Vaping Lung Injury Statistics: What the CDC Reports Show
Vaping lung injury statistics tell a sharp story: the outbreak moved quickly, affected mostly younger adults at first, and then produced a large national hospitalization and death count across every state and multiple U.S. territories.
The numbers below come from CDC outbreak reporting and CDC MMWR summaries, and they are most useful when read as a timeline rather than a single snapshot.
Table of Contents
- At a glance
- The national case count over time
- Who was affected
- Product use patterns in reported cases
- Hospitalization and emergency department trends
- Product source patterns
- What the BAL-fluid findings added
- How the Minnesota interview study fits in
- Why the case classifications matter
At a glance
- By February 18, 2020, CDC had reported 2,807 hospitalized EVALI cases or deaths from all 50 states, DC, Puerto Rico, and the U.S. Virgin Islands (CDC outbreak page).
- By February 18, 2020, 68 EVALI deaths had been confirmed in 29 states and DC (CDC outbreak page).
- The median age of deceased EVALI patients was 49.5 years, with an age range of 15 to 75 years (CDC outbreak page).
- On January 14, 2020, CDC had received reports of 2,668 hospitalized EVALI patients from all 50 states, DC, the U.S. Virgin Islands, and Puerto Rico (MMWR Jan. 24, 2020).
- Among the January 14, 2020 hospitalized reports with substance-use data, 82% reported THC-containing product use (MMWR Jan. 24, 2020).
- In the January 14, 2020 dataset, 76% of patients were younger than 35 years old (MMWR Jan. 24, 2020).
- The weekly number of hospital admissions for EVALI peaked at 215 during the week of September 15, 2019 (MMWR Jan. 24, 2020).
- The possible EVALI-related ED visit rate peaked at 116 per million during the week of September 8, 2019 (MMWR Jan. 24, 2020).
The national case count over time
The strongest pattern in the CDC reporting is the scale-up itself. Early in the outbreak, CDC was still assembling reports from states and territories, but the national totals already showed a broad event rather than a local cluster.
As of September 24, 2019, CDC had received 805 reported EVALI cases from 46 state health departments and one territorial health department (MMWR Sept. 27, 2019). At that point, 91% of the 805 reported patients were hospitalized (MMWR Sept. 27, 2019). That is a severe case mix, and it shows why the outbreak rapidly became a major public-health response.
Later in the year, the cumulative count continued to rise. As of December 3, 2019, all 50 states, DC, Puerto Rico, and the U.S. Virgin Islands had reported 2,291 hospitalized EVALI cases (MMWR Dec. 20, 2019). By that same date, there were 48 EVALI-associated deaths, which represented 2% of total reported cases (MMWR Dec. 20, 2019). The death count had grown further by February 18, 2020, when CDC reported 68 confirmed deaths (CDC outbreak page).
A compact way to read the timeline is to compare the major reporting points side by side:
| Reporting date | Reported hospitalized EVALI cases or deaths | Deaths reported | Source |
|---|---|---|---|
| Sept. 24, 2019 | 805 cases | 12 deaths | MMWR Sept. 27, 2019 |
| Dec. 3, 2019 | 2,291 hospitalized cases | 48 deaths | MMWR Dec. 20, 2019 |
| Jan. 14, 2020 | 2,668 hospitalized cases | Not stated in the supplied statistics | MMWR Jan. 24, 2020 |
| Feb. 18, 2020 | 2,807 hospitalized cases or deaths | 68 deaths | CDC outbreak page |
That table is useful because it shows the outbreak was not static. The case burden kept moving upward across fall and winter reporting windows, even as the data became more complete.
Who was affected
The demographics in the CDC summaries are important because they show a heavily skewed age pattern early in the outbreak.
On September 24, 2019, the median age of patients was 23 years, and the age range was 13 to 72 years (MMWR Sept. 27, 2019). In that same report, 61.9% of patients were 18 to 34 years old, while 16.2% were younger than 18 years old (MMWR Sept. 27, 2019). That means the outbreak was not limited to one narrow adult segment; adolescents and young adults were both represented.
By January 14, 2020, the median patient age among the hospitalized reports was 24 years (MMWR Jan. 24, 2020). In that dataset, 76% of patients were younger than 35 years old, and 66% were male (MMWR Jan. 24, 2020). The same report said 73% were non-Hispanic white and 15% were Hispanic (MMWR Jan. 24, 2020).
