2019’s States that Vaccinate the Most

Posted by: Adam McCann

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.

The World Health Organization (WHO) estimates that vaccines prevented at least 10 million deaths worldwide just between the years of 2010 and 2015. A similar study by the Centers for Disease Control and Prevention (CDC) found vaccines prevented 732,000 deaths in the U.S. between 1994 and 2013, as well as eliminated $1.38 trillion in total societal costs that those diseases would have caused. 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 18 key categories. Our data set ranges from share of vaccinated children to share of people without health insurance to presence of reported measles outbreaks. Read on for the full ranking, additional insight from a panel of experts and a detailed explanation of our methodology.

  1. Main Findings
  2. Ask the Experts
  3. Methodology

Main Findings

Embed on your website<iframe src="//d2e70e9yced57e.cloudfront.net/wallethub/embed/66237/geochart-vaccination.html" width="556" height="347" frameBorder="0" scrolling="no"></iframe> <div style="width:556px;font-size:12px;color:#888;">Source: <a href="https://ift.tt/2mW2J38>  

Vaccination Rates by State

Overall Rank (1 = Most)


Total Score

‘Children & Teenagers Immunization Rates’ Rank

‘Adult & Elderly Vaccination Rates’ Rank

‘Immunization Uptake Disparities & Influencing Factors’ Rank

3Rhode Island65.815127
4North Dakota64.327134
5New Hampshire62.843729
8South Dakota59.552266
9West Virginia58.7412183
19District of Columbia51.5993410
23North Carolina47.70302315
30New Mexico41.71292451
33South Carolina39.98363620
43New York35.53314236
44New Jersey34.39324346

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 10 threats to global health. What measures should be taken to reduce vaccine exemptions and safeguard at-risk population?
  3. What role does the media play in educating the public when it comes to vaccination hesitancy?
  4. Is the introduction of a ‘No jab, No school’ policy that requires mandatory vaccination at school entry necessary in the U.S.?
< >More Experts


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 18 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 19-35 Months with Combined 7-Vaccine Series: Triple Weight (~13.33 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 (~4.44 Points)
  • Share of Teenagers Aged 13-17 Years with Up-To-Date HPV Vaccination: Full Weight (~4.44 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 Years with Tdap Vaccination: Full Weight (~4.44 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 Years with MenACWY Vaccination: Full Weight (~4.44 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 (~4.44 Points)
  • Vaccinations Required for Public School Kindergarten Access: Full Weight (~4.44 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 (~10.00 Points)
  • Share of Adults Aged 18-64 Years at Increased Risk with Pneumococcal Vaccination: Full Weight (~10.00 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 (~10.00 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 Years and Older with Zoster Vaccination: Full Weight (~10.00 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 (2017 vs 2012): Double Weight (~4.44 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 (~2.22 Points)
  • Presence of Reported Measles Outbreaks: Double Weight (~4.44 Points)Note: This binary metric measures the presence or absence of measles outbreaks in a state.
  • Share of People Without Health Insurance: Full Weight (~2.22 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 (~2.22 Points)
  • Annual Economic Burden of Vaccine-Preventable Diseases for Adults Aged 50 Years and Older per Population 50 Years and Older: Full Weight (~2.22 Points)
  • Share of Population Participating in an Immunization Information System (IIS): Full Weight (~2.22 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.
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    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, The Journal of Primary Prevention, IBTimes and ProCon.org.

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