Document text
Current Epidemiology of COVID -19
Coronavirus and Other Respiratory Viruses Division
Advisory Committee on Immunization Practices (ACIP)
June 25, 2025National Center for Immunization and Respiratory Diseases
1
COVID- 19 continues to impact Americans’ health.
* Based on data from September 29, 2024 through June 7, 2025.
Source: https://www.cdc.gov/covid/php/surveillance/burden- estimates.html 2
Among adults aged ≥18 years, 3.6%
reported Long COVID
symptoms, and 8.4% reported ever
having Long COVID1
More than 3 in 5 adults with Long
COVID reported activity limitations1
Among children aged 0 -17
years, 0.4% reported Long COVID
symptoms, and 1.4% reported ever
having Long COVID2Long COVID is a significant public health threat.
1.Vahratian , et al . Prevalence of Post –COVID -19 Condition and Activity -Limiting Post –COVID -19 Condition Among Adults. doi:10.1001/jamanetworkopen.2024.51151
2.Ford, et al. Long COVID Prevalence and Associated Activity Limitation in US Children. doi:10.1001/jamapediatrics.2024.6206National surveys in 2023 estimated approximately 9.2 million adults and 0.3 million
children in the U.S. had Long COVID.
Almost 4 in 5 children with Long
COVID reported activity limitations2
3
COVID- NET is a population -based hospitalization
surveillance platform.
•RESP -NET includes COVID -NET, RSV -NET, FluSurv -NET
•>300 acute -care hospitals
•185 counties in 13 states (population- based rates)
•~10% of the U.S. population
•Positive SARS -CoV-2 test ≤14 days before admission or during hospitalization
•Screening or clinician -driven testing
•Clinical data: age - and site -stratified random sample of hospitalized patients
•Seasons defined in this presentation as July –June for rates.
-Most recent 12 months of sampled data
COVID -NET: https://www.cdc.gov/covid/php/covid- net/index.html Some slides display data from 90 counties in 12 states due to incomplete data.4
010203040
20
2020
21202220
2320242025Rates of COVID -19, influenza, and RSV hospitalization — RESP -NET, 2020– 2025
2020 2021 2022 2023 2024 2025Weekly COVID- 19-associated hospitalization rates have
peaked in both winter and summer.
50246810121416Hospitalizations per 100,000 population
Month and YearWeekly Rates of COVID -19–, Influenza -, and RSV -Associated
Hospitalizations — RESP- NET, July 2023– April 2025
COVID-19 Influenza RSV
Figures displays weekly Rates of COVID -19–, Influenza -, and RSV -Associated Hospitalizations — RESP -NET, July 2023 –May 2025.
Rates for all three pathogens (COVID -19, influenza, and respiratory syncytial virus [RSV]) are laboratory -confirmed. Data source : https://www.cdc.gov/resp -net/dashboard/
Note that rates are not adjusted for testing. Rates are not limited to admissions where the respiratory infection is the like ly primary reason for admission.
Cumulative COVID- 19–associated hospitalization rates for the
July 2024–May 2025 period were higher during summer and fall
2024 and lower during the winter months compared to July
2023–June 2024.
6020406080100120140160180200
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May JuneHospitalizations per 100,000 population
MonthCumulative Rates of COVID -19–, Influenza- , and RSV -Associated Hospitalizations, by Surveillance Season* —
RESP- NET, July 2023– May 2025
COVID 2023– 2024 Influenza 2023– 2024 RSV 2023– 2024
COVID 2024– 2025 Influenza 2024– 2025 RSV 2024– 2025
* Seasons are defined as July through June. The 2024 –2025 season shows data from July 2024– May 2025 and is ongoing. Influenza surveillance is conducted October – April.
Rates for all three pathogens (SARS- CoV-2, influenza, and respiratory syncytial virus [RSV]) are laboratory -confirmed. Data sour ce: https://www.cdc.gov/resp -net/dashboard/
Note that rates are not adjusted for testing. Rates are not limited to admissions where the respiratory infection is the like ly primary reason for admission.
From July 2024 – April 2025, a period that included a high
severity influenza season1, more infants <1 and adults ≥75 had
hospitalizations associated with COVID -19 than influenza.
701002003004005006007008009001000
<1 1–4 5–11 12–17 18–49 50–64 65–74 ≥75Hospitalizations per 100,000 population
Age group (years)Cumulative hospitalization rates of laboratory -confirmed COVID-19 and influenza hospitalizations —
RESP-NET, July 2024–April 2025
COVID-19 Influenza
Cumulative hospitalization rates with laboratory -confirmed SARS -CoV-2 and influenza hospitalizations — RESP -NET, July 2024 –April 2025. Note that influenza surveillance is conducted
from October –April annually. Data source: https://www.cdc.gov/resp -net/dashboard/ . Note that rates are not adjusted for testing nor limited to admissions where the respiratory
infection is the likely primary reason for admission. 1https://www.cdc.gov/flu/php/surveillance/in- season -severity.html
Cumulative COVID- 19-associated hospitalization rates are highest
among adults aged ≥75 years, followed by adults aged 65–74 years
and infants aged <6 months.
