Before the coronavirus pandemic, vaccines rarely dominated the news as much as COVID-19 vaccines have recently. Though some oppose the COVID-19 vaccine mandates, it’s been over 100 years since states began to require immunizations for certain populations, most often school children. Childhood vaccines have saved countless lives and protected children for over a century.
To identify the states with the highest and lowest vaccination rates, 24/7 Tempo reviewed vaccine data from the Centers for Disease Control and Prevention. The data includes the percentage of vaccination coverage for the combined 7-vaccine series among children up to kindergarten age in each state for the 2019-2020 school year. The series includes several vaccines that protect against such diseases as measles, pertussis, hepatitis B, and polio.
A little over 95% of kindergarteners and children entering child care during the 2019-2020 school year were up to date with required and strongly encouraged vaccinations. This is higher than in previous years but a jump in measles cases in 2019 resulted in immunizations soaring. The average vaccination rate varies from more than 98% in some states to less than 87% in others.
Before vaccines, children — and adults — regularly contracted serious infectious diseases that are now a distant memory. The paralytic disease polio was eradicated in the U.S. by 1979, and one of the most terrible diseases in history — smallpox — no longer exists outside the laboratory.
Several vaccines are widely available in the United States, including against some of the most aggressive contagions that are particularly dangerous to children such as measles. Measles was a serious cause of concern in the U.S. and Europe in 2019 as several cases were detected, mostly among the unvaccinated. These are the 20 worst epidemics and pandemics in history.
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.
Click here for the states with the highest and lowest non-COVID 19 vaccination rates
Click here for our detailed methodology
Source: Kruck20 / Getty Images
48. Alabama
> Child vaccination rate: 86.6%
> Total exemptions: 713
> Population under 5 years: 286,597 (or 5.8% — 22nd lowest)
> Population with no health insurance: 9.7% — 17th highest
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Source: Art Wager / Getty Images
47. Hawaii
> Child vaccination rate: 86.8%
> Total exemptions: 943
> Population under 5 years: 85,335 (or 6.0% — 17th highest)
> Population with no health insurance: 4.2% — 3rd lowest
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Source: mattalberts / Getty Images
46. Idaho
> Child vaccination rate: 89.4%
> Total exemptions: 1,764
> Population under 5 years: 115,837 (or 6.5% — 7th highest)
> Population with no health insurance: 10.8% — 12th highest
Source: Creative-Family / Getty Images
45. Colorado
> Child vaccination rate: 91.5%
> Total exemptions: 3,376
> Population under 5 years: 327,302 (or 5.7% — 16th lowest)
> Population with no health insurance: 8.0% — 25th lowest
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Source: DenisTangneyJr / Getty Images
44. New Hampshire
> Child vaccination rate: 91.5%
> Total exemptions: 389
> Population under 5 years: 64,200 (or 4.7% — 3rd lowest)
> Population with no health insurance: 6.3% — 13th lowest
Source: Sean Pavone / Getty Images
43. Indiana
> Child vaccination rate: 91.8%
> Total exemptions: 1,901
> Population under 5 years: 414,553 (or 6.2% — 12th highest)
> Population with no health insurance: 8.7% — 22nd highest
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Source: Davel5957 / Getty Images
42. Kansas
> Child vaccination rate: 91.9%
> Total exemptions: 805
> Population under 5 years: 183,236 (or 6.3% — 10th highest)
> Population with no health insurance: 9.2% — 19th highest
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Source: collins_family / Flickr
41. Wyoming
> Child vaccination rate: 92.5%
> Total exemptions: 280
> Population under 5 years: 33,098 (or 5.7% — 19th lowest)
> Population with no health insurance: 12.3% — 6th highest
Source: johnnya123 / Getty Images
40. Utah
> Child vaccination rate: 92.8%
> Total exemptions: 2,639
> Population under 5 years: 245,883 (or 7.7% — the highest)
> Population with no health insurance: 9.7% — 18th highest
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Source: Davel5957 / Getty Images
39. Ohio
> Child vaccination rate: 92.8%
> Total exemptions: 3,921
> Population under 5 years: 686,672 (or 5.9% — 25th lowest)
> Population with no health insurance: 6.6% — 16th lowest
Source: culbertson / Getty Images
38. Minnesota
> Child vaccination rate: 93.0%
> Total exemptions: 2,699
> Population under 5 years: 349,621 (or 6.2% — 11th highest)
> Population with no health insurance: 4.9% — 5th lowest
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Source: 4nadia / Getty Images
37. Oregon
> Child vaccination rate: 93.0%
