States that Vaccinate the Most (2025)

Vaccinations represent one of the most significant advancements in modern medicine. They have greatly reduced the incidence of numerous diseases, such as polio, tetanus, measles, and chickenpox. Remarkably, smallpox has been completely eradicated, with the last natural case recorded in 1977. More recently, COVID-19 vaccines significantly lowered infection and death rates, helping society return to normalcy.

Vaccines work best when a large portion of the population is immunized, which is why public education about their benefits is crucial. The World Health Organization (WHO) estimates that vaccines save approximately 4 to 5 million lives each year. They are also extremely safe; as the WHO notes, vaccine-related deaths are so rare that assessing the statistical risk is challenging.

In order to see where people are most responsible about getting vaccines, WalletHub examined the 50 states and the District of Columbia across 16 key metrics. Our data set ranges from the rates of children, teens and adults vaccinated against various diseases to the share of people without health insurance.

“Seeing as being anti vaccination has become trendy in some circles and misinformation is all over the internet, it’s more crucial now than ever to spread awareness of the benefits of vaccines and make sure as many people as possible receive potentially life-saving immunizations. The states that vaccinate the most provide the safest environments when it comes to public health, as the likelihood that the next outbreak will begin or spread there is minimized.”

Chip Lupo, WalletHub Analyst

Main Findings

Vaccination Rates by State

Notes: *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.

Influenza Vaccination Rate in Children Aged 6 Months to 17 Years

Highest

• 1. Massachusetts
• 2. Connecticut
• 3. New Jersey
• 4. Rhode Island
• 5. District of Columbia

Lowest

• 47. Alabama
• 48. Idaho
• 49. Montana
• 50. Wyoming
• 51. Mississippi

Best State vs. Worst State: 2x Difference

Massachusetts vs. Mississippi

Share of Teenagers Aged 13-17 with Up-To-Date HPV Vaccination

Highest

• 1. Rhode Island
• 2. Massachusetts
• 3. North Dakota
• 4. Michigan
• 5. Delaware

Lowest

• 47. Nevada
• 48. Kentucky
• 49. Oklahoma
• 50. Georgia
• 51. Mississippi

Best State vs. Worst State: 2x Difference

Rhode Island vs. Mississippi

Share of Teenagers Aged 13-17 with Men ACWY Vaccination

Highest

• 1. Connecticut
• 2. Rhode Island
• 3. Indiana
• 4. New York
• 5. Arkansas

Lowest

• 47. Montana
• 48. Wyoming
• 49. Alaska
• 50. Oklahoma
• 51. Mississippi

Best State vs. Worst State: 2x Difference

Connecticut vs. Mississippi

Flu Vaccination Coverage Rate Among Adults

Highest

• 1. District of Columbia
• 2. Massachusetts
• 3. Rhode Island
• 4. Vermont
• 5. Maryland

Lowest

• 47. Louisiana
• 48. Wyoming
• 49. Arizona
• 50. Nevada
• 51. Mississippi

Best State vs. Worst State: 2x Difference

District of Columbia vs. Mississippi

Share of Adults with Tetanus Vaccination

Highest

• 1. Vermont
• 2. New Hampshire
• 3. Minnesota
• 4. Maine
• 5. North Dakota

Lowest

• T-46. Georgia
• T-46. New York
• 48. Louisiana
• 49. New Jersey
• 50. Nevada
• 51. Mississippi

Best State vs. Worst State: 2x Difference

Vermont vs. Mississippi

Share of Adults Aged 60 and Older with Zoster Vaccination

Highest

• 1. Vermont
• 2. South Dakota
• 3. Washington
• 4. North Dakota
• 5. Colorado

Lowest

• 47. Tennessee
• 48. Pennsylvania
• 49. Alabama
• 50. Kentucky
• 51. Mississippi

Best State vs. Worst State: 2x Difference

Vermont vs. Mississippi

Share of Children 19-35 Months old Living in Poverty with Combined 7-Vaccine Series

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

Best State vs. Worst State: 2x Difference

Minnesota vs. California

Share of Civilian Noninstitutionalized Population without Health Insurance Coverage

Lowest

• 1. Massachusetts
• 2. District of Columbia
• 3. Hawaii
• 4. Vermont
• 5. Rhode Island

Highest

• T-46. Mississippi
• T-46. Wyoming
• 48. Florida
• 49. Georgia
• 50. Oklahoma
• 51. Texas

Best State vs. Worst State: 7x Difference

Massachusetts vs. Texas

Share of Children Under 6 Years Participating in an Immunization Information System

Highest

• 1. District of Columbia
• 2. Massachusetts
• 3. Virginia
• 4. South Carolina
• 5. Louisiana

Lowest

• 47. Missouri
• 48. Alaska
• 49. New Hampshire
• 50. Hawaii
• 51. Alabama

Best State vs. Worst State: 2x Difference

District of Columbia vs. Alabama

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In-Depth Look at the States That Vaccinate the Most

Massachusetts

Massachusetts is the state that vaccinates the most. It’s also one of only 18 states that allow minors to receive vaccinations without parental consent, allowing young people with anti-vaccine parents to choose to become protected anyway. Massachusetts requires children to be vaccinated against common diseases before attending kindergarten, too.