Weekly rates of COVID -19–associated hospitalizations per 100,000 population by age group— COVID- NET, July 2024– May 2025
Note that rates are not adjusted for testing. Rates are not limited to admissions where the respiratory infection is the like ly primary reason for admission. 8050100150200250300
Jul 2024 Aug 2024 Sep 2024 Oct 2024 Nov 2024 Dec 2024 Jan 2025 Feb 2025 Mar 2025 Apr 2025 May 2025Rate per 100,000 population
Surveillance week end date
<6 months 6–23 months 2–4 years 5–11 years
12–17 years 18–49 years 50–64 years 65–74 years50–64 years: 101
18–49 years: 36
2–4 years: 22
12–17 years: 12
5–11 years: 10<6 months: 268
65–74 years: 266
50–64 years: 103
6–23 months: 10002505007501000Rate per 100,000≥75 years: 884
COVID -19 Mortality
9
Weekly number of COVID- 19-associated deaths reported
to CDC, United States, June 8, 2024 – June 7, 2025
The most recent 3 weeks of mortality counts are shaded grey because NVSS reporting is <95% during this period.
Provisional data are non -final counts of deaths based on reported mortality data in NVSS. Deaths include those with COVID- 19, coded as ICD– 10 code U07.1, on the death certificate.
Death data are displayed by date of death (event). Data include underlying and contributing causes of death.CDC COVID Data Tracker. National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS).
https://covid.cdc.gov/covid- data -tracker/#trends_weeklydeaths_select_00
Accessed June 18, 202502004006008001,0001,2001,4001,600
6/8/2024 8/8/2024 10/8/2024 12/8/2024 2/8/2025 4/8/2025Weekly Deaths
10
Total number of deaths with COVID -19listed as the underlying
cause1,2 in July 2024–June 2025, by age group, United States
1. Provisional data
2. Underlying cause of death Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Natio nal Vital Statistics System, Provisional Mortality on CDC
WONDER Online Database. Data are from the final Underlying Cause of Death Files, provisional data for 2024 and provisional and partial data from 2025 , as compiled from data provided
by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Number of deaths includes COVID- 19 code (U07.1) as the underlying cause of death.
http://wonder.cdc.gov/mcd -icd10 -provisional.html, accessed June 20 , 2025 45 16 294761,7684,00916,375
020004000600080001000012000140001600018000
<2 years 2-4 years 5-17 years 18-49 years 50-64 years 65-74 years ≥75 yearsNumber of Deaths
1
11
Death certificate data likely underestimate COVID -19-associated
deaths.
Figure displays the weighted percentage of COVID -19-associated hospitalizations with COVID -19 listed as an underlying or contributing cause of death,* by surveillance period** — COVID -NET, March 2020–
September 2023
* COVID -19 as a cause of death was defined as the inclusion of International Classification of Diseases, Tenth Edition (ICD- 10) code U07.1 on the death certificate as an underlying or contributing cause of death.
**Surveillance periods are defined as October –September, except for 2020, which was defined as March 2020– September 2020.
12Among in- hospital
deaths in patients
with laboratory -
confirmed SARS -
CoV- 2, the proportion
with a COVID- 19
cause of death listed decreased from 95%
in 2020 to 60% in
2022– 2023.95
89
77
60
0102030405060708090100
Category 1Percent of in -hospital deaths with COVID -
19 cause of death on the death certificate
2020 2020 –2021 2021 –2022 2022 –2023
COVID -19 continues to contribute to a large number of deaths in
the United States.
* COVID -19 as a cause of death was defined as the inclusion of International Classification of Diseases, Tenth Edition (ICD- 10) code U07.1 on the death certificate (October 2024- May 2025) as underlying or
contributing cause of death. Provisional death certificate data from the National Center for Health statistics
† Based on data from September 29, 2024 through June 7, 2025. Source: https://www.cdc.gov/covid/php/surveillance/burden- estimates.html . Accessed June 20, 2025
13Data sourceEstimated COVID -19
deaths since October
2024
Death certificate data* 20,800
Modeled estimates based on
multiple data sources†32,000– 51,000
Pediatric COVID -19–Associated
Hospitalizations
14
The highest rates for COVID- 19 in the New Vaccine Surveillance
Network were observed in infants <6 months of age.
Pediatric COVID- 19 and influenza hospitalization rates among children <18 years, New Vaccine Surveillance Network (NVSN), July 2024- March 2025. Rate estimates with standard error >30 due to few
detections are not presented. Annual rates presented July – June of each season, with exception of 2024 -2025, which represents J uly 2024 – March 2025.