> Total exemptions: 3,265
> Population under 5 years: 223,364 (or 5.3% — 9th lowest)
> Population with no health insurance: 7.2% — 20th lowest
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Source: Sean Pavone / Getty Images
36. Georgia
> Child vaccination rate: 93.1%
> Total exemptions: 3,899
> Population under 5 years: 639,713 (or 6.0% — 18th highest)
> Population with no health insurance: 13.4% — 3rd highest
Source: Dreamframer / Getty Images
35. Arizona
> Child vaccination rate: 93.2%
> Total exemptions: 4,638
> Population under 5 years: 427,707 (or 5.9% — 25th highest)
> Population with no health insurance: 11.3% — 9th highest
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Source: pabradyphoto / Getty Images
34. Iowa
> Child vaccination rate: 93.2%
> Total exemptions: 1,004
> Population under 5 years: 190,606 (or 6.0% — 15th highest)
> Population with no health insurance: 5.0% — 6th lowest
Source: Davel5957 / Getty Images
33. Kentucky
> Child vaccination rate: 93.3%
> Total exemptions: 1,082
> Population under 5 years: 273,130 (or 6.1% — 13th highest)
> Population with no health insurance: 6.4% — 14th lowest
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32. Washington
> Child vaccination rate: 93.4%
> Total exemptions: 5,005
> Population under 5 years: 455,283 (or 6.0% — 21st highest)
> Population with no health insurance: 6.6% — 17th lowest
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Source: EJ-J / Getty Images
31. Montana
> Child vaccination rate: 93.5%
> Total exemptions: 535
> Population under 5 years: 58,850 (or 5.5% — 11th lowest)
> Population with no health insurance: 8.3% — 24th highest
Source: marchello74 / Getty Images
30. Florida
> Child vaccination rate: 93.5%
> Total exemptions: 7,758
> Population under 5 years: 1,131,148 (or 5.3% — 8th lowest)
> Population with no health insurance: 13.2% — 4th highest
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Source: chefranden / Flickr
29. Wisconsin
> Child vaccination rate: 93.7%
> Total exemptions: 3,861
> Population under 5 years: 327,258 (or 5.6% — 14th lowest)
> Population with no health insurance: 5.7% — 8th lowest
Source: DenisTangneyJr / Getty Images
28. Oklahoma
> Child vaccination rate: 94.0%
> Total exemptions: 1,468
> Population under 5 years: 251,083 (or 6.3% — 8th highest)
> Population with no health insurance: 14.3% — 2nd highest
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Source: SeanPavonePhoto / Getty Images
27. Maine
> Child vaccination rate: 94.1%
> Total exemptions: 795
> Population under 5 years: 62,813 (or 4.7% — 2nd lowest)
> Population with no health insurance: 8.0% — 25th highest
Source: Davel5957 / Getty Images
26. Arkansas
> Child vaccination rate: 94.2%
> Total exemptions: 769
> Population under 5 years: 183,327 (or 6.1% — 14th highest)
> Population with no health insurance: 9.1% — 20th highest
Source: SeanPavonePhoto / Getty Images
25. Virginia
> Child vaccination rate: 94.5%
> Total exemptions: 1,711
> Population under 5 years: 499,906 (or 5.9% — 23rd lowest)
> Population with no health insurance: 7.9% — 24th lowest
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Source: SeanPavonePhoto / Getty Images
24. Vermont
> Child vaccination rate: 94.5%
> Total exemptions: 232
> Population under 5 years: 29,021 (or 4.7% — the lowest)
> Population with no health insurance: 4.5% — 4th lowest
Source: f11photo / Getty Images
23. Missouri
> Child vaccination rate: 94.8%
> Total exemptions: 1,970
> Population under 5 years: 365,451 (or 6.0% — 23rd highest)
> Population with no health insurance: 10.0% — 15th highest
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Source: DenisTangneyJr / Getty Images
22. North Dakota
> Child vaccination rate: 94.9%
> Total exemptions: 413
> Population under 5 years: 50,567 (or 6.6% — 6th highest)
> Population with no health insurance: 6.9% — 19th lowest
Source: photoquest7 / Getty Images
21. Nevada
> Child vaccination rate: 95.0%
> Total exemptions: 1,492
> Population under 5 years: 184,168 (or 6.0% — 20th highest)
> Population with no health insurance: 11.4% — 8th highest
Source: pawel.gaul / Getty Images
20. Michigan
> Child vaccination rate: 95.1%
> Total exemptions: 5,320
> Population under 5 years: 567,914 (or 5.7% — 17th lowest)
> Population with no health insurance: 5.8% — 10th lowest
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Source: traveler1116 / Getty Images
19. South Carolina
> Child vaccination rate: 95.1%
> Total exemptions: 1,731
> Population under 5 years: 289,537 (or 5.6% — 15th lowest)
> Population with no health insurance: 10.8% — 11th highest
Source: SeanPavonePhoto / Getty Images
18. North Carolina
> Child vaccination rate: 95.7%
> Total exemptions: 2,161
> Population under 5 years: 596,583 (or 5.7% — 18th lowest)
> Population with no health insurance: 11.3% — 10th highest
