The Best & Worst States for Vaccinating Children [2021 Update]

Child vaccination rates in the U.S. vary across states. The 10 states with the highest child vaccination rates have an average of 83% 7-series vaccination record, whereas the 10 states with the lowest child vaccination rates have an average of 69% 7-series vaccination record. The best states and worst states for vaccinating children are represented in every region throughout the country.

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Sara Routhier, Managing Editor and Outreach Director, has professional experience as an educator, SEO specialist, and content marketer. She has over five years of experience in the insurance industry. As a researcher, data nerd, writer, and editor she strives to curate educational, enlightening articles that provide you with the must-know facts and best-kept secrets within the overwhelming world o...

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: May 6, 2021

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The Highlights

  • Montana is the worst state with just a 64% 7-vaccine series of children
  • Measles cases are at their highest point since 1992
  • Impoverished children are most likely to complete the 7-vaccine series
  • Blacks and Native Americans have the lowest vaccination rates of all races

Thanks to a worldwide vaccination effort led by the World Health Organization, smallpox became the first disease to be completely eradicated in 1978. Since then, the United States has eliminated other diseases including polio (in 1979) and measles (in 2000) as a result of the collective immunity acquired through vaccination rates in the U.S.

However, in the last several years, diseases like measles have returned to the U.S., with a significant spike in the number of cases reported. This article dives deep into the best and worst states for vaccinating children.

New data from the CDC shows a more than 3X increase in the number of measles cases between 2018 and 2019.

The number of reported measles cases in 2019 is the highest since 1992, countering a long-term downward trend since the measles vaccination program started in 1963.

While the current measles vaccine is about 97 percent effective at preventing the disease, the majority of new measles cases are among groups of people who were not vaccinated.

line graph showing Measles cases over time

Disparities in vaccination rates have long persisted across certain demographic groups due to differences in health care access. For example, affluent children are more likely to be vaccinated than children in low-income communities. However, increased parental concern over vaccine safety and efficacy has rejuvenated a social movement aiming to prevent children’s vaccinations.

The anti-vaccination movement, which gained prominence in the U.S. through social media and television talk shows, is weakening the nation’s collective immunity.

This became particularly evident in 2014 during one of the most infamous measles outbreaks in recent years, which originated in Disneyland and spread to 111 cases nationwide.

Some victims were too young to have been vaccinated, but almost half did not receive vaccines due to “philosophical or religious objections,” a phenomenon that has been growing in recent years.

Given recent outbreaks in measles and the rise of the anti-vaccination movement, researchers here at wanted to find which states are best and worst at vaccinating their children.

Using data from the Centers for Disease Control and Prevention’s National Immunization Survey, we examined how many children have completed the combined 7-vaccine series, which includes:

  • 4 or more doses of DTaP
  • 3 or more doses of Polio
  • 1 or more dose of MMR
  • Hib full series (3 or 4 doses)
  • 3 or more doses of HepB
  • 1 or more dose of Varicella
  • 4 or more doses of PCV

There are large differences in vaccination rates across many state lines; for example, Montana and North Dakota are at opposite ends of the spectrum despite their geographic proximity.

Interestingly, Western states including Oregon, Arizona, and Washington, which ordinarily score well in health-related measures, have low vaccination rates among kids. With the exception of New York State, New England is the only region with consistently high combined vaccination rates in the U.S.

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If you want to switch companies to save money that can be put towards annual vaccinations, we put together a guide to the best insurance companies from auto, life, and health insurance segments. If you’re looking to get a quote right away, just enter your ZIP code into our FREE online quote comparison tool. It’ll give you the best rates for your area based on your demographic information.

In this article, we’ll look at states with the lowest and highest vaccination rates, vaccination rates by state according to the CDC (Centers for Disease Control and Prevention), and specifically childhood vaccination rates by state.

There are other topics you might be interested in, such as:

  • Vaccination exemption rates by state
  • Vaccination coverage rates by state

Those will be touched on in the frequently asked question section. Now, let’s jump into the 20 best and worst states starting with the 10 with the most children immunized against these diseases.