NVSN, unpublished data209.8
83.0
17.07.4149.4
82.9
58.5
39.6
11.1
0100200300
<6m 6-23m 2-4y 5-11y 12-17yHospitalization rate , No./100000 children
AgeSARS-CoV-2
Influenza
15
More than half of pediatric COVID- 19-associated
hospitalizations occur in children aged <2 years.
160%10%20%30%40%50%60%70%80%90%100%Percent of COVID -19–associated hospitalizations
Surveillance week end datePercent of weekly COVID -19–associated hospitalizations among children and adolescents, by age group
—
COVID -NET, July 2024– April 2025
<6 months 6–23 months 2–4 years 5–11 years 12–17 years
Figure displays percent of weekly COVID -19–associated hospitalizations among children and adolescents, by age group — COVID -NET, July 2024– May 2025.≤6 months = 27%6–23 months = 30%
<2 years = 57%2–17 years = 43%
COVID- 19 causes severe disease in infants ages <6 months.
Data reported from July 2024– May 2025. Excludes newborns who were admitted during the same hospitalizations as their birth. Note that rates are not adjusted for testing. Rates are not
limited to admissions where the respiratory infection is the likely primary reason for admission. •Highest rate of COVID -19-
associated hospitalization
among all pediatric age groups
-Rates comparable to adults ages
65–74 years
050100150200250300
Jul
2024Aug
2024Sep
2024Oct
2024Nov
2024Dec
2024Jan
2025Feb
2025Mar
2025Apr
2025May
2025Rate per 100,000 population
Surveillance week end dateCumulative rates of COVID -19–associated hospitalizations among
children and adolescents ages <18 years —
COVID -NET, July 2024– May 2025
<6 months 6–23 months 2–4 years
5–11 years 12–17 years 50–64 years
65–74 yearsCumulative rate per 100,000:
<6 months: 268
65–74 years: 266
17
Infants <6 months experience high rates of severe COVID-
19 disease.
18No COVID -19 vaccine products are approved for infants ages <6 months.
Any protection must come from transfer of maternal antibodies, either from
vaccination during pregnancy or prior infectionAmong infants <6 months hospitalized recently for COVID -19:
22% were admitted to the ICU
71% had no underlying medical conditions
3.5% had any record of maternal COVID -19 vaccination during pregnancy
Data reported from April 2024 –March 2025. Hospitalizations are limited to those with COVID -19 as the likely reason for admission . Excludes newborns who were admitted during the
same hospitalizations as their birth.
190%10%20%30%40%50%60%70%80%90%100%Percent of COVID -19–associated
hospitalizations
Surveillance week end datePercent of weekly COVID -19–associated hospitalizations among children and adolescents, by age group
—
COVID -NET, October 2024– April 2025
6–23 months 2–4 years 5–11 years 12–17 years
Figure displays the percent of weekly COVID -19–associated hospitalizations among children and adolescents, by age group — COVID -NET, October 2024– May 2025.Among vaccine -eligible children and adolescents ages 6
months –17 years, 41% of COVID- 19-associated hospitalizations
occurred among children ages 6–23 months.
During July 2024– May
2025:
•6–23 months = 41%
•2–4 years = 18%
•5–11 years = 20%
•12–17 years = 21%
COVID -19-associated cumulative hospitalization rates are
highest among the youngest age groups.
Note that rates are not adjusted for testing. Rates are not limited to admissions where the respiratory infection is the like ly primary reason for admission. 20050100150200250300
Jul 2024 Aug 2024 Sep 2024 Oct 2024 Nov 2024 Dec 2024 Jan 2025 Feb 2025 Mar 2025 Apr 2025 May 2025Rate per 100,000 population
Surveillance week end dateCumulative rates of COVID -19–associated hospitalizations among children and adolescents ages ≤17 years —
COVID -NET, July 2024– May 2025
<6 months 6–23 months 2–4 years ≤4 years 5–11 years 12–17 years65–74 years: 258
50–64 years: 101
18–49 years: 36
12–17 years: 12
5–11 years: 10≤4 years: 68257Rates for 100K population,
by age group:
<6 months: 268
6–23 months: 100
2–4 years: 22
The youngest age groups have comparable rates of cumulative
COVID -19-associated hospitalization to some adult age groups, but
direct comparisons are challenging.
Note that rates are not adjusted for testing. Rates are not limited to admissions where the respiratory infection is the like ly primary reason for admission. 21050100150200250300
Jul 2024 Aug 2024 Sep 2024 Oct 2024 Nov 2024 Dec 2024 Jan 2025 Feb 2025 Mar 2025 Apr 2025 May 2025Rate per 100,000 population
Surveillance week end dateCumulative rates of COVID -19–associated hospitalizations among children and adolescents ages ≤17 years —
COVID -NET, July 2024– May 2025
<6 months 6–23 months 2–4 years 5–11 years65–74 years: 258
50–64 years: 101
18–49 years: 36
12–17 years: 12
5–11 years: 10Rates for 100K population,
by age group:
<6 months: 268
65–74 years: 266
50–64 years: 103
6–23 months: 100
2–4 years: 22
The youngest age groups have comparable rates of cumulative
COVID -19-associated hospitalization to some adult age groups, but
direct comparisons are challenging.
