Public Health Data Methodology and Documentation
Frequently Asked Questions
Recent Updates to the Dashboard
Addition of 12-14-year-old Age Group:
To line up with eligibility for the COVID-19 vaccine, Missouri DHSS has added a new 12-14-year-old age group to both the Vaccine Dashboard and to the accompanying downloadable datasets. As vaccinations for this age group were not widely available until mid-May, the percent of the age group completing vaccination is low; this should begin to increase in mid-late June as the age group becomes eligible for their second dose.
Update to Dashboard Refresh Time:
The Vaccine Dashboard is set to refresh at 9:15am Monday – Friday. The weekend refresh time remains 12:15pm.
Update to Downloadable Datasets:
MO DHSS has added the counts of non-Missouri residents to the downloadable datasets found at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/data/public-health/vaccine.php. This update also clarifies the different types of unknown residence. Unknown Jurisdiction represents recipients who reported an incomplete Missouri address which did not include the county of residence. These individuals are known to be Missouri residents but cannot be assigned to a specific jurisdiction within the state. Unknown State represents recipients who did not report a state of residence when receiving their vaccination. It is unknown in which state the recipients live, and they cannot be assigned to any state.
The downloadable datasets can now be used to examine:
- the total number of doses administered in Missouri (sum of all columns),
- the total number of doses administered in Missouri to known Missouri residents (total #1 minus the Out-of-State column and the Unknown State column), and
- the total number of doses administered in Missouri to Missouri residents with a known county of residence (total #2 minus the Unknown Jurisdiction column).
Please note that total #1 matches the top-line and demographic data on the Vaccine Dashboard, while total #3 matches the maps and associated table on the Vaccine Dashboard.
These data are generated based upon the address reported by the recipient at the time of vaccination, and are only as good as what is reported. Addresses with incomplete information are used for analysis, when possible.
Correction of Racial Data:
Missouri DHSS is working to address the underlying issues driving the over-count of vaccinations for multi-racial individuals in Missouri. There is not a one-size-fits-all fix for these data corrections. Instead, the team must work with each provider and the ShowMeVax contractor, Envision, to correct these records on a provider-by-provider basis. These corrections to more accurately reflect the self-reported race of Missouri vaccine recipients will be made over the coming weeks as the underlying issues are fixed. During this time, the vaccination rates by race will fluctuate as the records are corrected. The total number of records being corrected will be noted on the dashboard.
New Topline Number:
In order to better match vaccination rates provided by the CDC and to better convey the percent of the eligible population vaccinated, Missouri DHSS has added the percent of population age 18+ who have initiated and completed vaccination in Missouri. The percent of total population will remain on the dashboard. Note: Not all vaccines administered in Missouri (numerator) go to Missouri residents, however the Missouri population is used as a denominator in these calculations.
Change to Dashboard Update Schedule:
Weekend updates to the COVID-19 Vaccine Dashboard will occur at 12:15pm starting on Saturday 5/8/2021. Weekday updates will continue on the existing schedule of 7:15am.
After adding COVID-19 vaccination completion data to the Vaccine Dashboard on April 8th, Missouri DHSS has added the completion data to the downloadable datasets. These datasets are now broken down by vaccination initiation (a first dose of vaccine by any manufacturer) and vaccination completion (a second dose of the Moderna or Pfizer vaccines or a single dose of the Johnson & Johnson vaccine). The demographic breakdowns remain the same: sex, race, ethnicity, and age group.
As a part of the sustained quality checks on COVID-19 vaccination data, the DHSS team continue to work with all partners to remove duplicate records from the ShowMeVax system. These duplicate records cause a variety of data integrity issues, including difficulty in assigning dose numbers to records. Due to this issue, the vaccination completion downloadable datasets show instances of completed vaccinations early in the vaccination process when it was not possible for any individuals to have completed the vaccine regimen. These are attributable to duplicate records and are not valid completions.
