The likelihood of experiencing a vaccine-preventable disease outbreak has much to do with where you live.
A September report from the personal finance website WalletHub analyzed US vaccination rates across all 50 states and the District of Columbia, using data from the US Census Bureau, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, IBTimes, Kaiser Family Foundation, and ProCon.org.
The analysis examined vaccination rates among children, teenagers, adults, and the elderly, as well as differences in access and other factors that influence vaccination rates. WalletHub then scored each state and DC through a weighted average across all metrics.
New England states made up the top 5 and had among the highest flu shot rates, while Mississippi ranked last. The data comes as flu season enters full swing and measles outbreaks continue across the US.
CDC data show that fewer than 44% of people in the US aged 6 months and older received a flu shot during the 2024-2025 season, compared with roughly 52% in 2020-2021. About 51 million people caught the flu that year, with about 710,000 people hospitalized due to complications and 45,000 dying from it.
As of February 2026, an estimated 47% of adults got the flu shot for the 2025-2026 season.
Measles vaccination rates are also lower than a few years ago. Pennsylvania, Texas, Utah, and other states have reported measles outbreaks and rising case numbers.
WalletHub analyst Chip Lupo said anti-vaccination rhetoric and skepticism toward vaccination benefits since COVID-19 have contributed to lower vaccination rates.
"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," he said.
Still, some diseases, like smallpox, have been completely eradicated, thanks to widespread vaccinations. Lupo said the states that vaccinate the most people "provide the safest environments when it comes to public health" and have a lower likelihood of outbreaks.
Here are the states with the highest and lowest vaccination rates nationwide.
10. Washington
Score: 66.75
Children and Teenagers Immunization Rates Rank: 13
Adult & Elderly Vaccination Rates Rank: 7
9. Minnesota
Score: 66.78
Children and Teenagers Immunization Rates Rank: 24
Adult & Elderly Vaccination Rates Rank: 6
8. Virginia
Score: 67.75
Children and Teenagers Immunization Rates Rank: 7
Adult & Elderly Vaccination Rates Rank: 17
7. Wisconsin
Score: 68.55
Children and Teenagers Immunization Rates Rank: 18
Adult & Elderly Vaccination Rates Rank: 8
6. Pennsylvania
Score: 68.60
Children and Teenagers Immunization Rates Rank: 6
Adult & Elderly Vaccination Rates Rank: 15
5. Maine
Score: 69.04
Children and Teenagers Immunization Rates Rank: 17
Adult & Elderly Vaccination Rates Rank: 2
4. Rhode Island
Score: 69.16
Children and Teenagers Immunization Rates Rank: 4
Adult & Elderly Vaccination Rates Rank: 18
3. New Hampshire
Score: 73.67
Children and Teenagers Immunization Rates Rank: 5
Adult & Elderly Vaccination Rates Rank: 2
2. Massachusetts
Score: 80.63
Children and Teenagers Immunization Rates Rank: 1
Adult & Elderly Vaccination Rates Rank: 4
1. Vermont
Score: 84.77
Children and Teenagers Immunization Rates Rank: 2
Adult & Elderly Vaccination Rates Rank: 1
41. Florida
Score: 47.44
Children and Teenagers Immunization Rates Rank: 27
Adult & Elderly Vaccination Rates Rank: 48
42. Idaho
Score: 46.92
Children and Teenagers Immunization Rates Rank: 38
Adult & Elderly Vaccination Rates Rank: 40
43. Tennessee
Score: 46.80
Children and Teenagers Immunization Rates Rank: 42
Adult & Elderly Vaccination Rates Rank: 43
44. Kentucky
Score: 45.93
Children and Teenagers Immunization Rates Rank: 45
Adult & Elderly Vaccination Rates Rank: 32
45. Nevada
Score: 42.53
Children and Teenagers Immunization Rates Rank: 35
Adult & Elderly Vaccination Rates Rank: 49
46. Texas
Score: 37.95
Children and Teenagers Immunization Rates Rank: 47
Adult & Elderly Vaccination Rates Rank: 42
47. Wyoming
Score: 37.79
Children and Teenagers Immunization Rates Rank: 48
Adult & Elderly Vaccination Rates Rank: 44
48. Alaska
Score: 35.15
Children and Teenagers Immunization Rates Rank: 49
Adult & Elderly Vaccination Rates Rank: 34
49. Alabama
Score: 34.43
Children and Teenagers Immunization Rates Rank: 43
Adult & Elderly Vaccination Rates Rank: 50
50. Oklahoma
Score: 34.18
Children and Teenagers Immunization Rates Rank: 50
Adult & Elderly Vaccination Rates Rank: 38
51. Mississippi
Score: 17.54
Children and Teenagers Immunization Rates Rank: 51
Adult & Elderly Vaccination Rates Rank: 51
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Tristin Hoffman is a Life Fellow on Business Insider’s Editorial Partnerships team. Her reporting focuses on retail, travel, business, and more through a visual storytelling and lifestyle lens. She has previously reported on Oregon’s economy for The Oregonian and Pennsylvania litigation for Law.com. Her stories have inspired policy changes, shed light on public officials’ misconduct, and gained national awards. She graduated from the University of Oregon, where she studied journalism and law while serving as editor-in-chief of The Daily Emerald.