Note that rates are not adjusted for testing. Rates are not limited to admissions where the respiratory infection is the like ly primary reason for admission. 22050100150200250300
Jul 2024 Aug 2024 Sep 2024 Oct 2024 Nov 2024 Dec 2024 Jan 2025 Feb 2025 Mar 2025 Apr 2025 May 2025Rate per 100,000 population
Surveillance week end dateCumulative rates of COVID -19–associated hospitalizations among children and adolescents ages ≤17 years —
COVID -NET, July 2024– May 2025
<6 months 6–23 months 2–4 years 5–11 years65–74 years: 258
50–64 years: 101
18–49 years: 36
12–17 years: 12
5–11 years: 10Rates for 100K population,
by age group:
<6 months: 268
65–74 years: 266
50–64 years: 103
6–23 months: 100
2–4 years: 22% with ≥1 underlying medical conditions
among those hospitalized for COVID -19:
Adults aged 50 -64: 94%
Infants and children 6 -23 months: 46%
Proportion of children hospitalized for COVID- 19 who
had no underlying medical conditions
Figure displays the weighted percent of children and adolescents hospitalized for COVID -19 with no underlying medical conditions, by age group — COVID -NET, April 2024 –March 2025.
Hospitalizations are limited to those with COVID -19 as the presenting complaint upon admission. Pregnant adolescents ages 15 –17 years are excluded from proportions
presented. 2371
54
29
24 23
01020304050607080
<6 months 6–23 months 2–4 years 5–11 years 12–17 yearsPercentage of pediatric patients hospitalized
who have no underlying medical conditions
Age Group<2 years
2–17 yearsMost hospitalized
children ages <2
years did not have
any underlying
medical condition.
Percent of children and adolescents for COVID -19 who were admitted to the ICU, by age group — COVID -NET, April 2024 –March 2025
Hospitalizations are limited to those with COVID -19 as the likely reason for admission. Pregnant adolescents ages 15 –17 years are excluded from proportions presented. 2225
2128
26
051015202530
<6 months 6–23 months 2–4 years 5–11 years 12–17 yearsPercent of pediatric hospitalizations
requiring ICU admission
Age group~1 in 4 children ages <18 years in all age groups
hospitalized for COVID- 19 required ICU admission.
2424%
Percent of children and adolescents for COVID -19 who were admitted to the ICU, by age group — COVID -NET, April 2024 –March 2025
Hospitalizations are limited to those with COVID -19 as the likely reason for admission. Pregnant adolescents ages 15 –17 years are excluded from proportions presented. 2225
2128
26
051015202530
<6 months 6–23 months 2–4 years 5–11 years 12–17 yearsPercent of pediatric hospitalizations
requiring ICU admission
Age groupAmong children <2
years admitted to
ICU, most (53%) did
not have underlying
medical conditions.
25~1 in 4 children ages <18 years in all age groups
hospitalized for COVID- 19 required ICU admission.
23%
89% of COVID -19 vaccine-eligible children and adolescents who were
hospitalized with COVID -19 had no record of receiving the most recently
recommended COVID -19 vaccines.
