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During June–August 2020, COVID-19 incidence was highest in persons aged 20–29 years, who accounted for> 20% of all confirmed cases. Younger adults likely contribute to community transmission of COVID-19. Across the southern United States in June 2020, increases in percentage of positive SARS-CoV-2 test results among adults aged 20–39 years preceded increases among those aged≥ 60 years by 4–15 days.