December 25, 2021, ages 12 years and older from December 26, 2021, and ages 5 years and older from June 5, 2022 onwards. Small numbers could contribute to less precision when calculating death rates among some groups. 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 with a primary series either overall or with a booster dose. Publications: 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

This dataset provides values for CORONAVIRUS DEATHS reported in several countries. The data includes current values, previous releases, historical highs and record lows, release frequency, reported unit and currency.

In 2023, the infant mortality rate in India was at about 24.5 deaths per 1,000 live births, a significant decrease from previous years. Infant mortality as an indicatorThe infant mortality rate is the number of deaths of children under one year of age per 1,000 live births. This rate is an important key indicator for a country’s health and standard of living; a low infant mortality rate indicates a high standard of healthcare. Causes of infant mortality include premature birth, sepsis or meningitis, sudden infant death syndrome, and pneumonia. Globally, the infant mortality rate has shrunk from 63 infant deaths per 1,000 live births to 27 since 1990 and is forecast to drop to 8 infant deaths per 1,000 live births by the year 2100. India’s rural problemWith 32 infant deaths per 1,000 live births, India is neither among the countries with the highest nor among those with the lowest infant mortality rate. Its decrease indicates an increase in medical care and hygiene, as well as a decrease in female infanticide. Increasing life expectancy at birth is another indicator that shows that the living conditions of the Indian population are improving. Still, India’s inhabitants predominantly live in rural areas, where standards of living as well as access to medical care and hygiene are traditionally lower and more complicated than in cities. Public health programs are thus put in place by the government to ensure further improvement.

This dataset reports the daily reported number of the 7-day moving average rates of Deaths involving COVID-19 by vaccination status and by age group. Learn how the Government of Ontario is helping to keep Ontarians safe during the 2019 Novel Coronavirus outbreak. Effective November 14, 2024 this page will no longer be updated. Information about COVID-19 and other respiratory viruses is available on Public Health Ontario’s interactive respiratory virus tool: https://www.publichealthontario.ca/en/Data-and-Analysis/Infectious-Disease/Respiratory-Virus-Tool Data includes: * Date on which the death occurred * Age group * 7-day moving average of the last seven days of the death rate per 100,000 for those not fully vaccinated * 7-day moving average of the last seven days of the death rate per 100,000 for those fully vaccinated * 7-day moving average of the last seven days of the death rate per 100,000 for those vaccinated with at least one booster ##Additional notes As of June 16, all COVID-19 datasets will be updated weekly on Thursdays by 2pm. As of January 12, 2024, data from the date of January 1, 2024 onwards reflect updated population estimates. This update specifically impacts data for the 'not fully vaccinated' category. On November 30, 2023 the count of COVID-19 deaths was updated to include missing historical deaths from January 15, 2020 to March 31, 2023. CCM is a dynamic disease reporting system which allows ongoing update to data previously entered. As a result, data extracted from CCM represents a snapshot at the time of extraction and may differ from previous or subsequent results. Public Health Units continually clean up COVID-19 data, correcting for missing or overcounted cases and deaths. These corrections can result in data spikes and current totals being different from previously reported cases and deaths. Observed trends over time should be interpreted with caution for the most recent period due to reporting and/or data entry lags. The data does not include vaccination data for people who did not provide consent for vaccination records to be entered into the provincial COVaxON system. This includes individual records as well as records from some Indigenous communities where those communities have not consented to including vaccination information in COVaxON. “Not fully vaccinated” category includes people with no vaccine and one dose of double-dose vaccine. “People with one dose of double-dose vaccine” category has a small and constantly changing number. The combination will stabilize the results. Spikes, negative numbers and other data anomalies: Due to ongoing data entry and data quality assurance activities in Case and Contact Management system (CCM) file, Public Health Units continually clean up COVID-19, correcting for missing or overcounted cases and deaths. These corrections can result in data spikes, negative numbers and current totals being different from previously reported case and death counts. Public Health Units report cause of death in the CCM based on information available to them at the time of reporting and in accordance with definitions provided by Public Health Ontario. The medical certificate of death is the official record and the cause of death could be different. Deaths are defined per the outcome field in CCM marked as “Fatal”. Deaths in COVID-19 cases identified as unrelated to COVID-19 are not included in the Deaths involving COVID-19 reported. Rates for the most recent days are subject to reporting lags All data reflects totals from 8 p.m. the previous day. This dataset is subject to change.

Note: Reporting of new COVID-19 Case Surveillance data will be discontinued July 1, 2024, to align with the process of removing SARS-CoV-2 infections (COVID-19 cases) from the list of nationally notifiable diseases. Although these data will continue to be publicly available, the dataset will no longer be updated.

Authorizations to collect certain public health data expired at the end of the U.S. public health emergency declaration on May 11, 2023. The following jurisdictions discontinued COVID-19 case notifications to CDC: Iowa (11/8/21), Kansas (5/12/23), Kentucky (1/1/24), Louisiana (10/31/23), New Hampshire (5/23/23), and Oklahoma (5/2/23). Please note that these jurisdictions will not routinely send new case data after the dates indicated. As of 7/13/23, case notifications from Oregon will only include pediatric cases resulting in death.

This case surveillance public use dataset has 12 elements for all COVID-19 cases shared with CDC and includes demographics, any exposure history, disease severity indicators and outcomes, presence of any underlying medical conditions and risk behaviors, and no geographic data.