Massachusetts has high levels of vaccination for all major diseases, including seasonal coverage. It has the second-highest share of adults with flu vaccinations, at over 59%, and the highest rate for children, at over 75%.

To top things off, the Bay State has the fourth-highest share of residents participating in an “information immunization system,” which is a confidential online database recording vaccination data about a particular geographic area. This helps inform people about how safe a certain area is from disease outbreaks.

New Hampshire

New Hampshire is the state with the second-best vaccination coverage. It ranks ninth in the nation when it comes to HPV vaccination among teens ages 13 to 17 and 12th for the flu vaccination rate among children.

New Hampshire also has the sixth-highest share of babies under three years old who have the combined seven-vaccine series, which prevents multiple common illnesses, such as polio, tetanus and hepatitis B. In addition, New Hampshire requires children to be vaccinated against major diseases before attending kindergarten.

When it comes to adults, the Granite State has the seventh-highest flu vaccine coverage. It also has the eighth-highest share of adults at high risk for pneumococcal disease who have the pneumococcal vaccination.

Washington

Washington ranks third among the states that vaccinate the most. Over 89% of babies under three years old have received the combined seven-vaccine series, the fifth-highest rate in the country. In addition, over 90% of teens have received the Tdap (tetanus, diphtheria and pertussis) vaccination. Teen vaccination coverage is boosted by the fact that Washington allows minors to get vaccinated without parental consent, countering anti-vaccination trends.

Vaccination also remains high among adults in Washington. The state has the 11th-highest share of adults vaccinated against tetanus, the 10th-best flu vaccine coverage, and the fifth-highest share of at-risk adults with a pneumococcal vaccination.

Finally, Washington has the third-highest share of the population over 60 years who have received the Zoster vaccinations, which means the state has been relatively effective in promoting preventive healthcare measures among its older residents, too.

Ask the Experts

Vaccines are incredibly important, but in light of 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:

1. What are the steps local authorities can take in order to counter the current anti-vaccination trend?
2. 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?
3. What role should the media play in educating the public when it comes to vaccination hesitancy?
4. Is it necessary for the U.S. to introduce a ‘no jab, no school’ policy that requires mandatory vaccination before enrolling in school?
5. Why does confidence in vaccines matter, and how can it be increased?

Ask the Experts

Purnima Madhivanan
MBBS, MPH, PhD - Associate Professor, Dept of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health; Associate Professor, Division of Infectious Diseases, College of Medicine, Tucson; Director, Global Health Equity Scholars & Fogarty-Fulbright Global Health Program - University of Arizona, Tucson
Read More

Gregory W. Heath
DHSc, MPH, FACSM, FAHA, EIS’85, Guerry Professor Emeritus, Public Health - University of Tennessee at Chattanooga, Epidemiologist and Professor of Medicine - UTHSC College of Medicine Chattanooga
Read More

Jane M. Orient
M.D. - Executive Director, Association of American Physicians and Surgeons
Read More

Abram L. Wagner
Ph.D., MPH - Assistant Professor of Epidemiology and Global Public Health - University of Michigan
Read More

Paul Perrin
Ph.D., MPH, Academic Director of the Master of Global Affairs Integration Lab, Associate Professor of the Practice in Global Affairs/Global Health, Pulte Institute for Global Development, Keough School of Global Affairs - University of Notre Dame
Read More

Martine Hackett
Associate Professor of Population Health, Chair - Hofstra University
Read More

More Experts

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 16 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 Immunization 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 or more doses of DTaP, 3 or more doses of Polio, 1 or more doses of MMR, Hib full series (3 or 4 doses, depending on product type received), 3 or more doses of HepB, 1 or more doses of Varicella, and 4 or more doses of PCV.
• Influenza Vaccination Rate in Children Aged 6 Months to 17 Years: Double 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: Half 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 Rates – 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 Aged 0-35 Months Immunization Uptake (2023 vs 2018): Double Weight (~6.67 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.
• Share of Children Aged 19-35 Months Living in Poverty with Combined 7-Vaccine Series: Full Weight (~3.33 Points)
• Share of People Without Health Insurance: Full Weight (~3.33 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 (~3.33 Points)
• Share of Population Participating in an Immunization Information System (IIS): Full Weight (~3.33 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 as of August 12, 2025 from the U.S. Census Bureau, Centers for Disease Control and Prevention, Health Resources and Services Administration, IBTimes, Kaiser Family Foundation and ProCon.org.

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