Wide Variations in Flu Vaccination Rates Across States Highlight Challenges as State and Local Authorities Plan to Distribute a COVID-19 Vaccine

If a COVID-19 vaccine becomes available, all or most of the people living in the country will need to be vaccinated to maximize its benefits and maintain adequate immunity nationwide.

This could pose a daunting challenge to state and local health officials as a new KFF analysis shows that vaccination rates for the annual flu vaccine vary widely across states, as well as by race and ethnicity, age, and other demographics.

The flu vaccine provides a good model for understanding how quickly and comprehensively a new vaccine can be distributed and administered across the country. It has been recommended for everyone over 6 months of age for the past decade and is available free of charge to both insured persons and uninsured children under the Vaccines for Children program under the Affordable Care Act.

Even so, the analysis found that just over half (52%) of the population received the recommended vaccine during last year's flu season, well below the federal government's target vaccination rate of 70%. In all states, Rhode Island had the highest (61%) and Nevada the lowest (44%) vaccination rates for seasonal flu.

Further results are:

• In most states, black and Spanish people had lower flu vaccination rates compared to their white counterparts, but these differences were different between states.
• Immunization rates were highest for seniors and significantly lower for other adults in all states. The vaccination rates for children are generally in the middle.
• In all states, adults with underlying health conditions that could put them at increased risk of developing serious illness from COVID-19 generally had higher flu vaccination rates than other adults.

The analysis highlights factors that may contribute to the variability in flu vaccination rates across states and could result in similar variability for any future COVID-19 vaccine. These include lower insurance coverage rates, especially for people of color; the lack of special vaccination programs for uninsured adults; whether and for whom states prescribe vaccinations; Differences in funding and public health infrastructure; and different concerns or misconceptions about vaccine safety, side effects, and effectiveness.