The 10 States with the Highest Child Vaccination Rates

#10 – New Hampshire

  • Combined 7-vaccine series: 79.8%
  • DTaP (≥4 doses): 91.1%
  • Polio (≥3 doses): 95.9%
  • MMR (≥1 dose): 93.0%
  • Hib (full series): 87.6%
  • HepB (≥3 doses): 73.2%
  • Varicella (≥1 dose): 89.2%
  • PCV (≥4 doses): 86.0%

#9 – Colorado

  • Combined 7-vaccine series: 80.0%
  • DTaP (≥4 doses): 89.9%
  • Polio (≥3 doses): 91.3%
  • MMR (≥1 dose): 92.8%
  • Hib (full series): 87.8%
  • HepB (≥3 doses): 73.2%
  • Varicella (≥1 dose): 91.1%
  • PCV (≥4 doses): 85.2%

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#8 – North Carolina

  • Combined 7-vaccine series: 80.8%
  • DTaP (≥4 doses): 89.8%
  • Polio (≥3 doses): 96.2%
  • MMR (≥1 dose): 94.0%
  • Hib (full series): 87.1%
  • HepB (≥3 doses): 73.7%
  • Varicella (≥1 dose): 94.4%
  • PCV (≥4 doses): 88.9%

#7 – Alabama

  • Combined 7-vaccine series: 81.3%
  • DTaP (≥4 doses): 91.1%
  • Polio (≥3 doses): 93.9%
  • MMR (≥1 dose): 94.8%
  • Hib (full series): 88.0%
  • HepB (≥3 doses): 78.3%
  • Varicella (≥1 dose): 94.4%
  • PCV (≥4 doses): 86.3%

#6 – Pennsylvania

  • Combined 7-vaccine series: 81.5%
  • DTaP (≥4 doses): 89.1%
  • Polio (≥3 doses): 94.2%
  • MMR (≥1 dose): 96.1%
  • Hib (full series): 86.1%
  • HepB (≥3 doses): 83.4%
  • Varicella (≥1 dose): 94.5%
  • PCV (≥4 doses): 92.5%

#5 – Iowa

  • Combined 7-vaccine series: 81.9%
  • DTaP (≥4 doses): 92.4%
  • Polio (≥3 doses): 96.0%
  • MMR (≥1 dose): 92.9%
  • Hib (full series): 87.6%
  • HepB (≥3 doses): 82.3%
  • Varicella (≥1 dose): 91.2%
  • PCV (≥4 doses): 92.5%

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#4 – Connecticut

  • Combined 7-vaccine series: 85.2%
  • DTaP (≥4 doses): 93.1%
  • Polio (≥3 doses): 97.7%
  • MMR (≥1 dose): 96.3%
  • Hib (full series): 90.9%
  • HepB (≥3 doses): 80.2%
  • Varicella (≥1 dose): 99.5%
  • PCV (≥4 doses): 90.8%

#3 – Nebraska

  • Combined 7-vaccine series: 85.5%
  • DTaP (≥4 doses): 95.3%
  • Polio (≥3 doses): 95.1%
  • MMR (≥1 dose): 94.9%
  • Hib (full series): 92.0%
  • HepB (≥3 doses): 87.4%
  • Varicella (≥1 dose): 95.4%
  • PCV (≥4 doses): 92.2%

#2 – North Dakota

  • Combined 7-vaccine series: 85.6%
  • DTaP (≥4 doses): 90.2%
  • Polio (≥3 doses): 95.1%
  • MMR (≥1 dose): 93.6%
  • Hib (full series): 90.3%
  • HepB (≥3 doses): 88.2%
  • Varicella (≥1 dose): 92.2%
  • PCV (≥4 doses): 89.5%

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#1 – Massachusetts

  • Combined 7-vaccine series: 85.9%
  • DTaP (≥4 doses): 92.5%
  • Polio (≥3 doses): 97.5%
  • MMR (≥1 dose): 96.9%
  • Hib (full series): 92.3%
  • HepB (≥3 doses): 74.8%
  • Varicella (≥1 dose): 97.3%
  • PCV (≥4 doses): 93.3

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The 10 States with the Lowest Child Vaccination Rates

#10 – New York

  • Combined 7-vaccine series: 70.9%
  • DTaP (≥4 doses): 85.7%
  • Polio (≥3 doses): 94.8%
  • MMR (≥1 dose): 93.0%
  • Hib (full series): 83.3%
  • HepB (≥3 doses): 72.0%
  • Varicella (≥1 dose): 93.4%
  • PCV (≥4 doses): 86.6%