No record of COVID -19 vaccine since July 1, 2023: No recorded doses of any COVID -19 vaccine dose since July 1, 2023. ≥1 vaccine dose since July 1, 2023, but
no 2024– 2025 dose: Received at least one COVID -19 vaccination since July 1, 2023, but no record of receiving 2024- 2025 vaccine dose. Receipt of ≥1 24- 25 formula
dose: Received at least 1 dose of the 2024- 2025 vaccine dose. Persons with unknown vaccination status (6.4%) are excluded. Hospitaliza tions are limited to those with
COVID -19 as the presenting complaint upon admission.908589 89
1 2 311013
810
0102030405060708090100
6 months –4 years 5–11 years 12–17 years 6 months –17 yearsWeighted percent of hospitalizationsVaccination status among children and adolescents with COVID-19 –associated hospitalizations,
by age group — COVID -NET, October 2024 –March 2025
No record of COVID-19 vaccine since July 1, 2023
≥1 vaccine dose since July 1, 2023, but no record of receiving 24- 25 formula dose
Receipt of ≥1 24- 25 formula dose
26
Pediatric COVID -19 mortality
27
Total number of COVID -19- and Influenza -associated
deaths1,2, among ages 0 –17 years in July 2024 –June 2025,
United States
45
162944 42142
020406080100120140160
<2 year 2–4 years 5–17 yearsNumber of Deaths
COVID-19 Influenza
1. Provisional data
2. Underlying cause of death Source: Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Provisional Mortality on CDC WONDER Online
Database. Data are from the final Underlying Cause of Death Files, provisional data for 2024 and provisional and partial data from 2025 , as compiled from data provided by the 57 vital statistics jurisdictions
through the Vital Statistics Cooperative Program. Number of deaths includes influenza codes (J09 -J11) or COVID -19 code (U07.1) as the underlying cause of death. http://wonder.cdc.gov/mcd -icd10 -
provisional.html , accessed June 20, 2025
Note: Estimates of pediatric influenza deaths reported to CDC can be found here: https://www.cdc.gov/fluview/surveillance/2025 -week -15.html . Estimates will vary due to differences in reporting methods
and timeframes used. 28
Deaths among children with COVID- 19-associated
hospitalizations within COVID- NET catchment area
29Since March
2020July 2022–
June 2023July 2023–
March 2025
In-hospital and out- of-hospital deaths 128 32 25 (including 10*
since April 2024)
•Among 25 pediatric deaths since July 2023:
•13 (52%) were aged <2 years: 9 aged <6 months; 4 aged 6 –23 months
•18 (72%) had ≥1 underlying medical condition
•Of the 16 who were age- eligible for COVID -19 vaccination, 14 had no record of COVID -19 vaccination
and none were up to date.
•Death certificate data alone may underestimate COVID -19-associated pediatric deaths
-Among the 25 deaths** for whom we have death certificate data with ICD -10 codes, 7 (28%) had COVID -19 listed
as a cause of death (COD)
-Additional 9 (36%) had CODs related to other respiratory or circulatory causesCOVID -NET
represents 10% of
the U.S. population
* In-hospital deaths only; complete death certificate data not yet available.
** Deaths occurred during July 2022 and August 2023.
Summary
COVID -19 Epidemiology in Infants, Children, and Adolescents
30
Summary of COVID- 19 Epidemiology for Infants, Children, and
Adolescents
•Most (57%) pediatric hospitalizations occur in children ages <2 years .
-Most hospitalized children in these age groups have no underlying medical conditions, including 71%
of infants ages <6 months and 54% of children ages 6 –23 months.
•Rates of COVID -19–associated hospitalizations are highest among infants ages <6 months, followed by
those ages 6 –23 months.
-Rates of COVID -19-associated hospitalizations among infants ages <6 months are comparable to rates
among adults ages 65 –74 years
-No COVID -19 vaccine products are approved for infants ages <6 months. Any protection must come
from transfer of maternal antibodies, either through vaccination during pregnancy or prior infection
•Outcomes among hospitalized children can be severe, with 1 in 4 admitted to ICU .
-Deaths from COVID -19 continue to occur among infants and children; death certificate data might
undercount these.
•The majority (89%) of COVID -19 vaccine -eligible children and adolescents who were hospitalized with
COVID -19 had no record of receiving the most recently recommended COVID -19 vaccine.
31
COVID -19–Associated Hospitalizations
Among Adults Ages ≥18 Years
32
Adults ages ≥65 years comprise more than 2/3 of all
COVID- 19–associated hospitalizations among adults.
Figure displays the percent of weekly COVID -19–associated hospitalizations among adults ages ≥18 years, by age group — COVID -NET, March 2020– May 2025.
During this same period of January 2024 through March 2025, children and adolescents ages 17 years and younger comprised 4.1% of all COVID -19-associated hospitalizations. 330%10%20%30%40%50%60%70%80%90%100%Percent of adults hospitalized with COVID -19
Surveillance week end datePercent of weekly COVID -19–associated hospitalizations among adults ages ≥18 years, by age group —
COVID -NET, March 2020– April 2025
18–49 years 50–64 years 65–74 years ≥75 years≥75 years=50%
≥65 years=72%
50–64 years=16%
Most adults hospitalized for COVID- 19 have ≥1
underlying medical condition; a majority have ≥2.
34Prevalence of underlying medical conditions among adults ages ≥18 years, by age group — COVID -NET, April 2024 –March 2025.
Pregnant women ages 18 –49 years are excluded from proportions presented. Data are limited to hospitalizations with COVID -19 as t he likely reason for admission.1486
61
694
75
397
85
298
84
0102030405060708090100
0 conditions ≥1 condition ≥2 conditionsWeighted percent of hospitalizations
Underlying medical conditionsPrevalence of underlying medical conditions among adults ages ≥18 years, by age group —
COVID -NET, April 2024 –March 2025
18–49 years 50–64 years
Among adults hospitalized for COVID- 19, 15% were
admitted to the intensive care unit (ICU).