The death data show a different age pattern. As of February 18, 2020, the median age of deceased EVALI patients was 49.5 years and the age range was 15 to 75 years (CDC outbreak page). On September 24, 2019, among the 12 deaths reported to CDC, the median age was 50 years and the age range was 27 to 71 years (MMWR Sept. 27, 2019). So while the hospitalized case profile was very young, the deaths were centered at an older median age.
Fast demographic readout
- Hospitalized cases were mostly young adults, especially under 35 (MMWR Jan. 24, 2020).
- Males made up 66% of the January 14, 2020 hospitalized reports (MMWR Jan. 24, 2020).
- On September 24, 2019, 69% of the 805 reported cases were in males (MMWR Sept. 27, 2019).
- Deaths had a much higher median age than hospitalized cases, with a median of 49.5 years by February 18, 2020 (CDC outbreak page).
Product use patterns in reported cases
The CDC reports repeatedly point to product use patterns that matter for interpreting the outbreak.
Among January 14, 2020 hospitalized EVALI reports with substance-use data, 82% reported THC-containing product use, 57% reported nicotine-containing product use, 33% reported exclusive THC-containing product use, 14% reported exclusive nicotine-containing product use, and 41% reported using both THC- and nicotine-containing products (MMWR Jan. 24, 2020).
That combination of figures matters. It tells you the outbreak cannot be reduced to a single-use category in every patient. Some patients reported THC products only, some nicotine only, and many reported both. The same January 14 report also showed that 80% of December 3, 2019 hospitalized patients reported any THC-containing product use, while 54% reported any nicotine-containing product use and 12% reported any CBD-containing product use (MMWR Dec. 20, 2019).
A useful comparison is below:
| Patient group | THC use | Nicotine use | CBD use | Source |
|---|---|---|---|---|
| Jan. 14, 2020 hospitalized reports with substance-use data | 82% | 57% | Not stated | MMWR Jan. 24, 2020 |
| Dec. 3, 2019 hospitalized reports | 80% any THC | 54% any nicotine | 12% any CBD | MMWR Dec. 20, 2019 |
| Sep. 24, 2019 reported cases with substance-use data in the report narrative | 86% reported THC-containing product use in the 3 months before symptom onset | Not stated | Not stated | MMWR Oct. 25, 2019 |
The 86% figure from the October 15, 2019 CDC report is especially useful because it shows that THC-containing product use was already prominent in the case history before the outbreak peak (MMWR Oct. 25, 2019).
Hospitalization and emergency department trends
The outbreak did not appear only in inpatient counts. The CDC also tracked emergency-department activity, which gives a second view of how rapidly the problem moved.
The weekly number of hospital admissions for EVALI peaked at 215 during the week of September 15, 2019 (MMWR Jan. 24, 2020). That is the clearest single-week hospitalization high point in the supplied statistics.
Emergency-department visits increased in a distinct wave. Possible EVALI-related ED visits increased by a mean of 26 visits per million each week during August 11 to September 8, 2019 (MMWR Jan. 24, 2020). The possible EVALI-related ED visit rate peaked at 116 per million during the week of September 8, 2019, then fell to 35 per million during the week of January 5, 2020 (MMWR Jan. 24, 2020). The rate was 23 per million during the week of August 18, 2019 (MMWR Jan. 24, 2020).
These values show a rise, peak, and then decline. The peak week for ED visits came before the peak week for hospital admissions, which suggests the clinical wave was already visible in acute-care settings before it reached the hospital-admission high point.
Product source patterns
The source of the products is another key part of the story.
As of January 7, 2020, among 1,782 hospitalized EVALI patients with product source information, 50% of THC-product users provided source data (CDC outbreak page). Among those THC-product users with source information, 78% reported acquiring products only from informal sources, 16% reported acquiring products only from commercial sources, and 6% reported obtaining products from both commercial and informal sources (CDC outbreak page).
Nicotine users showed a different sourcing pattern. Among nicotine-product users with source information as of January 7, 2020, 54% provided source data, 69% reported acquiring products only from commercial sources, 17% reported acquiring products only from informal sources, and 15% reported obtaining products from both commercial and informal sources (CDC outbreak page).
That contrast matters because it separates THC and nicotine sourcing patterns in the reported outbreak data. The THC-product cases leaned strongly toward informal sources, while nicotine-product cases leaned strongly toward commercial sources.
Source pattern snapshot
- THC-product users with source data: 78% informal only (CDC outbreak page).
- THC-product users with source data: 16% commercial only (CDC outbreak page).
- THC-product users with source data: 6% both source types (CDC outbreak page).
- Nicotine-product users with source data: 69% commercial only (CDC outbreak page).