CDC has three COVID-19 case surveillance datasets:

• COVID-19 Case Surveillance Public Use Data with Geography: Public use, patient-level dataset with clinical data (including symptoms), demographics, and county and state of residence. (19 data elements)
• COVID-19 Case Surveillance Public Use Data: Public use, patient-level dataset with clinical and symptom data and demographics, with no geographic data. (12 data elements)
• COVID-19 Case Surveillance Restricted Access Detailed Data: Restricted access, patient-level dataset with clinical and symptom data, demographics, and state and county of residence. Access requires a registration process and a data use agreement. (33 data elements)

• Data elements can be found on the COVID-19 case report form located at www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf.
• Data are considered provisional by CDC and are subject to change until the data are reconciled and verified with the state and territorial data providers.
• Some data cells are suppressed to protect individual privacy.
• The datasets will include all cases with the earliest date available in each record (date received by CDC or date related to illness/specimen collection) at least 14 days prior to the creation of the current datasets. This 14-day lag allows case reporting to be stabilized and ensures that time-dependent outcome data are accurately captured.
• Datasets are updated monthly.
• Datasets are created using CDC’s Policy on Public Health Research and Nonresearch Data Management and Access and include protections designed to protect individual privacy.
• For more information about data collection and reporting, please see https://www.cdc.gov/coronavirus/2019-ncov/covid-data/about-us-cases-deaths.html.
• For more information about the COVID-19 case surveillance data, please see https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html
  

Overview

The COVID-19 case surveillance database includes individual-level data reported to U.S. states and autonomous reporting entities, including New York City and the District of Columbia (D.C.), as well as U.S. territories and affiliates. On April 5, 2020, COVID-19 was added to the Nationally Notifiable Condition List and classified as “immediately notifiable, urgent (within 24 hours)” by a Council of State and Territorial Epidemiologists (CSTE) Interim Position Statement (Interim-20-ID-01). CSTE updated the position statement on August 5, 2020, to clarify the interpretation of antigen detection tests and serologic test results within the case classification (Interim-20-ID-02). The statement also recommended that all states and territories enact laws to make COVID-19 reportable in their jurisdiction, and that jurisdictions conducting surveillance should submit case notifications to CDC. COVID-19 case surveillance data are collected by jurisdictions and reported voluntarily to CDC.

For more information: NNDSS Supports the COVID-19 Response | CDC.

The deidentified data in the “COVID-19 Case Surveillance Public Use Data” include demographic characteristics, any exposure history, disease severity indicators and outcomes, clinical data, laboratory diagnostic test results, and presence of any underlying medical conditions and risk behaviors. All data elements can be found on the COVID-19 case report form located at www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf.

COVID-19 Case Reports

COVID-19 case reports have been routinely submitted using nationally standardized case reporting forms. On April 5, 2020, CSTE released an Interim Position Statement with national surveillance case definitions for COVID-19 included. Current versions of these case definitions are available here: https://ndc.services.cdc.gov/case-definitions/coronavirus-disease-2019-2021/.

All cases reported on or after were requested to be shared by public health departments to CDC using the standardized case definitions for laboratory-confirmed or probable cases. On May 5, 2020, the standardized case reporting form was revised. Case reporting using this new form is ongoing among U.S. states and territories.

Data are Considered Provisional

• The COVID-19 case surveillance data are dynamic; case reports can be modified at any time by the jurisdictions sharing COVID-19 data with CDC. CDC may update prior cases shared with CDC based on any updated information from jurisdictions. For instance, as new information is gathered about previously reported cases, health departments provide updated data to CDC. As more information and data become available, analyses might find changes in surveillance data and trends during a previously reported time window. Data may also be shared late with CDC due to the volume of COVID-19 cases.
• Annual finalized data: To create the final NNDSS data used in the annual tables, CDC works carefully with the reporting jurisdictions to reconcile the data received during the year until each state or territorial epidemiologist confirms that the data from their area are correct.
• Access Addressing Gaps in Public Health Reporting of Race and Ethnicity for COVID-19, a report from the Council of State and Territorial Epidemiologists, to better understand the challenges in completing race and ethnicity data for COVID-19 and recommendations for improvement.

Data Limitations

To learn more about the limitations in using case surveillance data, visit FAQ: COVID-19 Data and Surveillance.

Data Quality Assurance Procedures

CDC’s Case Surveillance Section routinely performs data quality assurance procedures (i.e., ongoing corrections and logic checks to address data errors). To date, the following data cleaning steps have been implemented:

• Questions that have been left unanswered (blank) on the case report form are reclassified to a Missing value, if applicable to the question. For example, in the question “Was the individual hospitalized?” where the possible answer choices include “Yes,” “No,” or “Unknown,” the blank value is recoded to Missing because the case report form did not include a response to the question.
• Logic checks are performed for date data. If an illogical date has been provided, CDC reviews the data with the reporting jurisdiction. For example, if a symptom onset date in the future is reported to CDC, this value is set to null until the reporting jurisdiction updates the date appropriately.
• Additional data quality processing to recode free text data is ongoing. Data on symptoms, race and ethnicity, and healthcare worker status have been prioritized.

Data Suppression

To prevent release of data that could be used to identify people, data cells are suppressed for low frequency (<5) records and indirect identifiers (e.g., date of first positive specimen). Suppression includes rare combinations of demographic characteristics (sex, age group, race/ethnicity). Suppressed values are re-coded to the NA answer option; records with data suppression are never removed.

For questions, please contact Ask SRRG (eocevent394@cdc.gov).

Additional COVID-19 Data

COVID-19 data are available to the public as summary or aggregate count files, including total counts of cases and deaths by state and by county. These

Number of deaths and mortality rates, by age group, sex, and place of residence, 1991 to most recent year.

