Vaccinations are some of the most valuable contributions to modern medicine. They have drastically reduced the prevalence of certain diseases, including polio, tetanus, measles and chicken pox. One disease, smallpox, has even been eradicated completely, with no natural cases since 1977. Most recently, we’ve developed a vaccine for COVID-19, which has drastically cut down cases and deaths, and allowed the country to reopen. Unfortunately, there is still a significant chunk of the population that is hesitant to get the vaccine, as only around 68% of Americans are fully vaccinated against COVID-19 as of September 2022.
The first step to getting more Americans to get vaccinated against COVID-19 and other diseases is to educate people on the importance of vaccines and how much good they have done for public health. The World Health Organization (WHO) estimates that vaccines prevent around 4 to 5 million deaths per year. Vaccines are also very safe, and according to the WHO, “so few deaths can plausibly be attributed to vaccines that it is hard to assess the risk statistically.”
Some states are better than others when it comes to vaccinating. In order to see where people are most responsible about getting vaccines, WalletHub examined the 50 states and the District of Columbia across 17 key metrics. Our data set ranges from share of vaccinated children to share of people without health insurance to presence of reported measles outbreaks.
Main Findings
Vaccination Rates by State
| Overall Rank* |
State | Total Score | Children & Teenagers Immunization Rates | Adult & Elderly Vaccination Rates | Immunization Uptake Disparities & Influencing Factors |
|---|---|---|---|---|---|
| 1 | Massachusetts | 83.67 | 1 | 5 | 1 |
| 2 | Vermont | 80.51 | 5 | 1 | 2 |
| 3 | New Hampshire | 75.46 | 4 | 2 | 13 |
| 4 | Rhode Island | 74.87 | 6 | 3 | 3 |
| 5 | Maine | 73.33 | 7 | 4 | 4 |
| 6 | Connecticut | 70.81 | 2 | 28 | 5 |
| 7 | Pennsylvania | 69.91 | 3 | 14 | 7 |
| 8 | Iowa | 66.47 | 9 | 6 | 25 |
| 9 | Maryland | 66.06 | 8 | 16 | 6 |
| 10 | Minnesota | 64.81 | 18 | 8 | 10 |
| 11 | Washington | 64.27 | 15 | 7 | 20 |
| 12 | Nebraska | 64.23 | 10 | 13 | 15 |
| 13 | Oregon | 61.69 | 17 | 15 | 11 |
| 14 | South Dakota | 61.51 | 12 | 10 | 28 |
| 15 | North Dakota | 60.12 | 11 | 12 | 33 |
| 16 | Utah | 59.62 | 19 | 18 | 14 |
| 17 | Virginia | 59.23 | 24 | 17 | 8 |
| 18 | Delaware | 58.32 | 14 | 24 | 16 |
| 19 | Colorado | 58.11 | 26 | 11 | 19 |
| 20 | District of Columbia | 55.95 | 23 | 23 | 17 |
| 21 | Wisconsin | 55.70 | 40 | 9 | 26 |
| 22 | North Carolina | 55.50 | 13 | 26 | 29 |
| 23 | West Virginia | 53.45 | 32 | 19 | 27 |
| 24 | Ohio | 52.78 | 22 | 25 | 30 |
| 25 | New York | 52.43 | 16 | 39 | 9 |
| 26 | Kansas | 52.18 | 31 | 20 | 34 |
| 27 | Illinois | 50.71 | 20 | 34 | 21 |
| 28 | Michigan | 50.25 | 36 | 21 | 35 |
| 29 | Kentucky | 50.10 | 21 | 29 | 39 |
| 30 | Missouri | 48.97 | 34 | 27 | 36 |
| 31 | New Mexico | 48.03 | 37 | 30 | 24 |
| 32 | California | 47.96 | 35 | 33 | 23 |
| 33 | Montana | 46.00 | 46 | 22 | 43 |
| 34 | Hawaii | 45.14 | 39 | 41 | 12 |
| 35 | Arkansas | 44.76 | 29 | 36 | 42 |
| 36 | Indiana | 43.88 | 33 | 32 | 45 |
| 37 | Idaho | 43.71 | 28 | 38 | 41 |
| 38 | Tennessee | 43.00 | 30 | 40 | 38 |
| 39 | South Carolina | 42.06 | 43 | 35 | 40 |
| 40 | Arizona | 40.10 | 41 | 43 | 32 |
| 41 | New Jersey | 39.42 | 25 | 48 | 22 |
| 42 | Alabama | 37.96 | 27 | 45 | 47 |
| 43 | Wyoming | 37.54 | 48 | 37 | 46 |
| 44 | Texas | 36.95 | 45 | 42 | 44 |
| 45 | Nevada | 34.57 | 38 | 49 | 31 |
| 46 | Alaska | 34.36 | 49 | 44 | 37 |
| 47 | Louisiana | 33.99 | 42 | 46 | 49 |
| 48 | Georgia | 33.52 | 44 | 47 | 48 |
| 49 | Florida | 32.04 | 47 | 50 | 18 |
| 50 | Oklahoma | 31.99 | 51 | 31 | 51 |
| 51 | Mississippi | 18.13 | 50 | 51 | 50 |
Note: *No. 1 = Vaccinates the Most
With the exception of “Total Score,” all of the columns in the table above depict the relative rank of that state, where a rank of 1 represents the best conditions for that metric category.