On Saturday, April 17th 2021, DHSS corrected an error in the COVID-19 database that was causing individuals who had both a positive PCR and Antigen result to be included in the counts for both Confirmed and Probable cases. This correction removed 11,454 cases that were double counted in previous Antigen+ Probable case totals. The change did not affect other metrics on the dashboard.
The regularly-scheduled Missouri COVID-19 Vaccine Dashboard update includes enhancements to the displayed data as well as corrections to a data filter.
As more Missourians are completing the COVID-19 vaccination regimen, demographic and geographic breakdowns of such data are now available on the COVID-19 Vaccine Dashboard. Data describing COVID-19 vaccination completion are now displayed side-by-side with vaccination initiation data.
The vaccination initiation data include those individuals who have received at least one dose of the Moderna or Pfizer vaccine as well as those who have received any dose of the Johnson & Johnson vaccine. Vaccination completion data include those individuals who have received two doses of the Moderna or Pfizer vaccine as well as those who have received any dose of the Johnson & Johnson vaccine. Individuals who have both initiated and completed vaccination are counted in both categories. These data are not mutually exclusive.
As with the percent initiated data that was already available in the demographics section, the percent completed data represent the percent of the demographic group who has completed vaccination. These percentages do not show the percent of those who have initiated vaccination who have also completed vaccination.
Note that the vaccination initiation data include individuals who are within their 21-28 – day waiting period between their first and second doses. A large difference between percent initiated and percent completed for a demographic group or geographic region does not necessarily represent a failure to complete vaccination. It is expected that once vaccination eligibility opens up on April 9th, the gap between percent initiated and percent completed will grow for many demographic groups, as newly-eligible individuals receive their first dose and await their second dose. These difference should stabilize over time as individuals receive their second dose of Moderna or Pfizer vaccine.
In the data table in the Where Do Vaccinated Residents Live section, please note that adding the COVID-19 Vaccine Regimen Initiated column and COVID-19 Vaccine Regimen Completed column will likely result in a higher count than the COVID-19 Doses Administered column. This is because the Johnson & Johnson single-dose vaccine is counted in both the initiated and completed columns and is therefore double-counted when adding both columns together.
Downloadable datasets for completion data are not yet available, but will be made available soon
In order to better display the added completion data, the demographics section of the Missouri COVID-19 Vaccine Dashboard now features a toggle to select between age, sex, race, and ethnicity data. All of the same data as before the update are available, the graphics just do not display at the same time
A new map has also been added to display completion data by jurisdiction. These maps are side-by-side, with the accompanying data table below the maps.
Data Filter Correction:
As COVID-19 vaccine is more widely distributed across the state and more providers are entering vaccine data at unprecedented levels, the Missouri DHSS team continues to perform quality assurance reviews on both historical and incoming data. During the routine process of performing such reviews, the team discovered that the COVID-19 Vaccine Dashboard was incorrectly displaying a total of 4,793 instances of dose numbers 3 and above. Missouri’s vaccine providers are very conscientious in entering this data into SMV and, at times, this has resulted in records being entered by multiple agencies as partnered vaccine events occur. Further provider education targeted at limiting this duplication of effort is ongoing. Approximately 60% of such doses were administered prior to March 1, 2021.
When the Vaccine Dashboard was initially created, imputed population denominators were used to calculate the percentages for demographic groups. To create imputed estimates, the estimated percentage of members in that group is applied to the population total. (For example, a hypothetical survey shows that roughly 5% of residents in a town of 200 speak Dutch. Our imputed estimate would calculate that there are 10 Dutch-speaking individuals in the town.) To maintain consistency with the remainder of the Show Me Strong Dashboard, these populations have been updated to the Census Bureau Population Estimates Program (PEP) 2019 estimates. As a result of this methodological shift, some demographic population groups saw large increases in the percent initiating vaccinations, including Asian, American Indian or Alaska Native, and Hispanic. These enhanced metrics more closely reflect the rates of vaccination for all demographic groups, however, actual rates may still be higher due to records with unknown demographic information. During the update of these metrics, analysts discovered an error in the calculation of the 75-84 age group, which has also been corrected as part of this release. The revised measure more accurately reflects vaccine initiation for members of this priority age group.
