Vital statistics data provide the most complete assessment of annual mortality burden and contrib- ute key measurements of the direct and indirect mor- tality burden during a public health pandemic. While mortality statistics have historically been produced annually, the COVID-19 pandemic introduced a press- ing need for the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) to rap- idly release reliable provisional mortality data. Provi- sional estimates indicate a 17.7% increase in the num- ber of deaths in 2020 (the increase in the age- adjusted rate was 15.9%) compared with 2019, with increases in many leading causes of death.1 The provi- sional leading cause-of-death rankings for 2020 indi- cate that COVID-19 was the third leading cause of death in the US behind heart disease and cancer.1