Health Insurance
National Flu Vaccination Rate Drops Across Every Age Group — Here Are the Numbers
As flu season draws near again, are Americans rolling up their sleeves? If prior vaccination rates are any indication, then yes — in fact, 51.4% of Americans received a flu shot during the 2021-22 flu season. However, that’s a slight decrease from the 52.1% who received a vaccine during the 2020-21 flu season.
In this study, we’ll go over which states had the highest vaccination rates during the 2021-22 flu season and which ones saw the biggest year-over-year drop. And while the flu shot is free for those with health insurance, stick around for some tips on reducing flu shot costs among the uninsured.
On this page
- Key findings
- Half of Americans got a flu shot during the 2021-22 flu season
- New England dominates top states with highest vaccination rates
- 16 states saw vaccination rates rise between 2020-21 and 2021-22
- Vaccine rates vary by age group — here’s how they’ve changed
- Getting jabbed without health insurance: Expert tips on cost reduction
- Methodology
Key findings
- More than half of Americans 6 months and older received a flu vaccine during the 2021-22 influenza season. 51.4% of Americans received the vaccine — down 1.3% from the 52.1% who received a vaccine during the 2020-21 flu season.
- New England states most commonly have the highest flu vaccination rates. 66.1% of Rhode Island residents received the flu vaccine during the 2021-22 season. While the District of Columbia in the South is second at 63.7%, other New England states — Connecticut (63.0%), Massachusetts (62.9%) and New Hampshire (62.1%) — occupy the rest of the top five.
- Mississippi, which had the biggest year-over-year drop, has the lowest flu vaccination rate. In this Southern state, just 38.2% of residents got jabbed during the 2021-22 flu season. Wyoming (41.2%) and Nevada (42.0%) are the other states with the lowest vaccination rates.
- Flu vaccination rates rose in just 16 states between the 2020-21 and 2021-22 flu seasons. The biggest jumps were in the District of Columbia (9.3%) and Alaska and Georgia (both 7.9%). Meanwhile, the states with the biggest decreases were Mississippi (9.3%), Illinois (8.8%) and Arizona (8.7%).
- Vaccination rates fell among all age groups. During the 2021-22 flu season, those 65 and older had the highest vaccination rate at 73.9% — a dip from 75.2% in 2020-21. Meanwhile, children younger than 5 have the second-highest vaccination rate at 66.7%, down from 68.0% during the previous flu season.
Half of Americans got a flu shot during the 2021-22 flu season
During the 2021-22 flu season, 51.4% of Americans received the vaccine — down 1.3% from the 52.1% who received a vaccine during the 2020-21 flu season.
When is the flu season? While flu season varies by year, it usually occurs in the fall and winter. More specifically, flu activity typically peaks between December and February. However, both the 2020-21 and 2021-22 flu seasons were unusual compared to normal flu activity. They were as follows:
- The 2020-21 flu season occurred between Sept. 27, 2020, and May 22, 2021, with no discernible peak in activity.
- The 2021-22 flu season occurred between Oct. 3, 2021, and Oct. 1, 2022, peaking once in late December 2021 and again in April 2022.
Although there was a small drop in flu vaccination rates, it’s worth noting that flu circulation was uncharacteristically low during the 2020-21 season — in fact, it had the lowest recorded rate of flu-related hospitalizations since flu data collection began in 2005. That’s probably because of precautions most Americans took against COVID-19 during that time, such as masking, staying home, hand-washing and limiting travel.
A low rate of Americans caught the flu, and a record number of flu vaccine doses were distributed in the U.S. during the 2020-21 season. That’s likely because many Americans were fearful of respiratory illnesses during the COVID-19 pandemic and taking more precautions than before. As these fears faded, many Americans probably didn’t feel as much of a need to prioritize flu vaccinations. Additionally, because the flu didn’t pose much of a risk during 2020-21, it’s likely many Americans didn’t feel the need to vaccinate during the 2021-22 flu season.
Despite this drop, the flu vaccination rate is still up 20% since the 2010-11 flu season, when the vaccination rate was just 43.0%. That signifies an overall positive trend.
Flu vaccination rates by season
Flu season | Vaccination rate |
|---|---|
| 2010-11 | 43.0% |
| 2011-12 | 41.8% |
| 2012-13 | 45.0% |
| 2013-14 | 46.2% |
| 2014-15 | 47.1% |
| 2015-16 | 45.6% |
| 2016-17 | 46.8% |
| 2017-18 | 41.7% |
| 2018-19 | 49.2% |
| 2019-20 | 51.8% |
| 2020-21 | 52.1% |
| 2021-22 | 51.4% |
Source: ValuePenguin analysis of Centers for Disease Control and Prevention (CDC) data.
