The world before vaccines was vastly different than today. Children — and adults — regularly contracted serious infectious diseases that up until recently have been but a distant memory. The paralytic disease polio has all but been eradicated in the United States by the 1980s, as were several other vaccine-preventable diseases. In fact, one of the most terrible diseases in history – smallpox – no longer exists outside the laboratory. Unfortunately, some of these diseases are now making a comeback due to lower immunization rates.

Several infection-preventing vaccines are widely available in the United States, including for some of the most aggressive contagions that are particularly harmful to children, the elderly, and people with auto-immune deficiencies.

In recent years, public health efforts to vaccinate children and protect them from such diseases as measles, mumps, and whooping cough have been undermined by the recent rise of the anti-vaccine movement and the considerable pervasive misinformation about vaccines. This is the one almost sure sign you have measles.

Compared to other developed countries with the highest measles vaccination rates, the United States is not near the top and could clearly do better. On the other hand, these are the 25 countries where measles is a serious problem.

The effects of the spread of vaccine misinformation has been felt across the United States. The Centers for Disease Control and Prevention has identified 1,182 individual cases of measles so far this year, the highest number since the virus had been declared eradicated from the country in 2000. The reappearance of measles since then is particularly disturbing — it is among a handful of infections that doctors fear most, along with viral pneumonia, meningitis, and influenza. 

In January, Washington Gov. Jay Inslee declared a public health emergency after health officials identified an outbreak of measles. Most of the infected individuals were under the age of 10 and none had received the standard MMR (measles, mumps, and rubella) vaccination that is typically administered twice within the first 15 months from birth. This was not an isolated incident. The CDC says measles outbreaks have occurred in 30 states so far this year.

Most U.S. states require childhood vaccinations before children can enter the public school system, but they also allow exemptions for parents based on religious or philosophical beliefs. New York – where more than 75% of this year’s measles cases are linked to – became the fifth state along with California, Maine, West Virginia, and Mississippi, in eliminating these belief-based exemptions.

Click here to see the states with the highest and lowest vaccination rates

To identify the states with the highest and lowest vaccination rates, 24/7 Wall St. reviewed vaccine data from the Centers for Disease Control and Prevention (CDC). The data included the percentage of vaccination coverage for the combined 7-vaccine series among children aged 19-35 months in each state in 2016. Vaccination rates for selected diseases by race and poverty level came from the CDC for 2017. U.S. adolescent vaccination coverage for the years 2008-2016 and Influenza vaccination rates among adults in the United States also came from the CDC and are for 2017. Social and economic factors, including health insurance coverage, household income, and educational attainment came from the U.S. Census Bureau’s 2017 1-year American Community Survey (ACS). Annual state unemployment data came from the Bureau of Labor Statistics (BLS) and is for 2018.