National Mortality from COVID-19 fell nearly 50% in 2022 from the previous year, a decline that was attributed to widespread vaccination as well as a rise in natural immunity following the first Omicron surge.

There were 244,986 deaths in the US in which COVID-19 was listed as the underlying or contributing cause, a 47% decrease from 462,193 deaths in 2021, according to the report. analysis preliminary death certificate data released Thursday by the US Centers for Disease Control and Prevention. The number does not include residents of US territories and foreign countries.

The first months of 2022 saw the second deadliest surge of COVID-19 as the first wave of Omicron sent out the highly contagious variant, seemingly everywhere in the US. But in the summer and last winter, mortality dropped sharply.

In addition to vaccinations and boosting natural immunity, 2022 also brought widespread availability of COVID therapeutics, such as Paxlovid, an oral drug that greatly reduces the risk of hospitalization and death when taken by people infected with the coronavirus.

However, with almost a quarter of a million dead in 2022, COVID-19 remains main cause of death – works less so. Last year, the death rate from COVID-19 was seven times higher than the annual rate. influenza deathswhich averaged about 35,000 per year during the decade prior to the pandemic.

Nationwide, COVID-19 was the third leading cause of death in both 2020 another 2021. It dropped to fourth place last year, behind heart disease, cancer and unintentional injuries (a category that remains high due to an elevated number of drug overdose deaths).

COVID-19 great death — now 1.13 million in the US and 6.9 million worldwide — staggering: the death toll in the country exceeds the last global pandemic of this magnitude, although the global figures are much lower. An influenza pandemic that began in 1918 killed an estimated 675,000 people in the United States and at least 50 million people worldwide.

According to the latest analysis released by the CDC’s National Center for Health Statistics, deaths from COVID-19 were the highest in the US among people aged 85 and over. In 2022, the death rate in this group was three times that of those aged 75 to 84, and about eight times that of the youngest seniors aged 65 to 74.

Mortality was 50% higher in men than in women.

Of all deaths with any mention of COVID-19 on the death certificate, 76% listed COVID-19 as the underlying cause. This is lower than in 2020 and 2021, when COVID-19 was the leading cause of 90% of deaths when the disease was mentioned anywhere on the death certificate; the rest listed it as one of the causes of death.

Among the deaths where COVID-19 was listed as a contributing factor, the most common underlying causes of death were heart disease, cancer, chronic lower respiratory disease, stroke, Alzheimer’s disease, unintentional injury, diabetes, kidney disease, and Parkinson’s disease.

In 2022, the majority of deaths from COVID-19 – 59% – occurred in hospitals. The report says that an increasing number of cases occur at home (15%), in a nursing home or in a long-term care facility (14%).

The analysis also calculated mortality rates for 10 regions designated by the US Department of Health and Human Services.

For the second year in a row, the South has the lowest death rates from COVID-19. The highest rate in both 2021 and 2022 was in the central south region, which covers Texas, Louisiana, Oklahoma, Arkansas, and New Mexico. In 2022, the rate for this region was 69.3 deaths from COVID-19 for every 100,000 inhabitants.

In second place for both years was the Southeast, defined as Florida, Georgia, North Carolina, Tennessee, South Carolina, Alabama, Kentucky, and Mississippi. The figure there in 2022 was 65.5 deaths from COVID-19 for every 100,000 inhabitants.

Close behind was the Midwest—Illinois, Ohio, Michigan, Indiana, Wisconsin, and Minnesota—with 65.1 deaths from COVID-19 for every 100,000 people; and Mid-Atlantic, which represents Pennsylvania, Virginia, Maryland, West Virginia, Delaware, and the District of Columbia, with 64.9 COVID-19 deaths for every 100,000 people.

In fifth place were the central Great Plains states of Missouri, Iowa, Kansas, and Nebraska, with 63.7 deaths from COVID-19 per 100,000 inhabitants, just above the national death rate of 61.3 deaths per 100,000 people.

Below the national COVID-19 death rate was the New York-New Jersey region, with 57.4 deaths per 100,000 residents. The Southwest, which covers California, Arizona, Nevada, and Hawaii, had the fourth lowest rate, with 53 COVID-19 deaths per 100,000 residents. In the northern Rocky Mountains and northern Great Plains states of Colorado, Utah, Montana, South Dakota, North Dakota and Wyoming, the COVID-19 death rate was 52.2 per 100,000 residents.

The region with the second-highest COVID-19 death rate in 2022 was the Northwest—Washington, Oregon, Idaho, and Alaska—with 50.9 deaths per 100,000 residents. New England had the lowest COVID-19 death rate in 2022, with 49.5 deaths per 100,000 residents.

The South has not always had the highest COVID-19 death rate in the country. In 2020, the New York-New Jersey region led the way, while New England’s death rate was also slightly higher than the national average.

Only in three regions, mortality from COVID-19 was lower than the national average for all three years of the pandemic: South-West; Northwest; and northern Rocky Mountains/northern Great Plains. Conversely, one region had a higher death rate than the nation in each of those years: the central south region, which includes Texas and its neighboring states.

The magnitude of the disparity in COVID-19 deaths across races and ethnic groups decreased in 2022 compared to the previous year, but still persists for many. In general, inequalities across race and ethnicity have been exacerbated during outbreaks of the pandemic, with fewer outbreaks in 2022.

In 2022, Native Americans had a 42% lower COVID-19 death rate than white residents; for Blacks and Pacific Islanders, the figures were 19% and 11% worse, respectively. Hispanic death rates from COVID-19 were about the same as white residents, while Asian American and multiracial groups had lower rates than white residents.

Mortality inequality was larger in 2021. Compared to white residents, the COVID-19 mortality rate for Native Americans and Pacific Islanders was more than 90% higher; Hispanic death rates were 54% higher; and black deaths were 44% higher.

In 2020, compared to white residents, Native Americans had a 157% higher death rate from COVID-19. For Hispanics, the rate was 122% higher; Black residents are 109% higher; and Pacific Islanders, 67% higher.

The death rate from COVID-19 has decreased for all racial and ethnic groups from 2021 to 2022. However, between 2020 and 2021, it rose markedly for white residents, jumping by 42%. They also increased by 59% for multiracial residents and 63% for Pacific Islanders. During the same period, the death rate among Hispanics, Blacks, and Native Americans remained generally at the same, depressingly high level.

The data released in the CDC analysis is considered preliminary and incomplete. The final mortality data for 2022 is expected to be released by the end of this year.