On December 3rd, DHSS was notified of a reporting issue with a provider in Pettis county that resulted in a reduced case count and positivity rate for the jurisdiction. DHSS is currently working with the provider to obtain the missing case data as expeditiously as possible. In the meantime, please refer to the Pettis County LPHA Facebook page here for a more accurate case count.
We added a new landing page here that provides an “at-a-glance” view of cases, deaths, tests, positivity rates, and hospitalizations in the state. This page links to the other dashboards which provide more detail in each of these areas.
Long-term care facility data was added to the data download page here.
An additional method of measuring positivity rate was added to the Statewide dashboard. This method reflects the CDC method of taking positive tests divided by total tests. A new chart was also added to the Testing dashboard so viewers can see how this metric has trended over time. Read more about these different methods below.
Updates were made to the public health dashboards to make them more mobile friendly and accessible.
In addition, we released an expanded health care system dashboard with additional metrics and visualizations for COVID-19 hospitalizations in Missouri. That page is here.
Daily updates to the public health dashboards resumed after being paused for a four days while a data extract error was resolved.
On 9/28 and 9/29, the dataset being pulled into the dashboards had some geographic inaccuracies that have now been resolved as of 9/30. Specifically, data prior to early-August was coded by county instead of by jurisdiction. As a result, cumulative cases, tests, and deaths for Kansas City and surrounding counties (Jackson, Platte, Clay, Cass), and for Joplin and surrounding counties (Jasper, Newton) were inaccurate. For example, a case from April that should have been coded to Kansas City was being coded to Jackson County. It is now being properly coded to Kansas City. Data since August was not affected.
General performance improvements to make dashboards quicker. Mobile optimizations are coming soon.
Overall Frequently Asked Questions
Q: What are these Dashboards?
A: These Dashboards provide a statewide view of the current status of COVID-19 in Missouri. The purpose is to provide a standardized and accessible source of critical public health data to help individuals, families, businesses, nonprofits, schools, public health authorities, health care providers, and community leaders remain up to date and make informed decisions regarding COVID-19.
Q: What data are used to generate these Dashboards?
A: The primary source of public health data feeding these dashboards are 1) daily COVID-19 testing data provided by the Missouri Department of Health and Senior Services (DHSS), and 2) daily hospitalization data as reported nationally by the federal government via TeleTracking (note: hospitalization data up to July 13, 2020, comes from NHSN). Additionally, national state-by-state COVID-19 case and testing data from The New York Times and https://www.tableau.com/covid-19-coronavirus-data-resources are used to calculate national state rankings.
Q: Why are the numbers on this Dashboard different from the ones I see from other national or local sources?
A: Differences among local, state, and national data can exist for metrics for a variety of reasons, including, but not limited to, reporting timing, method of calculation, and data source. See the methodology used for each metric below.
Q: How is this Dashboard different from the one on the Missouri Department of Health and Senior Services (DHSS) website?
A: This Dashboard is an expansion of the original DHSS Dashboard. It includes many additional metrics and views to provide more data to residents, local public health authorities, businesses, and community leaders. This Dashboard will replace the original DHSS Dashboard, but that team remains on hand to answer your questions and strive to improve this Dashboard over time.
Q: What does it mean if my jurisdiction is “yellow” or “red” for a particular metric?
A: On the Statewide and County Dashboards, colors indicate thresholds for each eight metrics to provide a sense of severity as defined by the White House Coronavirus Task Force. More detail behind each metric is provided below, under the “Statewide and County Overview Dashboards” section. All metrics and colors should be taken into context—including, but not limited to, local conditions (e.g., if an outbreak in one facility were to represent a significant share of new cases) and other metrics (e.g., the percent change in tests metric should be taken in the context of the total tests per 100,000 population metric). These color thresholds do not prescribe a certain course of action but rather aim to provide a view of intensity for each metric that can be standardized statewide and across jurisdictions. Any state and local actions considering these metrics should take other local public health and social conditions into context.