3517 17
14
6 6
4
145
02468101214161820
18–49 years 50–64 years ≥65 yearsWeighted percent of hospitalizationsAge groupProportion of adults hospitalized with COVID -19 with interventions and outcomes,
by age group — COVID -NET, April 2024 –March 2025
ICU admission Invasive mechical ventilation In-hospital death
The figure displays the proportion of adults hospitalized for COVID -19 with interventions and outcomes, by age group — COVID -NET, April 2024 –March 2025.
Data are limited to hospitalizations where COVID -19 is a likely primary reason for admission. Deaths do not include other COVID -19-related deaths that might occur after a patient is
discharged to hospice or deaths that occur soon after hospital discharge that could be attributable to COVID -19-related illness. Pregnant women ages 18 –49 years are excluded from
proportions presented. During this period, 85% of all adults hospitalized with COVID- 19 who died in -hospital were ages ≥65 years.
Most adults hospitalized for COVID- 19 had received no
COVID -19 vaccine since July 2023.
Figure displays the COVID- 19 vaccination status among adults hospitalized for COVID -19, by age group — COVID -NET, October 2024– March 2025.
Data are limited to hospitalizations where COVID -19 is a likely primary reason for admission. 3687
746862 65
2 1 1 1 11125313734
122117
0102030405060708090100
18–49 50–64 65–74 ≥75 ≥65Weighted percent of hospitalizations Age group in yearsVaccination status among adults hospitalized with COVID -19, by age group —
COVID -NET, October 2024– March 2025
No record of vaccination since 7/1/2023
Record of ≥1 COVID dose since 7/1/2023, but no record of receiving the 24- 25
formula dose
COVID -19-Associated Hospitalizations
among Pregnant Women
37
Pregnant women with COVID- 19–associated
hospitalizations, April 2024 –March 2025
•Pregnancy status collected from
hospitalized women ages 15 –49
years
•28.5% of women ages 15 –49
years hospitalized with
laboratory- confirmed SARS-
CoV- 2 infection were pregnant
-50% of those had COVID -19-
related signs or symptoms
Source: COVID -NET, unpublished data.38
Pregnant women with COVID- 19–associated
hospitalization, April 2024– March 2025
Among 131 hospitalized pregnant women with a laboratory- confirmed
SARS -CoV- 2-positive test result and COVID -19-related signs or symptoms:
•50% had no underlying conditions
•68% were no longer pregnant at discharge, among whom:
-83% had a healthy newborn, 11% had a pre -term infant, 1% had an ill infant, and
5% had pregnancy loss*
•92% have no record of vaccination since July 1, 2023
-5.8% received recommended 2024- 25 COVID -19 vaccine dose**
* Includes spontaneous miscarriage and abortion.
** Vaccination might have occurred before the pregnancy period and is not necessarily indicative of maternal vaccination stat us.
Source: COVID -NET, unpublished data.39
Summary
Adults
40
Summary of COVID- 19 Epidemiology for Adults
•Rates of COVID -19– associated hospitalization are highest among oldest adult age groups
-Adults aged ≥65 years comprise 72% of adult COVID -19– associated hospitalizations
-Ages ≥75 years: 50% of adult hospitalizations
•COVID -19-associated hospitalization rates have decreased over time, but cumulative rates among
adults aged ≥75 years remain high
•Risk of hospitalization with COVID -19 continues year -round, peaking in the winter and summer.
•65% of adults ages ≥65 years hospitalized with COVID -19 had no record of receiving ≥1 dose of the
recommended 2024 -25 COVID -19 vaccine prior to hospitalization.
•Most adults with COVID -19-associated hospitalization have ≥1 underlying condition.
•Among SARS -CoV -2-positive pregnant women admitted during April 2024 –March 2025 with COVID -
19-related symptoms on admission, half had no underlying conditions and most (92%) have no
record of COVID -19 vaccination since July 1, 2023
41
Genomics
42
Subsampled SARS -CoV-2 sequences by lineage group, date of specimen collection, and number of
spike protein amino acid differences relative to Wuhan -Hu-1 reference
United States, January 1, 2021–March 29, 2025
* LF.7 includes LF.7, LF.7.2.1, LF7.7.1, and LF7.7.2.
Sequences were subsampled (100 per month) for analysis from an initial dataset of >1 million sequences spanning January 1, 20 21–March 29, 2025. Only lineages circulating at >5% prevalence nationally during at least one 2 -week period are displayed. Sequences are reported to CDC through the National
SARS -CoV-2 Strain Surveillance program, contract laboratories, public health laboratories, and other U.S. institutions. Lineages were ordered by date of first appearance on CDC’s COVID data tracker ( https://covid.cdc.gov/covid -data -tracker/#variant -proportions ). Lineages with identical spike receptor binding
domain amino acid sequences (residues 332 to 527) were grouped with a representative lineage and denoted as “representative l ineage-like.” Vaccine availability for a given composition was defined by the estimated date of earliest possible administration.Vaccine strain composition : original Bivalent (original, BA.4/5) XBB.1.5 JN.1/KP.2
Variant
43
In winter 2023-2024, we observed a strain replacement
of XBB.1.5 -like viruses to JN.1- like viruses.