2020 - 2022, county-level U.S. stroke death rates. Dataset developed by the Centers for Disease Control and Prevention, Division for Heart Disease and Stroke Prevention.Create maps of U.S. stroke death rates by county. Data can be stratified by age, race/ethnicity, and sex.Visit the CDC Atlas of Heart Disease and Stroke for additional data and maps. Atlas of Heart Disease and StrokeData SourceMortality data were obtained from the National Vital Statistics System. Bridged-Race Postcensal Population Estimates were obtained from the National Center for Health Statistics. International Classification of Diseases, 10th Revision (ICD-10) codes: I60-I69; underlying cause of death.Data DictionaryData for counties with small populations are not displayed when a reliable rate could not be generated. These counties are represented in the data with values of '-1.' CDC excludes these values when classifying the data on a map, indicating those counties as 'Insufficient Data.'Data field names and descriptionsstcty_fips: state FIPS code + county FIPS codeOther fields use the following format: RRR_S_aaaa (e.g., API_M_35UP)  RRR: 3 digits represent race/ethnicity    All - Overall    AIA - American Indian and Alaska Native, non-Hispanic    ASN - Asian, non-Hispanic    BLK - Black, non-Hispanic    HIS - Hispanic NHP – Native Hawaiian or Other Pacific Islander, non-Hispanic MOR – More than one race, non-Hispanic    WHT - White, non-Hispanic  S: 1 digit represents sex    A - All    F - Female    M - Male  aaaa: 4 digits represent age. The first 2 digits are the lower bound for age and the last 2 digits are the upper bound for age. 'UP' indicates the data includes the maximum age available and 'LT' indicates ages less than the upper bound. Example: The column 'BLK_M_65UP' displays rates per 100,000 black men aged 65 years and older.MethodologyRates are calculated using a 3-year average and are age-standardized in 10-year age groups using the 2000 U.S. Standard Population. Rates are calculated and displayed per 100,000 population. Rates were spatially smoothed using a Local Empirical Bayes algorithm to stabilize risk by borrowing information from neighboring geographic areas, making estimates more statistically robust and stable for counties with small populations. Data for counties with small populations are coded as '-1' when a reliable rate could not be generated. County-level rates were generated when the following criteria were met over a 3-year time period within each of the filters (e.g., age, race, and sex).At least one of the following 3 criteria:At least 20 events occurred within the county and its adjacent neighbors.ORAt least 16 events occurred within the county.ORAt least 5,000 population years within the county.AND all 3 of the following criteria:At least 6 population years for each age group used for age adjustment if that age group had 1 or more event.The number of population years in an age group was greater than the number of events.At least 100 population years within the county.More Questions?Interactive Atlas of Heart Disease and StrokeData SourcesStatistical Methods

Annual data on death registrations by area of usual residence in the UK. Summary tables including age-standardised mortality rates.

The dataset was originally created to allow the construction of age-specific mortality series and cohort mortality series for particular diseases, from the mid-nineteenth century to the present (in conjunction with the comparable mortality database created by the Office of National Statistics which covers 1901 – present). The dataset is fairly comprehensive and therefore allows both fine analysis of trends in single causes and also the construction of consistent aggregated categories of causes over time. Additionally, comparison of trends in individual causes can be used to infer transfers of deaths between categories over time, that may cause artifactual changes in mortality rates of particular causes. The data are presented by sex, allowing calculation of sex ratios. The age-specific and annual nature of the dataset allows the analysis of cause-specific mortality by birth cohort (assuming low migration at the national level). The database can be used in conjunction with the ONS database “Historic Mortality and Population Data, 1901-1992”, already in the UK Data Archive collection as SN 2902, to create continuous cause-of-death series for the period 1848-1992 (or later, if using more recent versions of the ONS database).

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

AbstractIn Italy, approximately 400.000 new cases of malignant tumors are recorded every year. The average of annual deaths caused by tumors, according to the Italian Cancer Registers, is about 3.5 deaths and about 2.5 per 1,000 men and women respectively, for a total of about 3 deaths every 1,000 people. Long-term (at least a decade) and spatially detailed data (up to the municipality scale) are neither easily accessible nor fully available for public consultation by the citizens, scientists, research groups, and associations. Therefore, here we present a ten-year (2009–2018) database on cancer mortality rates (in the form of Standardized Mortality Ratios, SMR) for 23 cancer macro-types in Italy on municipal, provincial, and regional scales. We aim to make easily accessible a comprehensive, ready-to-use, and openly accessible source of data on the most updated status of cancer mortality in Italy for local and national stakeholders, researchers, and policymakers and to provide researchers with ready-to-use data to perform specific studies. Methods For a given locality, year, and cause of death, the SMR is the ratio between the observed number of deaths (Om) and the number of expected deaths (Em): SMR = Om/Em (1) where Om should be an available observational data and Em is estimated as the weighted sum of age-specific population size for the given locality (ni) per age-specific death rates of the reference population (MRi): Em = sum(MRi x ni) (2) MRi could be provided by a public health organization or be estimated as the ratio between the age-specific number of deaths of reference population (Mi) to the age-specific reference population size (Ni): MRi = Mi/Ni (3) Thus, the value of Em is weighted by the age distribution of deaths and population size. SMR assumes value 1 when the number of observed and expected deaths are equal. Following eqns. (1-3), the SMR was computed for single years of the period 2009-2018 and for single cause of death as defined by the International ICD-10 classification system by using the following data: age-specific number of deaths by cause of reference population (i.e., Mi) from the Italian National Institute of Statistics (ISTAT, (http://www.istat.it/en/, last access: 26/01/2022)); age-specific census data on reference population (i.e., Ni) from ISTAT; the observed number of deaths by cause (i.e., Om) from ISTAT; the age-specific census data on population (ni); the SMR was estimated at three different level of aggregation: municipal, provincial (equivalent to the European classification NUTS 3) and regional (i.e., NUTS2). The SMR was also computed for the broad category of malignant tumors (i.e. C00-C979, hereinafter cancer macro-type C), and for the broad category of malignant tumor plus non-malignant tumors (i.e. C00-C979 plus D0-D489, hereinafter cancer macro-type CD). Lower 90% and 95% confidence intervals of 10-year average values were computed according to the Byar method.