Even so, ValuePenguin health insurance expert Divya Sangameshwar says it’s crucial Americans continue to vaccinate against the flu.
"The flu can be a serious disease that can lead to hospitalization or even death," she says. "In fact, hundreds of thousands of people are hospitalized and thousands of people die from flu-related causes every year. Unlike many other vaccines, which we may take once or twice in our lifetime, the CDC recommends that we get the flu vaccine annually because the influenza virus is constantly mutating. Every year, the flu vaccine is tweaked to offer protection against the strains of influenza most likely to occur that year."
Generally, the CDC recommends getting vaccinated during September or October — and even if you don’t receive your vaccine in this period, it recommends getting one at any point during the flu season.
New England dominates top states with highest vaccination rates
When it comes to those most likely to get the flu shot, look to the Northeast. More specifically, Rhode Island tops the list, with 66.1% of residents receiving the jab during the 2021-22 season.
Beyond that, fellow New England states Connecticut (63.0%), Massachusetts (62.9%) and New Hampshire (62.1%) are also among the top five. Just one state outside of New England — the District of Columbia — makes the list. In this Southern district, 63.7% of residents got the flu vaccine — ranking it second. (Note: While there’s some debate on whether D.C. is in the Northeast, we follow Census Bureau designations.)
10 states with the highest flu vaccination rates
Rank | State | 2021-22 vaccination rate |
|---|---|---|
| 1 | Rhode Island | 66.1% |
| 2 | District of Columbia | 63.7% |
| 3 | Connecticut | 63.0% |
| 4 | Massachusetts | 62.9% |
| 5 | New Hampshire | 62.1% |
| 6 | Maryland | 61.9% |
| 7 | Vermont | 60.9% |
| 8 | New Jersey | 59.3% |
| 9 | Maine | 58.5% |
| 10 | Minnesota | 57.7% |
Source: ValuePenguin analysis of CDC data.
Insurance rates may play a role in these rankings. A ValuePenguin study on uninsured rates shows Rhode Island had the lowest rate of Americans without health insurance: As of 2022, just 2.4% of Rhode Island residents were uninsured. Four other states with the highest vaccination rates are also among the 10 states with the lowest uninsured rates:
- Vermont ranked second, with an uninsured rate of 3.3%.
- The District of Columbia ranked third, with an uninsured rate of 3.8%.
- Massachusetts ranked sixth, with an uninsured rate of 4.3%.
- Connecticut ranked seventh, with an uninsured rate of 4.7%.
New Hampshire was the only exception here. With 6.8% of its residents uninsured, it fell in the middle of the rankings.
Access to health care could also play a role. In another ValuePenguin study on primary care providers (PCPs), the District of Columbia had the most PCPs per capita, at 464.1 PCPs per 100,000 residents. Following that, five of the 10 states with the highest vaccination rates are also among the 10 states with the most PCPs.
On the other end of the list, Mississippi has the lowest flu vaccination rate, with just 38.2% of residents receiving a shot during the 2021-22 flu season. Wyoming (41.2%) and Nevada (42.0%) follow.
10 states with the lowest flu vaccination rates
Rank | State | 2021-22 vaccination rate |
|---|---|---|
| 1 | Mississippi | 38.2% |
| 2 | Wyoming | 41.2% |
| 3 | Nevada | 42.0% |
| 4 | Idaho | 42.3% |
| 4 | Florida | 42.3% |
| 6 | Oklahoma | 42.9% |
| 7 | Louisiana | 43.1% |
| 8 | Arizona | 44.1% |
| 9 | Montana | 46.3% |
| 10 | Georgia | 46.5% |
Source: ValuePenguin analysis of CDC data.
In contrast with the highly immunized states, those with the lowest flu vaccination rates are among the states with the highest rates of uninsured residents. Mississippi tops the list here — as of 2022, 14.4% of its residents were uninsured. Both Wyoming and Nevada also made the top 10 list:
- Wyoming ranked fifth, with an uninsured rate of 10.6%.
- Nevada ranked sixth, with an uninsured rate of 10.5%.
In total, seven of the 10 states with the lowest vaccination rates are among the 10 states with the highest uninsured rates.
