TABLE 2. Average weekly incidence* of cases and deaths and incidence rate ratios† for unvaccinated compared with fully vaccinated persons§ with and without booster doses,¶ by age, vaccine type,** and period†† — 25 U.S. jurisdictions§§ October 3–December 25, 2021.
| Event/Time/Characteristic | COVID-19 vaccination status |
|||||||
|---|---|---|---|---|---|---|---|---|
| Unvaccinated |
Fully vaccinated (no booster dose) |
Fully vaccinated (with booster dose) |
||||||
| Total no. | Average weekly incidence* | Total no. | Average weekly incidence* | Average weekly IRR (95% CI)¶¶ | Total no. | Average weekly incidence* | Average weekly IRR (95% CI)¶¶ | |
|
COVID-19 cases
| ||||||||
|
October–November
| ||||||||
| Overall (age-standardized) |
1,108,298 |
347.8 |
650,820 |
87.7 |
4.0 (3.6–4.4) |
19,954 |
25.0 |
13.9 (12.2–15.9) |
|
Age group, yrs
| ||||||||
| 18–49 |
760,042 |
330.3 |
343,602 |
89.9 |
3.6 (3.2–4.3) |
6,265 |
27.4 |
12.0 (10.0–14.5) |
| 50–64 |
225,290 |
355.3 |
174,071 |
86.5 |
4.1 (3.5–4.8) |
4,911 |
23.2 |
15.3 (12.8–18.3) |
| ≥65 |
122,966 |
403.6 |
133,147 |
80.7 |
5.0 (4.4–5.6) |
8,778 |
18.1 |
22.3 (19.0–26.1) |
|
Vaccine product
| ||||||||
| Moderna |
NR |
NR |
219,623 |
75.0 |
4.6 (4.2–5.1) |
4,911 |
20.0 |
17.4 (14.5–21.1) |
| Pfizer-BioNTech |
NR |
NR |
358,933 |
93.9 |
3.7 (3.4–4.1) |
14,292 |
27.1 |
12.9 (11.4–14.5) |
| Janssen (Johnson & Johnson) |
NR |
NR |
71,897 |
107.5 |
3.2 (2.9–3.6) |
745 |
26.0 |
13.4 (10.6–16.9) |
|
December
| ||||||||
| Overall (age-standardized) |
1,061,684 |
725.6 |
800,940 |
254.8 |
2.8 (1.6–5.2) |
125,059 |
148.6 |
4.9 (2.7–8.9) |
|
Age group, yrs
| ||||||||
| 18–49 |
781,969 |
745.6 |
547,733 |
302.5 |
2.5 (1.1–5.6) |
65,710 |
191.7 |
3.9 (1.8–8.6) |
| 50–64 |
189,789 |
680.8 |
176,639 |
208.8 |
3.3 (1.7–6.4) |
31,753 |
97.0 |
7.0 (3.0–16.3) |
| ≥65 |
89,926 |
704.9 |
76,568 |
133.5 |
5.3 (3.3–8.4) |
27,596 |
50.4 |
14.0 (6.4–30.6) |
|
Vaccine
| ||||||||
| Moderna |
NR |
NR |
251,784 |
221.6 |
3.3 (1.7–6.1) |
39,813 |
130.4 |
5.6 (3.1–10.1) |
| Pfizer-BioNTech |
NR |
NR |
473,115 |
280.1 |
2.6 (1.4–4.7) |
77,844 |
162.6 |
4.5 (2.4–8.3) |
| Janssen (Johnson & Johnson) |
NR |
NR |
75,903 |
246.6 |
2.9 (1.8–4.8) |
7,377 |
132.7 |
5.5 (3.2–9.4) |
|
COVID-19–associated deaths
| ||||||||
|
October–November
| ||||||||
| Overall (age-standardized) |
16,527 |
7.8 |
5,493 |
0.6 |
12.7 (11.6–13.8) |
285 |
0.1 |
53.2 (37.5–75.4) |
|
Age, yrs
| ||||||||
| 18–49 |
2,094 |
1.0 |
124 |
0.0 |
27.6 (16.3–46.5) |
5 |
0.0 |
NC*** |
| 50–64 |
4,427 |
7.3 |
659 |
0.4 |
21.0 (18.9–23.2) |
38 |
0.2 |
38.0 (17.1–78.9) |
| ≥65 |
10,006 |
33.4 |
4,710 |
3.1 |
11.0 (9.8–12.2) |
242 |
0.5 |
61.4 (47.8–78.9) |
|
Vaccine
| ||||||||
| Moderna |
NR |
NR |
2,379 |
0.5 |
14.6 (13.0–16.4) |
96 |
0.2 |
40.1 (19.5–82.5) |
| Pfizer–BioNTech |
NR |
NR |
2,550 |
0.7 |
11.8 (10.8–12.9) |
187 |
0.1 |
58.7 (36.8–93.9) |
| Janssen (Johnson & Johnson) | NR | NR | 560 | 1.0 | 7.9 (6.0–10.3) | 2 | 0.1 | NC*** |
Abbreviations: FDA = Food and Drug Administration; IRR = incidence rate ratio; NC = not calculated for categories with counts <20; NR = not relevant for individual vaccine types because the comparison being made is to overall unvaccinated counts and age-adjusted rates.