These indicators are designed to accompany the SHMI publication. The SHMI methodology includes an adjustment for admission method. This is because crude mortality rates for elective admissions tend to be lower than crude mortality rates for non-elective admissions. Contextual indicators on the crude percentage mortality rates for elective and non-elective admissions where a death occurred either in hospital or within 30 days (inclusive) of being discharged from hospital are produced to support the interpretation of the SHMI. Notes: 1. As of the July 2020 publication, COVID-19 activity has been excluded from the SHMI. The SHMI is not designed for this type of pandemic activity and the statistical modelling used to calculate the SHMI may not be as robust if such activity were included. Activity that is being coded as COVID-19, and therefore excluded, is monitored in the contextual indicator 'Percentage of provider spells with COVID-19 coding' which is part of this publication. 2. Please note that there was a fall in the overall number of spells for England from March 2020 due to COVID-19 impacting on activity and the number has not returned to pre-pandemic levels. Further information at Trust level is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication. 3. There is a shortfall in the number of records for The Princess Alexandra Hospital NHS Trust (trust code RQW). Values for this trust are based on incomplete data and should therefore be interpreted with caution. 4. Frimley Health NHS Foundation Trust (trust code RDU) has not submitted data to the Secondary Uses Service (SUS) since June 2022 due to an issue with their patient records system. This is causing a large shortfall in records with data only submitted for 4 months out of the 12 months in the current time period. Values for this trust should be viewed in the context of this issue. 5. A number of trusts are currently engaging in a pilot to submit Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS), rather than the Admitted Patient Care (APC) dataset. As the SHMI is calculated using APC data, this does have the potential to impact on the SHMI value for these trusts. Trusts with SDEC activity removed from the APC data have generally seen an increase in the SHMI value. This is because the observed number of deaths remains approximately the same as the mortality rate for this cohort is very low; secondly, the expected number of deaths decreases because a large number of spells are removed, all of which would have had a small, non-zero risk of mortality contributing to the expected number of deaths. We are working to better understand the planned changes to the recording of SDEC activity and the potential impact on the SHMI. The trusts affected in this publication are: Barts Health NHS Trust (trust code R1H), Cambridge University Hospitals NHS Foundation Trust (trust code RGT), Croydon Health Services NHS Trust (trust code RJ6), Epsom and St Helier University Hospitals NHS Trust (trust code RVR), Frimley Health NHS Foundation Trust (trust code RDU), Imperial College Healthcare NHS Trust (trust code RYJ), Manchester University NHS Foundation Trust (trust code R0A), Norfolk and Norwich University Hospitals NHS Foundation Trust (trust code RM1), and University Hospitals of Derby and Burton NHS Foundation Trust (trust code RTG). 6. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of the publication page.

Background: Under-five mortality remains concentrated in resource-poor countries. Post-discharge mortality is becoming increasingly recognized as a significant contributor to overall child mortality. With a substantial recent expansion of research and novel data synthesis methods, this study aims to update the current evidence base by providing a more nuanced understanding of the burden and associated risk factors of pediatric post-discharge mortality after acute illness. Methods: Eligible studies published between January 1, 2017 and January 31, 2023, were retrieved using MEDLINE, Embase, and CINAHL databases. Studies published before 2017 were identified in a previous review and added to the total pool of studies. Only studies from countries with low or low-middle Socio-Demographic Index with a post-discharge observation period greater than seven days were included. Risk of bias was assessed using a modified version of the Joanna Briggs Institute critical appraisal tool for prevalence studies. Studies were grouped by patient population, and 6-month post-discharge mortality rates were quantified by random-effects meta-analysis. Secondary outcomes included post-discharge mortality relative to in-hospital mortality, pooled risk factor estimates, and pooled post-discharge Kaplan–Meier survival curves. PROSPERO study registration: #CRD42022350975. Findings: Of 1963 articles screened, 42 eligible articles were identified and combined with 22 articles identified in the previous review, resulting in 64 total articles. These articles represented 46 unique patient cohorts and included a total of 105,560 children. For children admitted with a general acute illness, the pooled risk of mortality six months post-discharge was 4.4% (95% CI: 3.5%–5.4%, I2 = 94.2%, n = 11 studies, 34,457 children), and the pooled in-hospital mortality rate was 5.9% (95% CI: 4.2%–7.7%, I2 = 98.7%, n = 12 studies, 63,307 children). Among disease subgroups, severe malnutrition (12.2%, 95% CI: 6.2%–19.7%, I2 = 98.2%, n = 10 studies, 7760 children) and severe anemia (6.4%, 95% CI: 4.2%–9.1%, I2 = 93.3%, n = 9 studies, 7806 children) demonstrated the highest 6-month post-discharge mortality estimates. Diarrhea demonstrated the shortest median time to death (3.3 weeks) and anemia the longest (8.9 weeks). Most significant risk factors for post-discharge mortality included unplanned discharges, severe malnutrition, and HIV seropositivity. Interpretation: Pediatric post-discharge mortality rates remain high in resource-poor settings, especially among children admitted with malnutrition or anemia. Global health strategies must prioritize this health issue by dedicating resources to research and policy innovation. Data Processing Methods: Data were extracted using a standard data extraction form developed by the review authors. Kaplan–Meier survival curves, where provided, were extracted using a plot digitizer. The data extraction file, “PDMSR2024_DataExtraction_Dataset_SD” was generated as described above and analyzed as is. Co-ordinates were extracted from the survival curves in their original, published form, using a plot digitizer (https://automeris.io/WebPlotDigitizer/). The co-ordinates for each survival curve were then cleaned up to: 1. Re-scale the time points to weeks 2. Curves which reported % mortality were converted to % survival (1 – mortality) 3. First co-ordinate was set to (0, 1), i.e., survival is 100% at time-point 0 4. Include the numbers at risk (if reported), primary reference, and subgroup information Using these cleaned co-ordinates, individual-level patient data were extracted (see Guyot et al, 2012, doi.org/10.1186/1471-2288-12-9) and the survival curves re-constructed to obtain the survival and number at risk at specified time-points (0-52 weeks). Where possible, disease and age subgroups were combined to create all admissions curves by combining the individual-level patient data from multiple curves in the same study. Additional data from the survival curves were extracted to produce the “PDMSR2024_AdditionalDataSurvivalCurves6M_Dataset_SD” and “PDMSR2024_AdditionalDataSurvivalCurves12M_Dataset_SD” files by extracting the survival rate at 6 and 12 months. Previously unpublished hazards ratios were extracted from the dataset used in the Wiens et al (2015) study on post-discharge mortality (doi:10.1136/bmjopen-2015-009449) to produce the “PDMSR2024_Wiens2015HazardsRatios_Dataset_SD.xlsx” file. These original data are published on Dataverse at: doi.org/10.5683/SP2/VBPLRM Analyses were in R version 4.3.0 (R Foundation for Statistical Computing, Vienna, Austria), and RStudio version 2023.6.1 (RStudio, Boston, MA). Additional Files: Survival curves in their original, published form, as well as survival curve coordinates files can be made available by request. NOTE for restricted files: If you are not yet a CoLab member, please complete our membership application survey to gain access to restricted files within 2 business...