Q: Why are Kansas City and Joplin listed separately from their respective counties?
A: COVID-19 tests, cases, and deaths data are usually tracked at the county level. However, the municipalities of Kansas City and Joplin have their own local public health authorities and thus track and report their tests, cases, and deaths separately. As a result, for “per 100k” calculations, adjustments have been made to the populations of Jackson, Platte, Clay, and Cass Counties to subtract Kansas City residents from their respective populations. The same has been done for Jasper and Newton Counties to account for Joplin residents. Note that case data and population within Independence, MO, are included in the figures for Jackson County.
Q: What if I have additional questions about the dashboard?
A: We hope this documentation provides the answers you need. If you have further questions, send us an email.
Statewide and County Overview Dashboards
3-day delay. All cumulative data are provided up to the most recent day of reporting. Time-based data such as 7-day averages, however, are subject to a 3-day delay to ensure that the data are accurate and complete. (Example, on 5/15 the dashboard will report 7-day averages for a 7-day period ending on 5/12). These data are provisional and may change daily. Investigations are being done on new cases, so as additional information is determined on these cases, information such as county, demographics, and the total counts will continue to change. Efforts are continually being made to improve data quality so that DHSS is providing the most accurate information possible.
Cases by Jurisdiction of Residence. The total number of laboratory-confirmed cases (individuals) by residence jurisdiction (county or city, when available). This number includes only individuals with positive PCR test results.
Lab-Confirmed Cases. The cumulative total number of cases that have been identified through PCR testing by state and private laboratories and reported to the state of Missouri, to-date. Most cases will recover from their illness, but this will not change the cumulative total. Serology tests are not included in the total number of Missouri cases, since they are considered to indicate possible past infection, and are not currently considered to be confirmed cases.
Deaths Attributed to COVID-19. The cumulative total of deaths that have been attributed to COVID-19. A death attributed to COVID-19 includes individuals who were identified as a positive COVID-19 case who died as a result of this illness or from a death certificate where COVID-19 was listed as a underlying or contributing cause of death.
Positivity rates. The dashboard shows two different methodologies for calculating percent positivity. The state method is more conservative and only counts individuals once, based on their first positive or negative test. For example, if someone tests negative in April and then negative again in September, only their April test is counted. As a result, 7-day percent positivity rates can appear much higher because many people who tested negative during that period already had a negative test earlier in the pandemic. The 7-day positivity rate is calculated by dividing the total number of people with their first positive PCR test in a week, divided by the number of people who had their first PCR test that week. The CDC method is less conservative and uses tests rather than individuals. The 7-day metric equals the number of positive PCR tests in a week divided by the total number of PCR tests that week. It does not exclude people who had already been tested before that 7-day period. Both methods can be helpful for tracking public health in communities.
7-Day Percent Positive of PCR Tested Individuals. Numerator: The number of patients with an initial positive laboratory PCR test result for COVID-19 within the last 7 days. Denominator. The number of patients who had an initial PCR COVID-19 test within the last 7 days. Note that the 7-day day range used to calculate this metric is subject to the standard 3-day data delay to help ensure accuracy.
Thresholds and colors
White House Coronavirus Task Force metrics and thresholds. The Statewide and County Overview Dashboards include eight metrics that are also tracked by the White House Coronavirus Task Force. The Task Force uses a five-color system to assess the severity of each metric. The thresholds for each metric are presented in the screenshot below. See the below note for more information about how to use these colors, and why some jurisdictions have no colors.
What these colors mean and how they can be used: These colors indicate thresholds for each metric. All metrics and colors should be taken into context—including, but not limited to, local conditions (e.g., if an outbreak in one facility were to represent a significant share of new cases) and other metrics (e.g., the percent change in tests metric should be taken in the context of the total tests per 100,000 population metric). These color thresholds do not prescribe a certain course of action but rather aim to provide a view of intensity for each metric that can be standardized statewide and across jurisdictions. Any state and local actions considering these metrics should take other local public health and social conditions into context.
