US States Ranked Lowest on 9 Essential Vaccination Indicators

Immunization coverage varies dramatically nationwide, creating significant health disparities between regions. Although certain states maintain consistently robust vaccination programs, others face persistent challenges that expose their populations to heightened risks of vaccine-preventable disease outbreaks. WalletHub's comprehensive 2025 state-by-state evaluation examined vaccination performance across all 50 states plus Washington, DC, analyzing 16 distinct immunization indicators that were grouped into 3 key areas: immunization rates among kids and teenagers; adult and elderly vaccination rates; and uptake disparities and influencing factors. The metrics evaluated range from coverage rates for various diseases to the share of people without insurance.

Key Patterns Revealed

States exhibiting the lowest immunization rates typically struggle with inadequate public health infrastructure, substantial uninsured populations, and cultural or regulatory barriers to vaccination acceptance.

The Southeast emerges as a particular concern, with Mississippi, Alabama, and Georgia appearing among the worst performers nationally.

These WalletHub results underscore the significant obstacles facing public health officials working to protect vulnerable communities in underperforming regions. Suboptimal vaccination coverage elevates outbreak probability, intensifies emergency healthcare utilization, and compounds pressure on already overburdened medical systems.

The analysis further demonstrates how policy frameworks, healthcare accessibility, and community perspectives continue shaping population health outcomes.