#9 – Florida

  • Combined 7-vaccine series: 70.8%
  • DTaP (≥4 doses): 85.7%
  • Polio (≥3 doses): 94.1%
  • MMR (≥1 dose): 92.6%
  • Hib (full series): 79.6%
  • HepB (≥3 doses): 66.2%
  • Varicella (≥1 dose): 92.9%
  • PCV (≥4 doses): 79.9%

#8 – Arizona

  • Combined 7-vaccine series: 70.7%
  • DTaP (≥4 doses): 84.5%
  • Polio (≥3 doses): 90.6%
  • MMR (≥1 dose): 91.1%
  • Hib (full series): 76.7%
  • HepB (≥3 doses): 79.6%
  • Varicella (≥1 dose): 91.8%
  • PCV (≥4 doses): 76.2%

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#7 – Missouri

  • Combined 7-vaccine series: 70.4%
  • DTaP (≥4 doses): 80.4%
  • Polio (≥3 doses): 96.6%
  • MMR (≥1 dose): 88.1%
  • Hib (full series): 75.5%
  • HepB (≥3 doses): 84.3%
  • Varicella (≥1 dose): 89.2%
  • PCV (≥4 doses): 78.9%

#6 – Mississippi

  • Combined 7-vaccine series: 70.2%
  • DTaP (≥4 doses): 81.1%
  • Polio (≥3 doses): 92.3%
  • MMR (≥1 dose): 91.3%
  • Hib (full series): 78.7%
  • HepB (≥3 doses): 75.5%
  • Varicella (≥1 dose): 92.0%
  • PCV (≥4 doses): 79.1%

#5 – South Carolina

  • Combined 7-vaccine series: 70.1%
  • DTaP (≥4 doses): 89.2%
  • Polio (≥3 doses): 94.2%
  • MMR (≥1 dose): 89.8%
  • Hib (full series): 80.0%
  • HepB (≥3 doses): 71.3%
  • Varicella (≥1 dose): 92.4%
  • PCV (≥4 doses): 85.3%

#4 – Minnesota

  • Combined 7-vaccine series: 68.9%
  • DTaP (≥4 doses): 82.5%
  • Polio (≥3 doses): 93.5%
  • MMR (≥1 dose): 93.2%
  • Hib (full series): 81.5%
  • HepB (≥3 doses): 68.0%
  • Varicella (≥1 dose): 91.2%
  • PCV (≥4 doses): 83.0%

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#3 – Washington

  • Combined 7-vaccine series: 68.6%
  • DTaP (≥4 doses): 84.4%
  • Polio (≥3 doses): 88.3%
  • MMR (≥1 dose): 93.8%
  • Hib (full series): 76.9%
  • HepB (≥3 doses): 72.0%
  • Varicella (≥1 dose): 93.0%
  • PCV (≥4 doses): 80.4%

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#2 – Indiana

  • Combined 7-vaccine series: 67.3%
  • DTaP (≥4 doses): 82.2%
  • Polio (≥3 doses): 93.4%
  • MMR (≥1 dose): 92.1%
  • Hib (full series): 76.0%
  • HepB (≥3 doses): 78.6%
  • Varicella (≥1 dose): 89.4%
  • PCV (≥4 doses): 77.5%

#1 – Montana

  • Combined 7-vaccine series: 64.0%
  • DTaP (≥4 doses): 81.0%
  • Polio (≥3 doses): 93.5%
  • MMR (≥1 dose): 92.1%
  • Hib (full series): 76.3%
  • HepB (≥3 doses): 75.4%
  • Varicella (≥1 dose): 89.7%
  • PCV (≥4 doses): 79.3%

All States + D.C. Child Vaccination % Ranked

North Dakota285.6%90.2%95.1%93.6%90.3%88.2%92.2%89.5%
North Carolina880.8%89.8%96.2%94.0%87.1%73.7%94.4%88.9%
New Hampshire1079.8%91.1%95.9%93.0%87.6%73.2%89.2%86.0%
New Mexico1478.8%91.3%96.4%93.6%86.2%70.0%92.3%85.8%
West Virginia1578.6%89.3%93.9%92.8%88.4%72.9%92.0%87.6%
New Jersey1778.4%90.1%95.5%96.5%87.2%68.0%94.2%88.3%
South Dakota2176.8%84.7%91.0%95.5%84.3%79.2%95.0%87.8%
Rhode Island3075.1%89.4%97.5%94.9%86.8%79.7%96.3%92.4%
District of Columbia3373.3%91.2%94.3%91.9%82.5%75.2%93.4%87.2%
New York4270.9%85.7%94.8%93.0%83.3%72.0%93.4%86.6%
South Carolina4770.1%89.2%94.2%89.8%80.0%71.3%92.4%85.3%
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Frequently Asked Questions: All About Vaccines

Now that we’ve covered the best and worst states for vaccinating children, let’s get to your frequently asked questions. They include:

  • What percent of the US population is vaccinated?
  • How many people are vaccinated in the US?
  • Are vaccine side effects a good sign?