It’s also worth noting that the District of Columbia had the biggest year-over-year rise in vaccination rates, while Mississippi had the biggest year-over-year drop — and there’s more information about changes in vaccination rates below.
Full rankings
States with the highest flu vaccination rates
Rank | State | 2021-22 vaccination rate |
|---|---|---|
| 1 | Rhode Island | 66.1% |
| 2 | District of Columbia | 63.7% |
| 3 | Connecticut | 63.0% |
| 4 | Massachusetts | 62.9% |
| 5 | New Hampshire | 62.1% |
| 6 | Maryland | 61.9% |
| 7 | Vermont | 60.9% |
| 8 | New Jersey | 59.3% |
| 9 | Maine | 58.5% |
| 10 | Minnesota | 57.7% |
| 11 | Colorado | 57.5% |
| 12 | Washington | 55.9% |
Source: ValuePenguin analysis of CDC data.
16 states saw vaccination rates rise between 2020-21 and 2021-22
Although the overall vaccine rate dropped slightly between the 2020-21 and 2021-22 flu seasons, vaccination rates rose in 16 states. The District of Columbia saw the biggest jump, rising from 58.3% to 63.7% — a 9.3% increase.
Alaska and Georgia tied for second, with vaccination rates rising by 7.9% for both. In Alaska, the vaccination rate rose from 45.4% to 49.0%. Meanwhile, in Georgia, the vaccination rate rose from 43.1% to 46.5%.
In all three states, health insurance rates jumped significantly between 2020 and 2022, which could account for the rise in vaccination rates. According to the prior ValuePenguin study on uninsured rates, the rate of uninsured residents in the District of Columbia dropped from 6.5% in 2020 to 3.8% in 2022 — a 41.5% decrease. Here’s how Alaska and Georgia stack up:
- In Alaska, the rate of uninsured residents dropped from 14.3% to 7.8% — a 45.5% decrease.
- In Georgia, the rate of uninsured residents dropped from 16.4% to 12.0% — a 26.8% decrease.
10 states with the biggest jumps in vaccination rates
Rank | State | 2020-21 vaccination rate | 2021-22 vaccination rate | % change |
|---|---|---|---|---|
| 1 | District of Columbia | 58.3% | 63.7% | 9.3% |
| 2 | Alaska | 45.4% | 49.0% | 7.9% |
| 2 | Georgia | 43.1% | 46.5% | 7.9% |
| 4 | New Jersey | 55.2% | 59.3% | 7.4% |
| 5 | Maryland | 58.5% | 61.9% | 5.8% |
| 6 | Kentucky | 46.7% | 48.5% | 3.9% |
| 7 | Colorado | 55.4% | 57.5% | 3.8% |
| 8 | Maine | 56.4% | 58.5% | 3.7% |
| 8 | Michigan | 53.7% | 55.7% | 3.7% |
| 10 | New Hampshire | 60.7% | 62.1% | 2.3% |
Source: ValuePenguin analysis of CDC data.
On the other hand, Mississippi saw the biggest decrease in flu vaccination rates, dropping from 42.1% to 38.2% — a 9.3% decrease. Illinois followed, with vaccination rates falling from 56.9% to 51.9% (an 8.8% drop). Arizona rounds out the top three — here, vaccination rates fell from 48.3% to 44.1% (an 8.7% drop).
Full rankings
States with the biggest jumps in vaccination rates
Rank | State | 2020-21 vaccination rate | 2021-22 vaccination rate | % change |
|---|---|---|---|---|
| 1 | District of Columbia | 58.3% | 63.7% | 9.3% |
| 2 | Alaska | 45.4% | 49.0% | 7.9% |
| 2 | Georgia | 43.1% | 46.5% | 7.9% |
| 4 | New Jersey | 55.2% | 59.3% | 7.4% |
| 5 | Maryland | 58.5% | 61.9% | 5.8% |
| 6 | Kentucky | 46.7% | 48.5% | 3.9% |
| 7 | Colorado | 55.4% | 57.5% | 3.8% |
| 8 | Maine | 56.4% | 58.5% | 3.7% |
| 8 | Michigan | 53.7% | 55.7% | 3.7% |
| 10 | New Hampshire | 60.7% | 62.1% | 2.3% |
| 11 | Vermont | 59.9% | 60.9% | 1.7% |
| 12 | Florida | 41.7% | 42.3% | 1.4% |
Source: ValuePenguin analysis of CDC data.