BackgroundThe Surviving Sepsis Campaign (SSC) believed that early identification of septic shock, aggressive fluid resuscitation and maintenance of effective perfusion pressure should be carried out. However, some of the current research focused on a single death factor for sepsis patients, based on a limited sample, and the research results of the relationship between comorbidities and sepsis related death also have some controversies.MethodTherefore, our study used data from a large sample of 9,544 sepsis patients aged 18–85 obtained from the MIMIC-IV database, to explore the risk factors of death in patients with sepsis. We used the general clinical information, organ dysfunction scores, and comorbidities to analyze the independent risk factors for death of these patients.ResultsThe death group had significantly higher organ dysfunction scores, lower BMI, lower body temperature, faster heart rate and lower urine-output. Among the comorbidities, patients suffering from congestive heart failure and liver disease had a higher mortality rate.ConclusionThis study helps to identify sepsis early, based on a comprehensive evaluation of a patient’s basic information, organ dysfunction scores and comorbidities, and this methodology could be used for actual clinical diagnosis in hospitals.

The Geisinger Rural Aging Study (GRAS) was initiated between 1994-99 as a longitudinal study of health outcomes in relation to nutritional status among 21,645 individuals ≥65-years of age. At the time of initiation, the participants were recruited from within the Geisinger Health System service area located in about 25 counties of north central and eastern Pennsylvania. Active participant data collection is complete but passive data collected through the Electronic Health Record continues for those surviving. Prior patient reported data were collected at baseline and at a rescreening visit occurring 3-4 years after baseline, using questionnaires that encompass multiple domains of nutrition risk. Our investigations have found high prevalence of poor-quality diets, obesity, and ill health. Low diet quality as revealed by the Diet Quality Screening Questionnaire (DQSQ) is associated with outcomes measured within our electronic medical record (low body mass index, increased co-morbidity, and increased mortality risk). The GRAS dataset currently spans more than two decades including patient reported data, clinical data captured within an electronic medical record, and includes novel sub-cohorts such as the oldest old (≥85 years) and centenarians (≥100 years).

BackgroundHeart failure (HF) is a complex disorder that has an association with increased morbidity and mortality rates globally. The association of statin use with mortality rate in individuals with HF remains unclear.ObjectivesTo examine the association of statin use with the short-term and long-term all-cause mortality rate in critically ill individuals with HF.MethodsWe performed a retrospective cohort analysis based on the Medical Information Mart for Intensive Care (MIMIC)-IV database. The critically ill people with HF were assigned to a statin group and a non-statin group according to whether they had been treated with statin or not during hospitalization. The Kaplan−Meier (KM) method and Cox proportional hazard models were adopted to explore the link between statin administration and the 30-day, 90-day, as well as 1-year mortality rates. To ensure the robustness of the findings, a 1:1 nearest propensity-score matching (PSM) was also performed.ResultsThe current research included 11,381 patients for the final analysis, with 7,561 in the statin group and 3,820 in the non-statin group. After multiple confounders were adjusted, we found that the Cox regression models revealed great beneficial effects of statin therapy on the 30-day, 90-day, as well as 1-year mortality rates among critically ill individuals with HF in the fully adjusted model. PSM also achieved consistent results. After PSM, the risk of mortality reduced by 23% for the 30-day mortality (HR = 0.77, 95%CI: 0.68–0.88, p < 0.001), 16% for the 90-day mortality rate (HR = 0.84, 95%CI: 0.75–0.93, p < 0.001), and 12% for the 1-year mortality rate (HR = 0.88, 95%CI: 0.81–0.97, p = 0.007). Patients treated with rosuvastatin had the greatest reduction in mortality rate. The 30-day, 90-day, and 1-year all-cause mortality rates were remarkably lower in patients who were treated with low-dose statins.ConclusionOur study unveiled that statin use was related to decreased short-term and long-term all-cause mortality rates in critically ill individuals with HF. Rosuvastatin was associated with the greatest reduction of all-cause mortality rates. Low-dose statins can significantly reduce short-term and long-term mortality, while high-dose statins are not significantly correlated with mortality. However, the results are not conclusive and should be interpreted with caution.