- Highest
- 1. Massachusetts
- 2. Rhode Island
- 3. Connecticut
- 4. Nebraska
- 5. Maryland
- Lowest
- T-46. Idaho
- T-46. West Virginia
- 48. Georgia
- 49. Wyoming
- 50. Nevada
- 51. Mississippi
- Highest
- 1. Rhode Island
- 2. Hawaii
- 3. Massachusetts
- 4. District of Columbia
- 5. South Dakota
- Lowest
- 47. Oklahoma
- 48. Utah
- 49. Wyoming
- 50. West Virginia
- 51. Mississippi
- Highest
- 1. Massachusetts
- T-2. Rhode Island
- T-2. New Jersey
- T-2. Georgia
- 5. Michigan
- Lowest
- 47. South Carolina
- 48. Alaska
- 49. Montana
- 50. Wyoming
- 51. Mississippi
- Highest
- 1. Rhode Island
- 2. Massachusetts
- 3. New Hampshire
- 4. Connecticut
- 5. Vermont
- Lowest
- T-47. Georgia
- T-47. Louisiana
- 49. Mississippi
- 50. Wyoming
- 51. Florida
- Highest
- 1. Minnesota
- 2. Vermont
- 3. New Hampshire
- 4. Iowa
- 5. Maine
- Lowest
- 47. Arkansas
- 48. Florida
- 49. Nevada
- 50. Mississippi
- 51. New Jersey
- Highest
- 1. South Dakota
- 2. North Dakota
- 3. Minnesota
- 4. Washington
- 5. Vermont
- Lowest
- T-47. Florida
- T-47. Illinois
- 49. New Jersey
- 50. Alabama
- 51. Mississippi
- Highest
- 1. Minnesota
- 2. North Dakota
- 3. Maryland
- 4. Massachusetts
- 5. Tennessee
- Lowest
- T-46. New Jersey
- T-46. New York
- 48. Montana
- 49. Virginia
- 50. Michigan
- 51. California
- Lowest
- 1. Massachusetts
- 2. District of Columbia
- 3. Hawaii
- 4. Vermont
- 5. Rhode Island
- Highest
- 47. Alaska
- 48. Florida
- 49. Georgia
- 50. Oklahoma
- 51. Texas
- Highest
- T-1. Virginia
- T-1. Georgia
- 3. Louisiana
- 4. Vermont
- 5. South Carolina
- Lowest
- 47. Connecticut
- 48. Texas
- 49. Missouri
- 50. Hawaii
- 51. New Hampshire
Ask the Experts
Vaccines are incredibly important, but in light of the COVID-19 pandemic and recent anti-vaccination trends, it’s clear that the public needs greater education on their benefits and how they work. For insight, we turned to a panel of experts. You can click on the experts to see their bios and answers to the following key questions:
- What are the steps local authorities can take in order to counter the current anti-vaccination trend?
- According to the World Health Organization, vaccine resistance is one of the top global health challenges. What measures should be taken to reduce vaccine exemptions and safeguard the at-risk population?
- What role does the media play in educating the public when it comes to vaccination hesitancy?
- Is the introduction of a ‘No jab, No school’ policy that requires mandatory vaccination at school entry necessary in the U.S.?
Ask the Experts
PhD, MPH – Director of Evidence and Learning and Associate Professor of the Practice in Global Affairs/Global Health, Pulte Institute for Global Development, Keough School of Global Affairs – University of Notre Dame
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Crisis Communication Researcher, George T and Gladys H Abell Professorship in Liberal Arts, Department of Communication – Texas A&M University
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MBBS, MPH, PhD – Associate Professor, Health Promotion Sciences Department, Mel & Enid College of Public Health – University of Arizona
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Ph.D. – Associate Professor, Marketing and Quantitative Methods, Mitchell College of Business – University of South Alabama
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Ph.D. – Infectious Disease Epidemiologist – UTHealth School of Public Health in Houston
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Gail Buttorff, Ph.D. – Instructional Assistant Professor, Hobby School of Public Affairs, Director, Survey Research Institute in collaboration with Agustin Vallejo, Ph.D. – Post-Doctoral Fellow at the Hobby School of Public Affairs, University of Houston
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Methodology
In order to determine the states in the U.S. that vaccinate most, WalletHub compared the 50 states and the District of Columbia across three key dimensions: 1) Children & Teenagers Immunization Rates, 2) Adult & Elderly Vaccination Rates and 3) Immunization Uptake Disparities & Influencing Factors.
We evaluated the three dimensions using 17 relevant metrics, which are listed below with their corresponding weights. Each metric was graded on a 100-point scale, with a score of 100 representing the most favorable conditions.