JN.1-likeHV.1FL.1.5.1 -
likeEG.5 -likeXBB.1.5 -
like
Genomic Surveillance for SARS -CoV -2 Variants: Circulation of Omicron XBB and JN.1 Lineages — United
States, May 2023– September 2024 | MMWR44
Weighted SARS -CoV-2 Variant Proportion Estimates: XBB and JN.1 Lineages
United States, October 1, 2023– March 29, 2025
* LF.7 includes LF.7, LF.7.2.1, LF7.7.1, and LF7.7.2.
† “Other” represents aggregated lineages circulating at <1% prevalence nationally during all 2 -week periods displayed.
Lineages were ordered by date of first appearance on CDC’s COVID data tracker ( https://covid.cdc.gov/covid- data -tracker/#variant- proportions ). Lineages with identical spike receptor binding domain amino acid sequences (residues 332 to 527) were
grouped with a representative lineage and denoted as “representative lineage -like.”†JN.1-likeKP.3.1.1-likeXEC
LP.8.1LB.1-like
45
Viruses that have predominated since January 2025
are all JN.1 descendants.
CDC COVID Data Tracker: Variant Proportions
Weighted and Nowcast Estimates in the United States
for 2 -week Periods, 2/16/2025 – 6/7/2025
CDC COVID Data Tracker: Variant
Proportions
As of June 15, 2025Due to low numbers of sequences being reported to CDC, precision for the most recent reporting periods is low
47
Convergent Evolution of Different Omicron JN.1 Lineages
Key changes in the spike receptor binding domain (RBD)* detected relative to KP.2
* Lineages or lineage groups with ≥1% prevalence in at least one 2 -week period and substitutions present in ≥50% of sequences bel onging to a lineage were included.
† The KP .2 spike protein sequence was used as a reference because of its inclusion in updated mRNA -based 2024– 2025 COVID -19 vaccin es. Substitutions compared to Wuhan- Hu-1 are
underlined.
§ Indicates sites of independent substitution or deletion in at least two different evolutionary lineages.
Bolded sub- lineages are expanding in the United States as of June 7, 2025.Lineage N-terminal domain Receptor binding domain S2
22 31 59 146 182 183 184 186 190 346 435 444 445 456 478 493 572 679 748 929 1086 1104 1235
KP.2
Reference
† T S F H K Q G F R T A K H L T Q T K E S K L C
KP.3 R E
KP.3.1.1 ∆ R E
KP.3.3 R E
KP.2.3 ∆ Q I
JN.1 R F V
JN.1.16 Q R V
JN.1.18.6 N S
KP.2.15 ∆
LB.1 ∆ H V
LF.7 N P R S R I V
LP.8.1 ∆ L S R E R
MC.10.1 ∆ R S E
MC.28.1 ∆ S E F
XEC N S R E
XEC.4 N S R E I
XEK N S R E Q
XFC N P R S R E R R
NB.1.8.1 N S G S H I E
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Human sera collected after 2024- 2025 COVID -19
vaccination neutralizes LP.8.1 pseudoviruses and XEC
virus.
Mellis et al. bioRxiv : Do Existing
COVID -19 Vaccines Need to Be
Updated in 2025?
Suthar et al. The Lancet Infectious Diseases: The KP.2- adapted
COVID -19 vaccine improves neutralising activity against the XEC
variant - ScienceDirect*Geometric mean titer (GMT)
49
Antigenic cartography with hamster and human sera
indicate that JN.1 lineage viruses group together.
Wu-1 BA.2BA.5
XBB.1.5
JN.1KP.3.1.1ProVac
Hamster sera
Live virus assay
+0.5 log2 unit reactivity
adjustment for the XEC
antigen
XEC LP.8.1 - H445R + L441I
Francis Crick Institute
MRC University of Glasgow Centre for Virus Research
Center for Pathogen Evolution, University of Cambridge
Antigenic and Virological Characteristics of
SARS -CoV-2 Variant BA.3.2, XFG, and
NB.1.8.1
•Current viruses are JN.1 descendants with 2 -3 substitutions in the spike receptor
binding domain in comparison to KP .2 spike
•Current viruses are neutralized with sera from participants who received the 2024 -
2025 COVID -19 vaccine
•Antigenic cartography indicates JN.1 viruses are antigenically similar
•FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC)
reviewed genomic and phenotypic data in May and voted unanimously to recommend a monovalent JN.1 -lineage vaccine composition.