Scroll down to read the answers to those questions and more.

#1 – What percent of the US population is vaccinated?

According to the Centers for Disease Control and Prevention (CDC), 68.3% of children up to the age of 24 months are vaccinated for the full 7-vaccine series.

#2 – How many people are vaccinated in the US?

While the numbers are difficult to find for the total number of people in the US that have received the 7-vaccine series (including adults), some organizations have noted that over 90% of children receive common vaccines like MMR, while others in the 7-vaccine series are rarer.

#3 – Are vaccine side effects a good sign?

They can be. Side effects from a vaccine mean that your body is fighting the smaller version of the illness, which builds immunity in the long run. It is a “mini-battle” that could lead to you winning the “war.”

#4 – Why are there side effects to vaccines?

Vaccines are considered “foreign substances,” which can cause someone’s body to fight it off through a fever or other methods. The vaccines help in the long run because they build immunity in a person’s body to the foreign substance, which may be deadly in full form.

#5 – What states do not require vaccinations?

All states have exemptions for people with contraindications, which just means a person would experience harm if they were to be given a vaccine. Five states — California, Maine, Mississippi, New York, and West Virginia — have religious exemptions for vaccines and 16 states allow parents to cite personal or philosophical reasons for not vaccinating their children.

#6 – How do you calculate vaccination coverage?

Vaccination coverage is calculated by taking the number of infants that have received a vaccine, dividing that number by the number of total infants eligible for a vaccine, then multiplying by 100. This gives the percentage of infants within a set that has vaccination coverage.

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Methodology: Determining the Best & Worst States for Vaccinating Children

Data on children’s vaccination coverage for the combined 7-vaccine series are from the Centers for Disease Control and Prevention’s National Immunization Survey. The 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.

Vaccine statistics by state are for 19- to 35-month old children born in 2015 and 2016. The numbers of measles cases by year, as well as vaccination rates by demographic group, are also from the CDC.

Race plays a significant role when it comes to vaccinations. Nationally, there is a consistent gap of almost 6 percentage points between the vaccination rate of whites and Asians compared to African-Americans and Native Americans. A characteristic even more impactful than race is poverty status—the analysis found that those below the poverty level have lower vaccination rates by 10 percentage points, a gap which has been consistent for the last decade, and which poses a serious health threat.

Vaccination rate by race

Despite the recent outbreaks in the U.S. and abroad, the combined 7-vaccine series rate has actually increased from 40 percent to more than 70 percent nationally since 2009. This is largely thanks to more vaccinations for Rotavirus and Hib (influenza), which were previously at lower levels.

The most pressing issue today is that a number of close-knit communities choose to exempt their children from vaccinations, frequently due to “philosophical or religious” reasons.

In 2014, when the U.S. experienced the largest measles outbreak in decades, more than half of those infected were from an under-immunized Amish community, which chose not to vaccinate their children.

Vaccination rate by poverty

The MMR vaccine, which protects children from measles, mumps, and rubella, has been associated with sizable controversy ever since a study was published linking the vaccine to autism. While the study has been retracted and debunked numerous times, healthcare workers and researchers still struggle to persuade some parents to vaccinate their children.

During the eradication of smallpox campaign, non-existing infrastructure, war conflict, and lack of trust in health authorities proved to be the toughest challenges. Today, despite improvements in infrastructure and living conditions, misinformation and lack of trust in authorities are proving as difficult to overcome as 50 years ago.

There are also other ways to measure vaccination coverage, such as vaccination coverage by area or vaccination coverage by county. Those statistics can be eye-opening as to which demographics are deciding not to vaccinate their children.

Whether you suffer from one of the maladies mentioned in this article because you weren’t vaccinated or are perfectly healthy, it always helps to save money on insurance. Enter your ZIP code into our online quote generator today to get the best insurance rates for your area based on your information.

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