Goal 3Ensure healthy lives and promote well-being for all at all agesTarget 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live birthsIndicator 3.1.1: Maternal mortality ratioSH_STA_MORT: Maternal mortality ratioIndicator 3.1.2: Proportion of births attended by skilled health personnelSH_STA_BRTC: Proportion of births attended by skilled health personnel (%)Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live birthsIndicator 3.2.1: Under-5 mortality rateSH_DYN_IMRTN: Infant deaths (number)SH_DYN_MORT: Under-five mortality rate, by sex (deaths per 1,000 live births)SH_DYN_IMRT: Infant mortality rate (deaths per 1,000 live births)SH_DYN_MORTN: Under-five deaths (number)Indicator 3.2.2: Neonatal mortality rateSH_DYN_NMRTN: Neonatal deaths (number)SH_DYN_NMRT: Neonatal mortality rate (deaths per 1,000 live births)Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseasesIndicator 3.3.1: Number of new HIV infections per 1,000 uninfected population, by sex, age and key populationsSH_HIV_INCD: Number of new HIV infections per 1,000 uninfected population, by sex and age (per 1,000 uninfected population)Indicator 3.3.2: Tuberculosis incidence per 100,000 populationSH_TBS_INCD: Tuberculosis incidence (per 100,000 population)Indicator 3.3.3: Malaria incidence per 1,000 populationSH_STA_MALR: Malaria incidence per 1,000 population at risk (per 1,000 population)Indicator 3.3.4: Hepatitis B incidence per 100,000 populationSH_HAP_HBSAG: Prevalence of hepatitis B surface antigen (HBsAg) (%)Indicator 3.3.5: Number of people requiring interventions against neglected tropical diseasesSH_TRP_INTVN: Number of people requiring interventions against neglected tropical diseases (number)Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-beingIndicator 3.4.1: Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory diseaseSH_DTH_NCOM: Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease (probability)SH_DTH_NCD: Number of deaths attributed to non-communicable diseases, by type of disease and sex (number)Indicator 3.4.2: Suicide mortality rateSH_STA_SCIDE: Suicide mortality rate, by sex (deaths per 100,000 population)SH_STA_SCIDEN: Number of deaths attributed to suicide, by sex (number)Target 3.5: Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcoholIndicator 3.5.1: Coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance use disordersSH_SUD_ALCOL: Alcohol use disorders, 12-month prevalence (%)SH_SUD_TREAT: Coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance use disorders (%)Indicator 3.5.2: Alcohol per capita consumption (aged 15 years and older) within a calendar year in litres of pure alcoholSH_ALC_CONSPT: Alcohol consumption per capita (aged 15 years and older) within a calendar year (litres of pure alcohol)Target 3.6: By 2020, halve the number of global deaths and injuries from road traffic accidentsIndicator 3.6.1: Death rate due to road traffic injuriesSH_STA_TRAF: Death rate due to road traffic injuries, by sex (per 100,000 population)Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmesIndicator 3.7.1: Proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methodsSH_FPL_MTMM: Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods (% of women aged 15-49 years)Indicator 3.7.2: Adolescent birth rate (aged 10–14 years; aged 15–19 years) per 1,000 women in that age groupSP_DYN_ADKL: Adolescent birth rate (per 1,000 women aged 15-19 years)Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for allIndicator 3.8.1: Coverage of essential health servicesSH_ACS_UNHC: Universal health coverage (UHC) service coverage indexIndicator 3.8.2: Proportion of population with large household expenditures on health as a share of total household expenditure or incomeSH_XPD_EARN25: Proportion of population with large household expenditures on health (greater than 25%) as a share of total household expenditure or income (%)SH_XPD_EARN10: Proportion of population with large household expenditures on health (greater than 10%) as a share of total household expenditure or income (%)Target 3.9: By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contaminationIndicator 3.9.1: Mortality rate attributed to household and ambient air pollutionSH_HAP_ASMORT: Age-standardized mortality rate attributed to household air pollution (deaths per 100,000 population)SH_STA_AIRP: Crude death rate attributed to household and ambient air pollution (deaths per 100,000 population)SH_STA_ASAIRP: Age-standardized mortality rate attributed to household and ambient air pollution (deaths per 100,000 population)SH_AAP_MORT: Crude death rate attributed to ambient air pollution (deaths per 100,000 population)SH_AAP_ASMORT: Age-standardized mortality rate attributed to ambient air pollution (deaths per 100,000 population)SH_HAP_MORT: Crude death rate attributed to household air pollution (deaths per 100,000 population)Indicator 3.9.2: Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene (exposure to unsafe Water, Sanitation and Hygiene for All (WASH) services)SH_STA_WASH: Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene (deaths per 100,000 population)Indicator 3.9.3: Mortality rate attributed to unintentional poisoningSH_STA_POISN: Mortality rate attributed to unintentional poisonings, by sex (deaths per 100,000 population)Target 3.a: Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriateIndicator 3.a.1: Age-standardized prevalence of current tobacco use among persons aged 15 years and olderSH_PRV_SMOK: Age-standardized prevalence of current tobacco use among persons aged 15 years and older, by sex (%)Target 3.b: Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for allIndicator 3.b.1: Proportion of the target population covered by all vaccines included in their national programmeSH_ACS_DTP3: Proportion of the target population with access to 3 doses of diphtheria-tetanus-pertussis (DTP3) (%)SH_ACS_MCV2: Proportion of the target population with access to measles-containing-vaccine second-dose (MCV2) (%)SH_ACS_PCV3: Proportion of the target population with access to pneumococcal conjugate 3rd dose (PCV3) (%)SH_ACS_HPV: Proportion of the target population with access to affordable medicines and vaccines on a sustainable basis, human papillomavirus (HPV) (%)Indicator 3.b.2: Total net official development assistance to medical research and basic health sectorsDC_TOF_HLTHNT: Total official development assistance to medical research and basic heath sectors, net disbursement, by recipient countries (millions of constant 2018 United States dollars)DC_TOF_HLTHL: Total official development assistance to medical research and basic heath sectors, gross disbursement, by recipient countries (millions of constant 2018 United States dollars)Indicator 3.b.3: Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basisSH_HLF_EMED: Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis (%)Target 3.c: Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing StatesIndicator 3.c.1: Health worker density and distributionSH_MED_DEN: Health worker density, by type of occupation (per 10,000 population)SH_MED_HWRKDIS: Health worker distribution, by sex and type of occupation (%)Target 3.d: Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risksIndicator 3.d.1: International Health Regulations (IHR) capacity and health emergency preparednessSH_IHR_CAPS: International Health Regulations (IHR) capacity, by type of IHR capacity (%)Indicator 3.d.2: Percentage of bloodstream infections due to selected antimicrobial-resistant organismsiSH_BLD_MRSA: Percentage of bloodstream infection due to methicillin-resistant Staphylococcus aureus (MRSA) among patients seeking care and whose

Note: Reporting of new COVID-19 Case Surveillance data will be discontinued July 1, 2024, to align with the process of removing SARS-CoV-2 infections (COVID-19 cases) from the list of nationally notifiable diseases. Although these data will continue to be publicly available, the dataset will no longer be updated.

Authorizations to collect certain public health data expired at the end of the U.S. public health emergency declaration on May 11, 2023. The following jurisdictions discontinued COVID-19 case notifications to CDC: Iowa (11/8/21), Kansas (5/12/23), Kentucky (1/1/24), Louisiana (10/31/23), New Hampshire (5/23/23), and Oklahoma (5/2/23). Please note that these jurisdictions will not routinely send new case data after the dates indicated. As of 7/13/23, case notifications from Oregon will only include pediatric cases resulting in death.

This case surveillance public use dataset has 19 elements for all COVID-19 cases shared with CDC and includes demographics, geography (county and state of residence), any exposure history, disease severity indicators and outcomes, and presence of any underlying medical conditions and risk behaviors.

Currently, CDC provides the public with three versions of COVID-19 case surveillance line-listed data: this 19 data element dataset with geography, a 12 data element public use dataset, and a 33 data element restricted access dataset.