Vaccine rates vary by age group — here’s how they’ve changed
By age group, vaccination rates also changed — though they followed a similar trend seen among the national rates. During both the 2020-21 and 2021-22 flu seasons, those 65 and older had the highest vaccination rate. While the rate was 75.2% during the 2020-21 flu season, it dropped slightly to 73.9% during the 2021-22 flu season.
Following that, children younger than 5 have the second-highest vaccination rate. During the 2021-22 flu season, 66.7% of children in this age group received the vaccine. The flu shot rate also dropped among this group, falling from 68.0% during the previous flu season.
Flu vaccination rates by age group
Age group | 2020-21 flu season | 2021-22 flu season |
|---|---|---|
| 6 months and younger | 52.1% | 51.4% |
| 6 months to 17 | 58.6% | 57.8% |
| 6 months to 4 | 68.0% | 66.7% |
| 5 to 12 | 59.0% | 58.4% |
| 13 to 17 | 50.8% | 49.8% |
| 18 and older | 50.2% | 49.4% |
| 18 to 49 | 37.7% | 37.1% |
| 18 to 64 | 43.0% | 42.0% |
| 50 to 64 | 54.2% | 52.4% |
| 65 and older | 75.2% | 73.9% |
Source: ValuePenguin analysis of CDC data. Note: Some age groups overlap.
Where are most Americans getting immunized? Overall, 38.5% of adults ages 18 and older received their flu vaccinations at a pharmacy or store in the 2021-22 season, while 34.3% received theirs at a doctor's office. Unsurprisingly, most children (66.5%) ages 17 and younger receive their vaccine at a doctor's office.
Where Americans receive their flu shots
Place of vaccination | % of adults | % of children |
|---|---|---|
| Doctor's office/HMO | 34.3% | 66.5% |
| Hospital/ER | 5.5% | 3.4% |
| Health center/other clinic | 6.9% | 10.2% |
| Health department | 2.1% | 1.2% |
| Pharmacy/store | 38.5% | 14.5% |
| Workplace | 8.3% | N/A |
| Senior/recreation/community center | 0.7% | N/A |
| School | 1.1% | 2.5% |
| Other place | 2.7% | 1.7% |
Source: ValuePenguin analysis of CDC data.
Getting jabbed without health insurance: Expert tips on cost reduction
If anything, COVID-19 proved that respiratory illnesses are no joke — and taking precautions is incredibly important. For example, the CDC finds that Mississippi (which falls at the bottom of our vaccination rankings) regularly ranks as the state with the most flu- and pneumonia-related deaths.
The good news, Sangameshwar says, is that the annual flu shot itself is free for those who have medical insurance, Medicare or Medicaid. "The shots are also widely available," she says. "Everyone from your primary care doctor, urgent care clinics, pharmacies and even grocery stores or wholesale clubs offer flu shots. And, in many cases, you can just walk in to get your shot with a very short wait involved."
For those who don’t have insurance, a flu shot typically costs between $25 and $110. Sangameshwar says that you can also look for flu vaccine discount vouchers or shop around local pharmacies to find the lowest-cost option. However, even those who don’t have insurance may be able to get the shot for free.
"Many local governments, employers, religious organizations and community organizations run flu clinics where they offer free vaccines," she says. "A child younger than 19 can also qualify for a free flu shot from the CDC’s Vaccines for Children (VFC) Program."
Finally, it’s worth remembering that the COVID-19 pandemic has impacted the flu season in ways we still don’t fully understand. The 2020-21 flu season was uncharacteristically short, and the 2021-22 season had a second peak in April, which is later than in pre-pandemic flu seasons. As we continue to navigate post-pandemic flu seasons, it’s crucial to stay up-to-date on the latest vaccines and follow CDC recommendations.
Methodology
ValuePenguin analysts used Centers for Disease Control and Prevention (CDC) seasonal influenza vaccination rate data from the 2010-11 through 2021-22 seasons. While flu season varies by year, it usually occurs in the fall and winter. The flu seasons in our analysis were defined as follows:
- The 2020-21 flu season occurred between Sept. 27, 2020, and May 22, 2021, with no discernible peak in activity.
- The 2021-22 flu season occurred between Oct. 3, 2021, and Oct. 1, 2022, peaking once in late December 2021 and again in April 2022.
ValuePenguin analysts compared 2020-21 and 2021-22 flu season data to calculate the year-over-year percentage change in vaccination rates at the state level and by age group.