Decreases in COVID-19 Cases, Emergency Department Visits, Hospital Admissions, and Deaths Among Older Adults Following the Introduction of COVID-19 Vaccine - United States, September 6, 2020-May 1, 2021

Abstract

Throughout the COVID-19 pandemic, older U.S. adults have been at increased risk for severe COVID-19-associated illness and death (1). On December 14, 2020, the United States began a nationwide vaccination campaign after the Food and Drug Administration's Emergency Use Authorization of Pfizer-BioNTech COVID-19 vaccine. The Advisory Committee on Immunization Practices (ACIP) recommended prioritizing health care personnel and residents of long-term care facilities, followed by essential workers and persons at risk for severe illness, including adults aged ≥65 years, in the early phases of the vaccination program (2). By May 1, 2021, 82%, 63%, and 42% of persons aged ≥65, 50-64, and 18-49 years, respectively, had received ≥1 COVID-19 vaccine dose. CDC calculated the rates of COVID-19 cases, emergency department (ED) visits, hospital admissions, and deaths by age group during November 29-December 12, 2020 (prevaccine) and April 18-May 1, 2021. The rate ratios comparing the oldest age groups (≥70 years for hospital admissions; ≥65 years for other measures) with adults aged 18-49 years were 40%, 59%, 65%, and 66% lower, respectively, in the latter period. These differential declines are likely due, in part, to higher COVID-19 vaccination coverage among older adults, highlighting the potential benefits of rapidly increasing vaccination coverage.

FIGURE 1

Average daily number of total COVID-19 vaccine doses administered and cumulative percentage of adults aged ≥18 years who received ≥1 dose and who were fully vaccinated, by age group — United States, December 14, 2020–May 1, 2021 * Based on 7-day moving average. ^† Age was unknown for 8% of fully vaccinated persons. ^§ Texas does not report demographic-specific dose number information to CDC, so data for Texas are not represented in cumulative percentage of population vaccinated.

FIGURE 2

Weekly COVID-19 rates (A),^,, emergency department visits for patients with a diagnosis of COVID-19 (B), hospital admissions with confirmed COVID-19 diagnosis (C),^, and COVID-19 deaths (D)^, among adults, by age group, and rate ratio for persons aged ≥65 or ≥70 years versus 18–49 years — United States, September 6, 2020–May 1, 2021 Sources: CDC’s case-based COVID-19 surveillance system, accessed May 26, 2021 (A); National Syndromic Surveillance Program, accessed May 26, 2021 (B); U.S. Department of Health and Human Services Unified Hospital dataset, accessed May 26, 2021 (C); National Vital Statistics System, accessed May 26, 2021 (D). Abbreviation: ED = emergency department. * COVID-19 cases per 100,000 persons. ^† Case classifications for COVID-19 are described in https://ndc.services.cdc.gov/case-definitions/coronavirus-disease-2019-2020-08-05 and https://www.cdc.gov/ coronavirus/2019-ncov/covid-data/faq-surveillance.html. ^§ Demographic data are based on a subset of COVID-19 cases for whom case-level data have been reported by state and territorial jurisdictions, accounting for approximately 80% of all cases reported to CDC. Patient age was unknown for 0.7% of cases. ^¶ ED visits are shown as visits for patients with a diagnosis of COVID-19 per 100,000 ED visits reported. ED visits for patients with a diagnosis of COVID-19 are defined as ED visits with any of the following: International Classification of Diseases, Tenth Revision codes U07.1 or J12.82 or Systematized Nomenclature of Medicine 840539006, 840544004, or 840533007. Patient age was unknown for 0.4% of ED visits. ** Hospital admissions with confirmed COVID-19 diagnosis per 100,000 persons. ^†† Dataset includes data reported by hospitals registered with the Centers for Medicare & Medicaid Services. Data were reported to the U.S. Department of Health and Human Services directly from facilities or via a state submission; on May 1, 2021, 98.5% of hospitals reported. This analysis includes Veterans Administration, Defense Health Agency, and Indian Health Services hospitals and excludes psychiatric, rehabilitation, and religious nonmedical hospitals. Patient age was unknown for 4% of hospital admissions. ^§§ COVID-19 deaths per 100,000 persons. ^¶¶ Deaths with confirmed or presumed COVID-19 as an underlying or contributing cause of death, with International Classification of Diseases, Tenth Revision code U07.1. Provisional data are incomplete. Decedent age was unknown for <0.01% of deaths.