Finally, we determined each state and the District’s weighted average across all metrics to calculate its overall score and used the resulting scores to rank-order our sample.
Children & Teenagers Vaccination Rates – Total Points: 40
- Share of Children Aged 0-35 Months with Combined 7-Vaccine Series: Triple Weight (~12.63 Points)
Note: Combined 7-Vaccine Series includes ≥4 DTaP (Diphtheria, Tetanus, and Whooping Cough) vaccine doses, ≥3 Polio (Poliomyelitis) vaccine doses, ≥1 MMR (Measles, Mumps, and Rubella) vaccine dose, Hib (Haemophilus influenzae type B) vaccine full series, ≥3 HepB (Hepatitis B) vaccine doses, ≥1 Varicella vaccine dose, and ≥4 PCV (Pneumococcal Conjugate) vaccine doses. - Influenza Vaccination Rate in Children Aged 6 Months to 17 Years: Full Weight (~8.42 Points)
- Share of Teenagers Aged 13-17 with Up-To-Date HPV Vaccination: Full Weight (~4.21 Points)
Note: An up-to-date HPV (Human papillomavirus) vaccination measure was added to assess completion of the HPV vaccine series (2-doses separated by 5 months (minus 4 days) for immunocompetent adolescents initiating the HPV vaccine series before their 15th birthday and 3 doses for all others). - Share of Teenagers Aged 13-17 with Tdap Vaccination: Full Weight (~4.21 Points)
Note: Tdap is a combination vaccine that protects against three potentially life-threatening bacterial diseases: tetanus, diphtheria, and pertussis (whooping cough). - Share of Teenagers Aged 13-17 with MenACWY Vaccination: Full Weight (~4.21 Points)
Note: The MenACWY vaccine is given by a single injection into the upper arm and protects against four different strains of the meningococcal bacteria that cause meningitis and blood poisoning (septicaemia): A, C, W and Y. - States Where Minors Can Get Vaccinated Without Parental Consent: Full Weight (~2.11 Points)
- Vaccinations Required for Public School Kindergarten Access: Full Weight (~4.21 Points)
Note: This is a composite binary metric which measures the number of vaccinations required for public school kindergarten access in a state. States receive 1 point for each required vaccine (Hep B/DTaP/Hib/PCV/IPV/Flu/MMR/Varicella/Hep A).
Adult & Elderly Vaccination Rate – Total Points: 40
- Adult Flu Vaccination Rate: Full Weight (~11.43 Points)
- Share of Adults Aged 18-64 at Increased Risk with Pneumococcal Vaccination: Full Weight (~11.43 Points)
Note: Pneumococcal vaccination is recommended for adults 18-64 years at increased risk for pneumococcal disease and all adults ≥65 years. Adults were considered at increased risk for pneumococcal disease or its complications if they self-reported one or more of the following: 1) having current asthma; 2) ever being told by a health professional they have diabetes, myocardial infarction, angina or coronary heart disease; or 3) being a current smoker. - Share of Adults with Tetanus Vaccination: Full Weight (~11.43 Points)
Note: Tetanus and diphtheria toxoids (Td) vaccination is recommended every 10 years for adults ≥18 years. A single tetanus toxoid, diphtheria toxoid, and acellular pertussis (Tdap) vaccination is recommended for adults ≥18 years who previously have not received a dose of Tdap vaccine. - Share of Adults Aged 60 and Older with Zoster Vaccination: Half Weight (~5.71 Points)
Note: Herpes zoster vaccination was determined by asking respondents ≥50 years if they had ever received a shingles or zoster vaccine. Herpes zoster vaccination is recommended for all adults ≥60 years.
Immunization Uptake Disparities & Influencing Factors – Total Points: 20
- Change in Children Immunization Uptake (2020 vs 2015): Double Weight (~4.00 Points)
Note: This refers to the 7-Vaccine series that includes ≥4 DTaP doses, ≥3 Polio doses, ≥1 MMR dose, Hib full series, ≥3 HepB doses, ≥1 Varicella dose, and ≥4 PCV doses; 19-35 months. - Share of Children Aged 19-35 Months Living in Poverty with Combined 7-Vaccine Series: Full Weight (~2.00 Points)
- Share of Population Aged 12 and Older Fully Vaccinated: Quadruple Weight (~8.00 Points)
- Share of People Without Health Insurance: Full Weight (~2.00 Points)
Note: Overall, vaccination coverage was generally lower among adults without health insurance compared with those with health insurance. - Share of Population Living in a Primary-Care HPSA (Health Professional Shortage Area): Full Weight (~2.00 Points)
- Share of Population Participating in an Immunization Information System (IIS): Full Weight (~2.00 Points)
Note: Immunization information systems (IIS) are confidential, population-based, computerized databases that record all immunization doses administered by participating providers to persons residing within a given geopolitical area.
Sources: Data used to create this ranking were collected from U.S. Census Bureau, Centers for Disease Control and Prevention, Health Resources and Services Administration, IBTimes, The Commonwealth Fund and ProCon.org.