Jurisdictions with few new cases: For jurisdictions with fewer than 20 new cases in the most recent 14-day period, no “threshold colors” are shown to account for a higher margin of error.
Population and geography
Populations and per 100,000 resident metrics. The statewide population and all county populations used in “per 100K” metrics are based on 2019 American Community Survey (ACS) estimates.
Kansas City and Joplin populations. As noted in the FAQ, COVID-19 tests, cases, and deaths data are usually tracked at the county level. However, the municipalities of Kansas City and Joplin have their own local public health authorities and thus track and report their tests, cases, and deaths separately. As a result, for “per 100k” calculations, adjustments have been made to the populations of Jackson, Platte, Clay, and Cass Counties to subtract Kansas City residents from their respective populations. The same has been done for Jasper and Newton Counties to account for Joplin residents. Note that case data and population within Independence, MO, are included in the figures for Jackson County.
Residence. The county or jurisdiction where an individual lives. This may not be the same county where an individual works, contracts COVID-19, is tested, or (if applicable) is hospitalized.
School District Dashboard
Developed through a partnership with the Missouri School Boards Association, this Dashboard is designed to assist elementary and secondary school boards and administrators in evaluating factors that may influence the success of in-person, hybrid and distance learning models. The data are designed to provide an overview of the current impact of COVID-19 for the general and school-aged populations within every unified and elementary public school district in Missouri.
These numbers reflect the total number of cases in in school-aged children in the community in the geographic area each school district occupies. Data include all residents in these age groups and therefore include students in non-public schools. A case denotes an individual with a positive PCR test. It is not currently possible to assign cases to specific schools due to limitations in testing reporting data.
School district boundaries
Testing data when correctly reported include a person’s zip code and address, among other fields. These fields are used to estimate the school district geographic area in which that individual lives. Because of gaps and errors in testing reporting data, these numbers should be considered an estimate.
Cases are geocoded to each school district’s geographic area as defined by the U.S. Census Bureau 2019 TIGER/Line Shapefiles.
Race and Ethnicity
The reported race and ethnicity of laboratory-confirmed cases. Note that a sizeable share of cases are reported without a race or ethnicity classified other than "Unknown." DHSS continues to work with healthcare providers and labs to gather greater completeness of demographic information.
Laboratory-confirmed cases by the age of the patient. A small number of patients do not have an age available for analysis at the time the data is published. For this reason, Cases by Age may not sum to the total number of cases reported.
Health Care System
Number of Hospitalizations
The number of individuals reported as hospitalized confirmed or presumed to have COVID-19 on the listed date. Individuals hospitalized for more than one day may be included in the count on multiple dates. This dashboard provides hospitalization numbers obtained through the TeleTracking system. Not every hospital in Missouri reports to TeleTracking every day.
PCR (Polymerase Chain Reaction) Test
A PCR test looks for the viral genetic material (RNA) in the nose, throat, or other areas in the respiratory tract to determine if there is an active infection with SARS-CoV-2, the virus that causes COVID-19. A positive COVID-19 PCR test means that the person has an active COVID-19 infection.
A Serology test looks for antibodies against SARS-CoV-2 in the patient’s blood to determine if there has been an infection in the past. Antibodies are formed by the body to fight off infections. A positive antibody test means that the person was infected with COVID-19 in the past or recently and that their immune system developed antibodies to try to fight it off.
(Not the same as an “antibody” test.) An Antigen test is for rapid detection of the virus that causes COVID-19. The test determines if a sample contains proteins found on the surface of the coronavirus, which allows much faster results. Antigen tests are very specific for the virus, but are not as sensitive as PCR tests, therefore negative antigen test results may need to be confirmed with a PCR test prior to making treatment decisions if the patient has concerning symptoms or potential exposures to COVID-19. Antigen tests are most commonly used for patients who exhibit symptoms of COVID-19, therefore the percent positive rates are likely to be higher.
Numerator. The number of patients with positive laboratory PCR test results for COVID-19. Denominator. The number of patients who had a PCR COVID-19 test.