The following apply to the public use datasets and the restricted access dataset:

• Data elements can be found on the COVID-19 case report form located at www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf.
• Data are considered provisional by CDC and are subject to change until the data are reconciled and verified with the state and territorial data providers.
• Some data are suppressed to protect individual privacy.
• Datasets will include all cases with the earliest date available in each record (date received by CDC or date related to illness/specimen collection) at least 14 days prior to the creation of the current datasets. This 14-day lag allows case reporting to be stabilized and ensure that time-dependent outcome data are accurately captured.
• Datasets are updated monthly.
• Datasets are created using CDC’s Policy on Public Health Research and Nonresearch Data Management and Access and include protections designed to protect individual privacy.
• For more information about data collection and reporting, please see https://www.cdc.gov/coronavirus/2019-ncov/covid-data/about-us-cases-deaths.html.
• For more information about the COVID-19 case surveillance data, please see https://www.cdc.gov/coronavirus/2019-ncov/covid-data/faq-surveillance.html
  

Overview

The COVID-19 case surveillance database includes individual-level data reported to U.S. states and autonomous reporting entities, including New York City and the District of Columbia (D.C.), as well as U.S. territories and affiliates. On April 5, 2020, COVID-19 was added to the Nationally Notifiable Condition List and classified as “immediately notifiable, urgent (within 24 hours)” by a Council of State and Territorial Epidemiologists (CSTE) Interim Position Statement (Interim-20-ID-01). CSTE updated the position statement on August 5, 2020, to clarify the interpretation of antigen detection tests and serologic test results within the case classification (Interim-20-ID-02). The statement also recommended that all states and territories enact laws to make COVID-19 reportable in their jurisdiction, and that jurisdictions conducting surveillance should submit case notifications to CDC. COVID-19 case surveillance data are collected by jurisdictions and reported voluntarily to CDC.

For more information: NNDSS Supports the COVID-19 Response | CDC.

COVID-19 Case Reports COVID-19 case reports are routinely submitted to CDC by public health jurisdictions using nationally standardized case reporting forms. On April 5, 2020, CSTE released an Interim Position Statement with national surveillance case definitions for COVID-19. Current versions of these case definitions are available at: https://ndc.services.cdc.gov/case-definitions/coronavirus-disease-2019-2021/. All cases reported on or after were requested to be shared by public health departments to CDC using the standardized case definitions for lab-confirmed or probable cases. On May 5, 2020, the standardized case reporting form was revised. States and territories continue to use this form.

Data are Considered Provisional

• The COVID-19 case surveillance data are dynamic; case reports can be modified at any time by the jurisdictions sharing COVID-19 data with CDC. CDC may update prior cases shared with CDC based on any updated information from jurisdictions. For instance, as new information is gathered about previously reported cases, health departments provide updated data to CDC. As more information and data become available, analyses might find changes in surveillance data and trends during a previously reported time window. Data may also be shared late with CDC due to the volume of COVID-19 cases.
• Annual finalized data: To create the final NNDSS data used in the annual tables, CDC works carefully with the reporting jurisdictions to reconcile the data received during the year until each state or territorial epidemiologist confirms that the data from their area are correct.

Access Addressing Gaps in Public Health Reporting of Race and Ethnicity for COVID-19, a report from the Council of State and Territorial Epidemiologists, to better understand the challenges in completing race and ethnicity data for COVID-19 and recommendations for improvement.

Data Limitations

To learn more about the limitations in using case surveillance data, visit FAQ: COVID-19 Data and Surveillance.

Data Quality Assurance Procedures

CDC’s Case Surveillance Section routinely performs data quality assurance procedures (i.e., ongoing corrections and logic checks to address data errors). To date, the following data cleaning steps have been implemented:

• Questions that have been left unanswered (blank) on the case report form are reclassified to a Missing value, if applicable to the question. For example, in the question "Was the individual hospitalized?" where the possible answer choices include "Yes," "No," or "Unknown," the blank value is recoded to "Missing" because the case report form did not include a response to the question.
• Logic checks are performed for date data. If an illogical date has been provided, CDC reviews the data with the reporting jurisdiction. For example, if a symptom onset date in the future is reported to CDC, this value is set to null until the reporting jurisdiction updates the date appropriately.
• Additional data quality processing to recode free text data is ongoing. Data on symptoms, race, ethnicity, and healthcare worker status have been prioritized.

Data Suppression

To prevent release of data that could be used to identify people, data cells are suppressed for low frequency (<11 COVID-19 case records with a given values). Suppression includes low frequency combinations of case month, geographic characteristics (county and state of residence), and demographic characteristics (sex, age group, race, and ethnicity). Suppressed values are re-coded to the NA answer option; records with data suppression are never removed.

Additional COVID-19 Data

COVID-19 data are available to the public as summary or aggregate count files, including total counts of cases and deaths by state and by county. These and other COVID-19 data are available from multiple public locations: COVID Data Tracker; United States COVID-19 Cases and Deaths by State; COVID-19 Vaccination Reporting Data Systems; and COVID-19 Death Data and Resources.

Notes:

March 1, 2022: The "COVID-19 Case Surveillance Public Use Data with Geography" will be updated on a monthly basis.

April 7, 2022: An adjustment was made to CDC’s cleaning algorithm for COVID-19 line level case notification data. An assumption in CDC's algorithm led to misclassifying deaths that were not COVID-19 related. The algorithm has since been revised, and this dataset update reflects corrected individual level information about death status for all cases collected to date.

