DOI: 10.3886/e243697v1
title: Rates of COVID-19 Cases or Deaths by Age Group and Updated (Bivalent) Booster Status

description: 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 &lt;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
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