Mapped: US Vaccination Rates for MMR, DTaP, and Varicella

Shots, doses, and boosters are common topics of conversation these days. We may think primarily of the COVID vaccine, though that is simply the latest to be recommended through the United States. We can look to other public health vaccines to better understand what places tend to get vaccinated… and which abstain.

It was December 31, 2019 when the world saw the first cases of the latest novel coronavirus. The New Year was only a month old when the World Health Organization declared a global health emergency. COVID-19 took over headlines and hospitals worldwide throughout 2020, leaving devastating consequences in its wake.

However, scientists rapidly developed a COVID-19 vaccine. As doses rolled out, the United States wondered about compliance. How many would voluntarily receive the vaccine? While these numbers are still changing daily, we can look back at older vaccines to see which states, territories, and associated states are likely to be the most compliant. We’ll also be able to identify the parts of the country with less than ideal compliance, as shown on the map below.

View MMR, DTaP, and Varicella US Vaccination Rates in a full screen map

The map contains the CDC’s estimated vaccination coverage for MMR, DTaP, and varicella vaccines among U.S. kindergarteners from 2017–18. You can sort the map by each vaccine’s percentages or use multi-column grouping and filtering to view multiple vaccines’ top or bottom rates altogether. Then read on for more information.

States With Highest Vaccine Compliance

West Virginia often appears in the news for exceptional vaccine rates. But it’s not the only (or even the best!) state, U.S. territory, or other associated states with high compliance among three vaccines: MMR, DTaP, and Varicella.

Measles, Mumps, & Rubella Rates

Doctors recommend two doses of the vaccine for measles, mumps, and rubella (MMR) for best protection. The first is generally given to children between 9-15 months, with a second dose at 15 months-6 years, meaning most children should be vaccinated by the time they enter kindergarten.

A median rate of 94.3% of US kindergarteners received the vaccine, indicating some places have better MMR vaccine compliance than others. Acknowledging the CDC didn’t have MMR data for Wyoming, Puerto Rico, or the U.S. Virgin Islands, below are the locations at or above 96.7% compliance.

State Kindergarten population % surveyed MMR 2 doses (%)
Palau 313 100 100
Mississippi 39,284 100 99.4
Maryland 68,528 98.9 98.6
West Virginia 19,519 77.5 98.4
New York 226,456 100 97.2
North Carolina 127,197 95 97
California 574,702 98.2 96.9
Tennessee 78,743 100 96.9
Texas 387,981 97.4 96.9
Pennsylvania 141,571 87.1 96.7
Delaware 10,988 9.6 96.7

Palau is an island country located east of the Philippines. The U.S. is responsible for the country’s defense until 2044, making it the only territory or associated state to make it in the top best, and the only U.S. location with a perfect MMR injection rate. Of course, these rates are samples. There’s likely someone in Palau who is not vaccinated, but the CDC doesn’t ask every single person.

Of the contiguous U.S., Mississippi has the best (and near-perfect) 99.4% rate of the MMR vaccination—and it’s not alone in the Southeast. West Virginia has a similarly high rate of compliance along with North Carolina and Tennessee. In the Southwest, Texas alone has high rates.

While Texas, Tennessee, and West Virginia, and other Southern states typically face many health struggles (as discovered in the Worst Statistic About Your State On a Map), it’s clear they excel at vaccinations. West Virginia and Mississippi have a logical reason—they’re the only two states in the U.S. that do not allow religious or philosophical exemptions for vaccines.

Up in the Northeast, Maryland touts the second-best MMR vaccination rate of U.S. states and the third-highest overall. Within the same region, New York, Pennsylvania, and Delaware also have rates far above other states. As only California represents the other side of the country, there’s not much about the West to discuss. Now let’s move on to rates of the multi-dose DTaP vaccine.

States Down with DTaP

With the DTaP or diphtheria and tetanus toxoids and acellular pertussis vaccine, four or five doses are required. Even with the hassle of the additional doses, DTaP compliance looks nearly identical to that of the MMR vaccine, as you’ll see below.

State Kindergarten population % surveyed DTaP 4 or 5 doses (%)
Palau 313 100 100
Mississippi 39,284 100 99.4
Maryland 68,528 98.9 99
Virginia** 100,581 4.2 98.2
West Virginia 19,519 77.5 98
Louisiana** 58,277 100 97.7
Pennsylvania 141,571 87.1 97
New York 226,456 100 96.9
Delaware 10,988 9.6 96.9
North Carolina 127,197 95 96.8
Texas 387,981 97.4 96.8

The island of Palau’s rate remains the same as its MMR rate: 100%. Plus, note the familiar states of Mississippi, Maryland, West Virginia, Pennsylvania, New York, Delaware, North Carolina, and Texas. These highly compliant states are newly joined by Virginia and Louisiana with notably high DTaP vaccine rates.

While Tennessee was included in the MMR list, The Volunteer State nearly missed the cutoff for the highest DTaP rates (it’s #12). Now let’s transition to the last vaccine we can compare: Varicella.

Varicella Vaccine

The varicella vaccine is a two-dose immunization that protects recipients from the highly contagious chickenpox. Aside from the Northern Mariana Islands, the vaccine is not required in most U.S. territories or associated states (American Samoa, Federated States of Micronesia, Guam, Marshall Islands, and Palau). The same goes for several U.S. states including Alabama, Arizona, California, Hawaii, Maine, New Jersey, Oklahoma, and Oregon.

Keeping that in mind, below are the states with the highest varicella compliance.

State Kindergarten population % surveyed Varicella 2 doses (%)
Mississippi 39,284 100 99.4
Maryland 68,528 98.9 98.6
West Virginia 19,519 77.5 98.1
Pennsylvania 141,571 87.1 97
New York 226,456 100 96.9
Tennessee 78,743 100 96.8
North Carolina 127,197 95 96.8
Delaware 10,988 9.6 96.7
Texas 387,981 97.4 96.4
Connecticut 39,174 100 96.3

With Palau Island out of the equation, Mississippi takes the lead, though the state is just short of 100% compliance. Once again, there aren’t many new players when compared to the MMR or DTaP’s top states. In fact, there’s only one new addition, Connecticut. Now let’s take a look in the opposite direction: states with the lowest injection rates.

Lowest Complying States

As the anti-vaccination notion spreads across the country, vaccine compliance has gone down. While many states allow religious or philosophical vaccination exemptions, below are the 10 states with the lowest calculated average of all four immunizations.

  • District of Columbia (80.5)
  • Marshall Islands (82.15)
  • Federated States of Micronesia (84.9)
  • American Samoa (86.35)
  • Northern Mariana Islands (87)
  • Colorado (88.33)
  • Guam (88.5)
  • Kansas (88.96)
  • Idaho (89.13)
  • Washington (90.23)

Perhaps most surprising is that the nation’s capital has the absolute worst vaccination compliance rate in the entire U.S. (and territories plus associated states). We hope our Senators don’t get chickenpox while working in D.C.!

You can view the rest of the places on the lower end of compliance for all the vaccines when you add multiple groups and values to your filter, explained below.

Group & Filter By Multiple Columns

What could be better than filtering your maps by one spreadsheet column? Filtering by two or more, simultaneously. We explain the easy way you can do so for all of your maps in our post on the subject, Multi-Column Grouping and Filtering. A preview: it involves adding additional values at the bottom of your map. The filter increases as you add more values and you can also include values from different groups via the drop-down on the bottom left. Be sure to implement this in your next map with the help BatchGeo.