- Nicotine-product users with source data: 17% informal only (CDC outbreak page).
- Nicotine-product users with source data: 15% both source types (CDC outbreak page).
What the BAL-fluid findings added
The BAL-fluid study added laboratory evidence to the outbreak narrative.
Among 29 bronchoalveolar lavage fluid specimens collected from EVALI patients in 10 states, vitamin E acetate was detected in all 29 samples (MMWR Nov. 8, 2019). That is the most striking laboratory finding in the supplied statistics because it was universal in that sample.
The same CDC analysis found THC or its metabolites in 23 of 28 BAL specimens and nicotine metabolites in 16 of 26 BAL specimens (MMWR Nov. 8, 2019). Among 27 BAL specimens with sufficient volume, 100% had measurable DPPC levels (MMWR Nov. 8, 2019). The patient profile in this BAL-fluid study was also young: 21 of the 29 patients with available specimens were male, or 72%, and the median age was 23 years with an age range of 16 to 67 years (MMWR Nov. 8, 2019).
Two of the 29 BAL-fluid study patients died (MMWR Nov. 8, 2019). And among 23 patients with self-reported THC information, 20 said they used THC-containing products (MMWR Nov. 8, 2019).
That combination of sample data and self-reported use data shows why the BAL-fluid report is often treated as a major supporting piece of the outbreak record.
How the Minnesota interview study fits in
The Minnesota interview study gives one of the clearest snapshots of patient-reported use patterns.
In that study, 96 patients were classified as EVALI during August 9 to October 31, 2019 (MMWR Nov. 22, 2019). Fifty-eight patients were interviewed, and 53 of them, or 91%, reported illicit THC-containing product use from informal sources (MMWR Nov. 22, 2019). Forty-one of 58 interviewed patients, or 71%, reported nicotine-containing product use, and 14 of 58 interviewed patients, or 24%, reported CBD oil product use (MMWR Nov. 22, 2019).
The interview study also breaks down product combinations in a way that helps explain the mixed-use picture:
- 47 of 58 interviewed patients, or 81%, reported prefilled cartridges (MMWR Nov. 22, 2019).
- 39 of 58 interviewed patients, or 67%, reported using Dank Vapes (MMWR Nov. 22, 2019).
- 11 of 58 interviewed patients, or 19%, used Dank Vapes exclusively with no other THC brands (MMWR Nov. 22, 2019).
- 2 of 58 interviewed patients, or 3%, used only Dank Vapes and no other THC, nicotine, or CBD oil products (MMWR Nov. 22, 2019).
- 26 of 58 interviewed patients, or 45%, used both illicit THC and nicotine products only (MMWR Nov. 22, 2019).
- 37 of 58 interviewed patients, or 64%, used both illicit THC- and nicotine-containing products (MMWR Nov. 22, 2019).
- 8 of 58 interviewed patients, or 14%, used CBD oil products with illicit THC and nicotine (MMWR Nov. 22, 2019).
- 3 of 58 interviewed patients, or 5%, used CBD oil with illicit THC (MMWR Nov. 22, 2019).
- 1 of 58 interviewed patients, or 2%, used CBD and nicotine products (MMWR Nov. 22, 2019).
If you only look at a single percentage, you miss the mix. The interview study shows both shared patterns and a lot of overlap between THC, nicotine, and CBD use.
Why the case classifications matter
The September 24, 2019 CDC report said 47% of reported cases were classified as probable and 53% as confirmed (MMWR Sept. 27, 2019). That split is important because it shows how the CDC was balancing case evidence during the outbreak response.
Probable and confirmed are not just labels; they reflect how case reporting matured over time as state and federal data accumulated. In a fast-moving outbreak, that distinction matters when comparing the earliest reports with later summaries.
The same report also gives a clear baseline for the outbreak’s early profile: 805 total reported cases, 12 deaths, 91% hospitalized, a median age of 23, and a 13 to 72 year age span (MMWR Sept. 27, 2019). Later reports expanded the picture to thousands of hospitalized cases, dozens of deaths, and a more complete product-use and sourcing story (CDC outbreak page; MMWR Dec. 20, 2019; MMWR Jan. 24, 2020).
Taken together, the supplied CDC statistics show three recurring facts about vaping lung injury: the outbreak was widespread, the hospitalized case load was concentrated among younger adults, and THC-containing product use appeared repeatedly across the major reporting summaries (CDC outbreak page; MMWR Jan. 24, 2020; MMWR Dec. 20, 2019; MMWR Nov. 22, 2019; MMWR Nov. 8, 2019).