* Events per 100,000 population.
† Average weekly incidence rates and rate ratios are provided by age group, primary series vaccine type, and overall; overall and vaccine-specific rates were standardized by age, according to the enumerated 2000 U.S. Census age distribution. IRRs were calculated by dividing incidence among unvaccinated persons by incidence among fully vaccinated persons (overall and by receipt of booster doses).
§ A COVID-19 case in a fully vaccinated person occurred when SARS-CoV-2 RNA or antigen was detected in a respiratory specimen collected ≥14 days after completing the primary series of a COVID-19 vaccine with FDA approval or emergency use authorization. A COVID-19 case in an unvaccinated person occurred when the person did not receive any FDA-authorized COVID-19 vaccine doses before the specimen collection date. Excluded were partially vaccinated persons who had received at least one FDA-authorized or approved vaccine dose but did not complete a primary series ≥14 days before collection of a specimen with SARS-CoV-2 RNA or antigen detected. This analysis represents the combined impact of BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), and Ad.26.COV2.S (Janssen [Johnson & Johnson]) COVID-19 vaccines, which had different clinical efficacies against confirmed infection; fully vaccinated persons also include those persons who received additional primary doses and booster doses starting in mid-August. A COVID-19–associated death occurred in a person with a documented COVID-19 diagnosis who died, and whose report local health authorities reviewed (e.g., using vital records, public health investigation, or other data sources) to make that determination. Per national guidance, this should include persons whose death certificate lists COVID-19 disease or SARS-CoV-2 as an underlying cause of death or as a significant condition contributing to death. 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.
¶ A COVID-19 case in a fully vaccinated person with a booster dose occurred when a person had SARS-CoV-2 RNA or antigen detected on a respiratory specimen collected ≥14 days after receipt of at least one additional or booster dose of any COVID-19 vaccine on or after August 13, 2021. On August 13, 2021, CDC recommended an additional Pfizer-BioNTech or Moderna primary series dose for persons with moderately or severely immunocompromise. On September 24, 2021, CDC recommended a Pfizer-BioNTech booster dose for certain Pfizer-BioNTech primary series recipients, including all adults aged ≥65 years and persons aged ≥18 years in certain populations and high risk occupational and institutional settings. On October 21, 2021, CDC recommended a booster dose for adults aged ≥18 years who received the Janssen vaccine and for Pfizer-BioNTech or Moderna primary series recipients, including all adults aged ≥65 years and persons aged ≥18 years in certain populations and high risk occupational and institutional settings. On November 19, 2021, and November 29, 2021, CDC expanded recommendations for booster doses to include all adults aged ≥18 years.
** 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. For primary mRNA vaccination series, the vaccine product of the second dose was used to determine primary series product type. If the Janssen vaccine was either the first dose or the second dose, the series type was called Janssen. The overall fully vaccinated group includes FDA-approved vaccinations of unknown vaccine type.
†† Analysis periods for this table were designated based on robust reporting of cases among persons with booster doses from October 2021 and the threshold week when the weighted proportions of lineages from whole-genome sequencing results submitted to or performed by CDC: October 3–November 27, 2021 (Delta predominance: 99%), and November 28–December 25, 2021 (Omicron emergence: 1%–72%).
§§ Alabama, Arkansas, California, Colorado, District of Columbia, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, New York, New York City (New York), Rhode Island, Seattle/King County (Washington), Tennessee, Texas, Utah, and Wisconsin.
¶¶ 95% CIs were calculated after detrending underlying linear changes in weekly incidence rates using piecewise linear regression. Each CI represents the remaining variation in observed weekly incidence rates and resulting incidence rate ratios. The number of observations informing each CI reflects the number of weeks per period: October–November (7), and December (4).