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Source: EunikaSopotnicka / Getty Images
17. South Dakota
> Child vaccination rate: 95.7%
> Total exemptions: 337
> Population under 5 years: 58,859 (or 6.7% — 5th highest)
> Population with no health insurance: 10.2% — 13th highest
Source: SeanPavonePhoto / Getty Images
16. New Jersey
> Child vaccination rate: 95.9%
> Total exemptions: 2,776
> Population under 5 years: 511,925 (or 5.8% — 21st lowest)
> Population with no health insurance: 7.9% — 23rd lowest
Source: SeanPavonePhoto / Getty Images
15. Connecticut
> Child vaccination rate: 96.2%
> Total exemptions: 975
> Population under 5 years: 180,598 (or 5.1% — 4th lowest)
> Population with no health insurance: 5.9% — 11th lowest
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Source: marchello74 / Getty Images
14. Illinois
> Child vaccination rate: 96.5%
> Total exemptions: 2,894
> Population under 5 years: 742,404 (or 5.9% — 24th lowest)
> Population with no health insurance: 7.4% — 21st lowest
Source: SpVVK / Getty Images
13. California
> Child vaccination rate: 96.6%
> Total exemptions: 4,249
> Population under 5 years: 2,377,839 (or 6.0% — 19th highest)
> Population with no health insurance: 7.7% — 22nd lowest
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Source: Sean Pavone / Getty Images
12. Tennessee
> Child vaccination rate: 96.6%
> Total exemptions: 1,610
> Population under 5 years: 407,026 (or 6.0% — 22nd highest)
> Population with no health insurance: 10.1% — 14th highest
Source: f11photo / Getty Images
11. Pennsylvania
> Child vaccination rate: 96.7%
> Total exemptions: 4,137
> Population under 5 years: 695,661 (or 5.4% — 10th lowest)
> Population with no health insurance: 5.8% — 9th lowest
Source: Davel5957 / Getty Images
10. Nebraska
> Child vaccination rate: 96.7%
> Total exemptions: 591
> Population under 5 years: 129,551 (or 6.7% — 4th highest)
> Population with no health insurance: 8.3% — 23rd highest
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Source: f11photo / Getty Images
9. Louisiana
> Child vaccination rate: 96.8%
> Total exemptions: 884
> Population under 5 years: 292,977 (or 6.3% — 9th highest)
> Population with no health insurance: 8.9% — 21st highest
Source: Sean Pavone / Getty Images
8. Texas
> Child vaccination rate: 96.8%
> Total exemptions: 9,894
> Population under 5 years: 1,981,755 (or 6.8% — 3rd highest)
> Population with no health insurance: 18.4% — the highest
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Source: ferrantraite / Getty Images
7. New Mexico
> Child vaccination rate: 97.0%
> Total exemptions: 344
> Population under 5 years: 116,978 (or 5.6% — 13th lowest)
> Population with no health insurance: 10.0% — 16th highest
Source: SeanPavonePhoto / Getty Images
6. Massachusetts
> Child vaccination rate: 97.4%
> Total exemptions: 890
> Population under 5 years: 355,066 (or 5.2% — 6th lowest)
> Population with no health insurance: 3.0% — the lowest
Source: SeanPavonePhoto / Getty Images
5. Rhode Island
> Child vaccination rate: 97.6%
> Total exemptions: 141
> Population under 5 years: 54,802 (or 5.2% — 7th lowest)
> Population with no health insurance: 4.1% — 2nd lowest
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Source: SeanPavonePhoto / Getty Images
4. Maryland
> Child vaccination rate: 98.1%
> Total exemptions: 991
> Population under 5 years: 358,346 (or 5.9% — 24th highest)
> Population with no health insurance: 6.0% — 12th lowest
Source: Eloi_Omella / Getty Images
3. New York
> Child vaccination rate: 98.1%
> Total exemptions: 320
> Population under 5 years: 1,119,825 (or 5.8% — 20th lowest)
> Population with no health insurance: 5.2% — 7th lowest
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Source: benedek / Getty Images
2. West Virginia
> Child vaccination rate: 98.7%
> Total exemptions: 21
> Population under 5 years: 91,548 (or 5.1% — 5th lowest)
> Population with no health insurance: 6.7% — 18th lowest
Source: SeanPavonePhoto / Getty Images
1. Mississippi
> Child vaccination rate: 99.1%
> Total exemptions: 62
> Population under 5 years: 179,497 (or 6.0% — 16th highest)
> Population with no health insurance: 13.0% — 5th highest
Methodology
To identify the states with the highest and lowest vaccination rates, 24/7 Tempo reviewed vaccine data from the Centers for Disease Control and Prevention.
The data included the percentage of vaccination coverage for the combined 7-vaccine series — MMR (measles, mumps, and rubella); DTaP (diphtheria, pertussis, and tetanus); varicella (chickenpox); hepatitis B; Hib (Haemophilus influenzae type b); PCV (pneumococcal); and polio — among children aged 19-35 months old in each state in 2019-2020. Vaccination data for Alaska and Delawere were not available.
Population data and health insurance coverage are one-year estimates from the U.S. Census Bureau’s 2019 American Community Survey.
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