It remains important to collect data-driven information on key priority areas that can help CDC and public health partners continue to fill critical scientific gaps, build on knowledge gained and advances made, and inform evidence-based decision-making for continued intervention through public health surveillance and epidemiologic research. CDC has developed priority questions around 8 thematic topic areas for The CDC Public Health Science Agenda for COVID-19: health equity, vaccines, variants, prevention, testing, treatment, natural history and post-COVID conditions.

The SARS-CoV-2 pandemic fueled massive growth in sequencing capability, with more countries beginning to conduct routine genomic epidemiological surveillance, mainly because of the accessibility and ease of use of portable nanopore sequencers. But we should not wait for the next pandemic to achieve full genomic equity, enabled by the end-to-end capability to sequence and analyze genomic data for public health in under-resourced settings!

Racial and ethnic minorities have borne a particularly acute burden of the COVID-19 pandemic in the United States. There is a growing awareness from both researchers and public health leaders of the critical need to ensure fairness in forecast results. Without careful and deliberate bias mitigation, inequities embedded in data can be transferred to model predictions, perpetuating disparities, and exacerbating the disproportionate harms of the COVID-19 pandemic.

In 2020, racial and ethnic disparities in COVID-19 age-adjusted death rates (AADR) were reported among U.S. residents. From 2020 to 2021, disparities in AADR ratios from COVID-19 decreased significantly by 14.0%–40.2% for most racial and ethnic groups, including non-Hispanic White persons, who accounted for 59.6%–65.2% of all decedents; and increased nonsignificantly (7.2%) for non-Hispanic Native Hawaiian and other Pacific Islander persons (0.2%–0.3% of all decedents) compared with non-Hispanic multiracial persons.

We analyzed data on 418 ZIP codes. We observed wide geographic variation in primary series vaccination and booster rates, with marked inequities by ZIP-code-level education, median household income, essential worker share, and racial-ethnic composition. In age-stratified analyses, primary series vaccine coverage was very high among the elderly. However, we found large inequities in vaccination rates among younger adults and children, and very large inequities in booster rates for all age groups. In multivariable regression models, each 10 percentage point increase in "percent college educated" was associated with a 5.0 percentage point increase in primary series vaccine coverage and a 4.9 percentage point increase in booster coverage.