June 25, 2024: An adjustment

The 1992 Malawi Demographic and Health Survey (MDHS) was a nationally representative sample survey designed to provide information on levels and trends in fertility, early childhood mortality and morbidity, family planning knowledge and use, and maternal and child health. The survey was implemented by the National Statistical Office during September to November 1992. In 5323 households, 4849 women age 15-49 years and 1151 men age 20-54 years were interviewed. The Malawi Demographic and Health Survey (MDHS) was a national sample survey of women and men of reproductive age designed to provide, among other things, information on fertility, family planning, child survival, and health of mothers and children. Specifically, the main objectives of the survey were to: Collect up-to-date information on fertility, infant and child mortality, and family planning Collect information on health-related matters, including breastleeding, antenatal and maternity services, vaccinations, and childhood diseases and treatment Assess the nutritional status of mothers and children Collect information on knowledge and attitudes regarding AIDS Collect information suitable for the estimation of mortality related to pregnancy and childbearing Assess the availability of health and family planning services. MAIN FINDINGS The findings indicate that fertility in Malawi has been declining over the last decade; at current levels a woman will give birth to an average of 6.7 children during her lifetime. Fertility in rural areas is 6.9 children per woman compared to 5.5 children in urban areas. Fertility is higher in the Central Region (7.4 children per woman) than in the Northem Region (6.7) or Southern Region (6.2). Over the last decade, the average age at which a woman first gives birth has risen slightly over the last decade from 18.3 to 18.9 years. Still, over one third of women currently under 20 years of age have either already given birlh to at least one child or are currently pregnant. Although 58 percent of currently married women would like to have another child, only 19 percent want one within the next two years. Thirty-seven percent would prefer to walt two or more years. Nearly one quarter of married women want no more children than they already have. Thus, a majority of women (61 percent) want either to delay their next birth or end childbearing altogether. This represents the proportion of women who are potentially in need of family planning. Women reported an average ideal family size of 5.7 children (i.e., wanted fertility), one child less than the actual fertility level measured in the surveyfurther evidence of the need for family planning methods. Knowledge of contraceptive methods is high among all age groups and socioeconomic strata of women and men. Most women and men also know of a source to obtain a contraceptive method, although this varies by the type of method. The contraceptive pill is the most commonly cited method known by women; men are most familiar with condoms. Despite widespread knowledge of family planning, current use of contraception remains quite low. Only 7 percent of currently married women were using a modem method and another 6 percent were using a traditional method of family planning at the time of the survey. This does, however, represent an increase in the contraceptive prevalence rate (modem methods) from about 1 percent estimated from data collected in the 1984 Family Formation Survey. The modem methods most commonly used by women are the pill (2.2 percent), female sterilisation (1.7 percent), condoms (1.7 percent), and injections (1.5 percent). Men reported higher rates of contraceptive use (13 percent use of modem methods) than women. However, when comparing method-specific use rates, nearly all of the difference in use between men and women is explained by much higher condom use among men. Early childhood mortality remains high in Malawi; the under-five mortality rate currently stands at 234 deaths per 1000 live births. The infant mortality rate was estimated at 134 per 10130 live births. This means that nearly one in seven children dies before his first birthday, and nearly one in four children does not reach his fifth birthday. The probability of child death is linked to several factors, most strikingly, low levels of maternal education and short intervals between births. Children of uneducated women are twice as likely to die in the first five years of life as children of women with a secondary education. Similarly, the probablity of under-five mortality for children with a previous birth interval of less than 2 years is two times greater than for children with a birth interval of 4 or more years. Children living in rural areas have a higher rate ofunder-fwe mortality than urban children, and children in the Central Region have higher mortality than their counterparts in the Northem and Southem Regions. Data were collected that allow estimation ofmatemalmortality. It is estimated that for every 100,000 live births, 620 women die due to causes related to pregnancy and childbearing. The height and weight of children under five years old and their mothers were collected in the survey. The results show that nearly one half of children under age five are stunted, i.e., too short for their age; about half of these are severely stunted. By age 3, two-thirds of children are stunted. As with childhood mortality, chronic undernutrition is more common in rural areas and among children of uneducated women. The duration of breastfeeding is relatively long in Malawi (median length, 21 months), but supplemental liquids and foods are introduced at an early age. By age 2-3 months, 76 percent of children are already receiving supplements. Mothers were asked to report on recent episodes of illness among their young children. The results indicate that children age 6-23 months are the most vulnerable to fever, acute respiratory infection (ARI), and diarrhea. Over half of the children in this age group were reported to have had a fever, about 40 percent had a bout with diarrhea, and 20 percent had symptoms indicating ARI in the two-week period before the survey. Less than half of recently sick children had been taken to a health facility for treatment. Sixty-three percent of children with diarrhea were given rehydration therapy, using either prepackaged rehydration salts or a home-based preparation. However, one quarter of children with diarrhea received less fluid than normal during the illness, and for 17 percent of children still being breastfed, breastfeeding of the sick child was reduced. Use of basic, preventive maternal and child health services is generally high. For 90 percent of recent births, mothers had received antenatal care from a trained medical person, most commonly a nurse or trained midwife. For 86 percent of births, mothers had received at least one dose of tetanus toxoid during pregnancy. Over half of recent births were delivered in a health facility. Child vaccination coverage is high; 82 percent of children age 12-23 months had received the full complement of recommended vaccines, 67 percent by exact age 12 months. BCG coverage and first dose coverage for DPT and polio vaccine were 97 percent. However, 9 percent of children age 12-23 months who received the first doses of DPT and polio vaccine failed to eventually receive the recommended third doses. Information was collected on knowledge and attitudes regarding AIDS. General knowledge of AIDS is nearly universal in Malawi; 98 percent of men and 95 percent of women said they had heard of AIDS. Further, the vast majority of men and women know that the disease is transmitted through sexual intercourse. Men tended to know more different ways of disease transmission than women, and were more likely to mention condom use as a means to prevent spread of AIDS. Women, especially those living in rural areas, are more likely to hold misconceptions about modes of disease transmission. Thirty percent of rural women believe that AIDS can not be prevented.

Complete summary data (mean, error, sample size) for all figures and tables associated with the present manuscript, which characterizes maternal, fetal, and neonatal effects of oral exposure to HFPO-DA (GenX) during gestation in the Sprague-Dawley rat . This dataset is associated with the following publication: Conley, J., C. Lambright, N. Evans, J. McCord, M. Strynar, D. Hill, E. MedlockKakaley, V. Wilson, and E. Gray. Hexafluoropropylene oxide-dimer acid (HFPO-DA or GenX) alters maternal and fetal glucose and lipid metabolism and produces neonatal mortality, low birthweight and hepatomegaly in the Sprague-Dawley rat. ENVIRONMENT INTERNATIONAL. Elsevier B.V., Amsterdam, NETHERLANDS, 146: 106204, (2021).