-FDA has advised manufacturers to use JN.1 -lineage based COVID -19 vaccines, preferentially
using the LP .8.1 strain, for the 2025- 2026 COVID -19 vaccinesSummary of COVID- 19 Genomics
Back -up
Among all age groups, weekly rates of COVID -19–associated
hospitalizations are highest among adults ages ≥75 years.
Figure displays the w eekly rates of COVID -19–associated hospitalizations — COVID -NET, March 2020 –May 2025 .
Note that rates are not adjusted for testing. Rates are not limited to admissions where the respiratory infection is the like ly primary reason for admission. 53010203040506070Rate per 100,000 population
Surveillance week end dateWeekly rates of COVID -19–associated hospitalizations — COVID -NET, July 2023– April 2025
<6 months 6–23 months 2–4 years 5–11 years 12–17 years
18–49 years 50–64 years 65–74 years ≥75 years
Among all children and adolescents, rates of COVID -19-associated
hospitalizations are highest among infants and children ages <2 years.
Figure displays weekly rates of COVID -19–associated hospitalizations among children and adolescents ages ≤17 years — COVID -NET, July 2023– May 2025.
Note that rates are not adjusted for testing. Rates are not limited to admissions where the respiratory infection is the like ly primary reason for admission. 540510152025
Jul
2023Aug
2023Sep
2023Oct
2023Nov
2023Dec
2023Jan
2024Feb
2024Mar
2024Apr
2024May
2024Jun
2024Jul
2024Aug
2024Sep
2024Oct
2024Nov
2024Dec
2024Jan
2025Feb
2025Mar
2025Apr
2025May
2025Jun
2025Hospitalizations per 100,000 population
Surveillance periodWeekly rates of COVID -19–associated hospitalizations among children and adolescents ages ≤17 years — COVID -NET, July 2023–
May 2025
<6 months 6–23 months 2–4 years
Structure of XBB.1.5 vs. JN.1 spike
Blue – NTD
Red – RBD
Green – RBM
Purple – S1
Gold – FCS
Brown – S2Red sphere – deletions in one chain (labeled)
Magenta sphere – substitutions in one chain (labeled)
Raspberry sphere – deletions in rest 2 chains
Cyan sphere – substitutions in rest 2 chains
Schrodinger homology model of JN.1, starting with 7YR2 (BA.2.75)
Prepared by CDC: Megha Aggarwal, PhD 55
LP.8.1, the lineage that predominated this spring, has
limited spike substitutions in comparison to KP.2
Red sphere – deletions in one chain (labeled)
Magenta sphere – substitutions in one chain (labeled)
Raspberry sphere – deletions in rest 2 chains
Cyan sphere – substitutions in rest 2 chainsBlue – NTD
Red – RBD
Green – RBM
Purple – S1
Gold – FCS
Brown – S2ACE-2
Structure of JN.1 in complex with ACE -2 (PDB ID: 8YZE) Structure of JN.1 (PDB ID: 8Y5J)
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COVID- NET Summary
•COVID -19 is estimated to have resulted in more than 250,000 hospitalizations since October 2024.
•Among children, rates of COVID -19–associated hospitalizations are highest among children ages <2 years.
-89% of children ages 6 months –17 years admitted for COVID -19 had no record of recent COVID -19 vaccination
-1 in 5 children aged <2 years admitted for COVID -19 are admitted to the ICU
•Of those ages <2 years admitted to the ICU, 53% had no underlying medical conditions
•Among adults, rates of COVID -19–associated hospitalizations are highest among adults ages ≥75 years.
•65% of adults ages ≥65 years hospitalized with COVID -19 had no record of receiving ≥1 dose of the
recommended 2024 -25 COVID -19 vaccine prior to hospitalization.
•Most adults ages ≥18 years hospitalized for COVID -19 have ≥1 underlying medical condition.
•Among SARS -CoV-2-positive pregnant women admitted during April 2024– March 2025 with COVID -19-
related symptoms on admission
-50% had no underlying medical condition
-92% have no record of COVID -19 vaccination since July 1, 2023
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~1 in 4 children and adolescents hospitalized for COVID- 19 are
admitted to the intensive care unit (ICU)
Hospitalizations are limited to those with COVID -19 as the presenting complaint upon admission. Pregnant adolescents ages 15 –17 years are excluded from proportions
presented. 2225
2128
26
051015202530
<6 months 6 months –<2
years2–4 years 5–11 years 12–17 yearsPercent of hospitalizationsPercent of children and adolescents with COVID-19 –
associated hospitalizations admitted to the ICU,
by age group — COVID -NET, April 2024 –March 2025
During this period, 7 children with COVID -19–associated
hospitalization died in -hospital in the COVID -NET
catchment area. Age categoryAmong those
admitted to
ICU, % with no
underlying
conditions
<6 months 62%
6–23 months 48%
2–4 years 23%
5–11 years 19%
12–17 years 16%
Among children <2 years admitted to
ICU, most did not have underlying
medical conditions
58