A Comprehensive Measurement of the Local Value of the Hubble Constant with 1 km/s/Mpc Uncertainty from the Hubble Space Telescope and the SH0ES Team

We report observations from HST of Cepheids in the hosts of 42 SNe Ia used to calibrate the Hubble constant (H0). These include all suitable SNe Ia in the last 40 years at z<0.01, measured with >1000 orbits, more than doubling the sample whose size limits the precision of H0. The Cepheids are calibrated geometrically from Gaia EDR3 parallaxes, masers in N4258 (here tripling that Cepheid sample), and DEBs in the LMC. The Cepheids were measured with the same WFC3 instrument and filters (F555W, F814W, F160W) to negate zeropoint errors. We present multiple verifications of Cepheid photometry and tests of background determinations that show measurements are accurate in the presence of crowding. The SNe calibrate the mag-z relation from the new Pantheon+ compilation, accounting here for covariance between all SN data, with host properties and SN surveys matched to negate differences. We decrease the uncertainty in H0 to 1 km/s/Mpc with systematics. We present a comprehensive set of ~70 analysis variants to explore the sensitivity of H0 to selections of anchors, SN surveys, z range, variations in the analysis of dust, metallicity, form of the P-L relation, SN color, flows, sample bifurcations, and simultaneous measurement of H(z). Our baseline result from the Cepheid-SN sample is H0=73.04+-1.04 km/s/Mpc, which includes systematics and lies near the median of all analysis variants. We demonstrate consistency with measures from HST of the TRGB between SN hosts and NGC 4258 with Cepheids and together these yield 72.53+-0.99. Including high-z SN Ia we find H0=73.30+-1.04 with q0=-0.51+-0.024. We find a 5-sigma difference with H0 predicted by Planck+LCDM, with no indication this arises from measurement errors or analysis variations considered to date. The source of this now long-standing discrepancy between direct and cosmological routes to determining the Hubble constant remains unknown.