7-Day Percent Positive of PCR-Tested Individuals
Numerator. The number of patients with an initial positive laboratory PCR test result for COVID-19 within the last 7 days. Denominator. The number of patients who had an initial PCR COVID-19 test within the last 7 days.
Total Doses Administered
Total doses administered reflects the total number of vaccinations administered in Missouri regardless of residence of recipients. This includes non-Missouri residents who are vaccinated in Missouri, but does not include Missouri residents who are vaccinated outside of Missouri. Only first and second doses administered after December 13, 2020 are included.
Number of People Who Have Initiated Vaccine
Number of people who have initiated vaccine reflects the number of people who have received at least one dose of either the Moderna or Pfizer vaccine, as well as those who have received a single dose of the Johnson & Johnson vaccine. Only first and second doses administered after December 13, 2020 are included.
Number of People Who Have Completed Vaccine
The number of people who have received either a second dose of the Moderna or Pfizer vaccine or a single dose of the Johnson & Johnson vaccine. For this reason, each individual dose of the Johnson and Johnson vaccine is counted as initiated as well as completed.
Share of Population Who Have Initiated Vaccine
This represents the number of people who have initiated vaccination in Missouri (regardless of state of residence) as a percent of the Missouri population (Census Bureau 2019 Estimates).
Detail by Jurisdiction
As noted in the Overall FAQ tab, COVID-19 test, case, death, and vaccination data are usually displayed at the county level. However, the municipalities of Kansas City and Joplin have their own local public health authorities and thus track and report their tests, cases, deaths, and vaccinations separately. As a result, adjustments have been made to the populations of Jackson, Platte, Clay, and Cass Counties to subtract Kansas City residents from their respective populations. The same has been done for Jasper and Newton Counties to account for Joplin residents. Note that vaccination data and population within Independence, MO, are included in the figures for Jackson County.
This count represents the total doses administered for residents of the jurisdiction and does not reflect the number of people who have initiated or completed vaccination.
Detail by Date
This chart represents the number of COVID-19 doses administered in Missouri, regardless of the state of residence of recipients, by day. These counts may change over time, particularly for the most recent days, due to delays in reporting.
Share of Population Who Have Completed Vaccine
This represents the number of people who have completed vaccination in Missouri (regardless of state of residence) as a percent of the Missouri population (per Census Bureau 2019 Estimates).
Doses Administered in Past 7 Days
This represents the total doses administered in Missouri over the past seven days, regardless of state of residence. These counts are subject to a three-day lag to allow providers time to report doses administered. Data include only first and second doses administered after December 13, 2020.
Share of Population Initiating Vaccination
Counts and percentages exclude records for which there is no age, sex, race, and/or ethnicity on file, so the actual rates may be higher. The data for demographic groups reflect what is reported to MO DHSS by vaccination providers. These percentages reflect the share of each population group who have initiated vaccination, regardless of the state of residence of recipients. Population estimates were derived from Census Bureau 2019 Estimates. Note: Individuals under the age of 18 are included in the percentages shown, though vaccine is not currently recommended for persons in that age group.
By Age Group
This percentage includes persons initiating vaccine in Missouri by age, as calculated based upon the reported date of birth.
This percentage includes persons initiating vaccine in Missouri by self-identified sex.
This percentage includes persons initiating vaccine in Missouri by self-identified race group.
Due to a known technical issue, vaccinations of multi-race residents are being over-counted.
This percentage includes persons initiating vaccine in Missouri by self-identified ethnicity.
With the influx of vaccine providers required to report vaccination data to MO DHSS, irregularities in data quality may occur. MO DHSS will work with providers to correct such irregularities as they become known. All data presented on the Vaccinations Dashboard is subject to change upon correction of any irregularities, and such changes will be noted in the Recent Updates to the Dashboard section of the FAQs.
Counts on the vaccination dashboard do not currently include doses administered by Federal partners who are not required to report data to MO DHSS through the ShowMeVax system. Actual counts and rates may therefore be higher.
The county or jurisdiction where an individual lives, self-reported by address. This may not be the same county where an individual works or is vaccinated.