State of the Pandemic – Fall 2021

In the United States, the SARS-CoV-2 pandemic has produced 5 waves of new cases. The peaks of those waves were on April 9, 2020 (34,893 cases), July 17, 2020 (78,252 cases), January 6, 2021 (295,378 cases), April 7, 2021 (79,302 cases), and September 1, 2021 (192,211 cases). The first peak likely under-represented the true case incidence because the availability and use of testing was limited at that early point in the pandemic. The third peak, in January 2021, was the highest. The recent fifth peak, in September 2021, was more than 100,000 cases lower than the January 2021 peak. Although the burden of severe illness was high with large numbers of hospitalizations and deaths in the most recent wave, both were much lower than in the third wave. Population immunity levels, both from vaccination and from previous infection, likely limited the impact of the virus during the fifth wave.

Nationally, surveillance indicators tracking levels of SARS-CoV-2 circulation and associated illnesses, hospital admissions, and deaths began declining in early September 2021, and continued into October 2021. As the weather began to get colder and people started to spend more time indoors, we started to see an increase in cases and hospitalizations in November 2021. On December 8, 2021, the current 7-day moving average of new cases nationwide was 118,515, up 37.3% from the previous week. The 7-day average of new hospital admissions was 7,441, up 15.9% from the previous week. The 7-day moving average of new deaths nationwide was 1,092, up 27.8% from the previous week.

As of December 9, 2021, over 237 million people (71.5% of the US population) have been fully vaccinated. Older adults have the highest vaccination rates of any age group: 87.0% of people ages 65 years or older are fully vaccinated. As of December 9, 2021, 17.9% of people ages 5 through 11 years old have received at least one dose of vaccine and 7.0% of people ages 5 through 11 years old are fully vaccinated. CDC recommends that people with compromised immune systems receive an additional dose of an mRNA COVID-19 vaccine.

For people who received a primary series of an mRNA COVID-19 vaccine, booster doses are recommended at least six months after completing the primary series for everyone ages 18 years and older. Everyone ages 18 years and older who received the Johnson & Johnson/Janssen vaccine should get a booster shot at least two months after receiving the primary shot. On December 9, 2021, the U.S. Food and Drug Administration authorized the use of a single booster dose for adolescents ages 16 and 17 years at least six months after completion of a primary series with the Pfizer-BioNTech COVID-19 vaccine. That same day, CDC strengthened its booster dose recommendations and now encourages everyone 16 years and older to receive a booster dose. At this time, only the Pfizer-BioNTech COVID-19 vaccine is authorized and recommended for adolescents ages 16 and 17 years. Since August 2021, over 49.9 million fully vaccinated people have received a booster dose; 26.9% of those ages 18 years or older and 49.1% of those ages 65 years or older who are fully vaccinated have received a booster dose.

A new SARS-CoV-2 variant, named Omicron by the World Health Organization, was classified on November 30, 2021, as a Variant of Concern by the U.S. government SARS-CoV-2 Interagency Group. The first U.S. case of the Omicron variant was confirmed on December 1, 2021, and has now been detected in a number of states. CDC is working with state and local public health officials to monitor the spread of the new variant. CDC is also working with its public health partners to determine how easily the variant is transmitted, the severity of disease caused by the variant, and how well vaccines and therapeutics will work against the variant. However, the emergence of this variant and the fact that the Delta variant continues to be the most dominant variant present in the United States, reinforces the need for people to get vaccinated and for those fully vaccinated to receive boosters.

As the country approaches the winter—typically the high season for respiratory viruses like SARS-CoV-2 and influenza — there are many unknowns. Continuing to monitor case rates and the burden of COVID-19 illnesses and hospitalizations will be key to responding quickly and effectively in the coming months to limit illness and keep our health systems functioning for all people. COVID-19 vaccination is crucial to controlling the pandemic as it provides substantial protection against infection, hospitalization, and death. As we approach the holiday season, a time when gatherings of friends and families are common, it is important to maintain prevention measures and ensure protection of those most vulnerable.

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map of US with text US COVID-19 Cases Caused by the Omicron Variant
On November 26, 2021, the World Health Organization external icon (WHO) classified a new variant, B.1.1.529, as a Variant of Concern (VOC) and named it Omicron. On November 30, 2021, the United States also classified it as a VOC. On December 1, 2021, CDC announced that the first confirmed case of the Omicron variant had been detected in the United States. As of December 9, 2021, 23 states have announced cases of the Omicron variant.

A new CDC report summarizes what’s known about initial cases of COVID-19 infection with the Omicron variant in the United States and prevention strategies to slow the spread. While Omicron viruses have been detected, the Delta variant still currently accounts for over 99.9% of all circulating SARS-CoV-2 viruses in the United States.COVID-19 vaccination, along with consistent use of prevention strategies, remains the best tool we have to protect people from COVID-19, slow transmission, and reduce the likelihood of new variants emerging. CDC recommends that:

Everyone 5 years and older protects themselves by getting fully vaccinated.
Everyone ages 18 years and over gets a COVID-19 booster dose.
Teens 16–17 years old who received Pfizer-BioNTech COVID-19 vaccines can get a booster dose.
Immunocompromised people talk with their healthcare professional about additional primary doses and booster doses following the primary series.*
As the weather gets colder and people gather indoors, getting a COVID-19 vaccine or booster dose can help protect you, the people around you, and the people you love. To find a COVID-19 vaccine provider near you, visit vaccines.gov or your state or local public health department website.