The best & worst states at vaccinating their children
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The best & worst states at vaccinating their children

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Photo Credit: Alamy Stock Photo

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. 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.

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.


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 at ExpertInsuranceReviews.com 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, they 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 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.


There are large differences in vaccination rates across state lines, with Montana and North Dakota 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.

Here are the 10 best and worst states for child vaccination.


The 10 States With the Highest Child Vaccination Rates

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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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

The 10 States With the Lowest Child Vaccination Rates

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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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Photo Credit: Alamy Stock Photo

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%

Detailed Findings & Methodology

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.


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 (influenzae), 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 underimmunized Amish community, which chose not to vaccinate their children.


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.

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