More to read: The 10 least vaccinated states in 2026
Exemptions from at least one required vaccine reached 4.2% of American kindergartners in the 2025-2026 school year, up from 3.6% the year before, and coverage slipped for every vaccine the CDC tracks. About 155,000 children now hold an exemption. Another 280,000 started school with no record of finishing the two-dose measles, mumps and rubella series.
WalletHub scored the 50 states and Washington, D.C., on 16 vaccination metrics grouped into three weighted dimensions: immunization rates among children and teenagers, vaccination rates among adults and older adults, and the disparities and access factors that shape uptake.
Each metric was graded on a 100-point scale. The data were collected as of Aug. 12, 2026, drawing on the Census Bureau, the CDC, the Health Resources and Services Administration, KFF and ProCon.org. Washington, D.C., is scored alongside the states and finished 30th, which puts it in neither this list nor the bottom 10.
Five of the six New England states finished in the top five. Seven of the top 10 sit within two and a half points of one another, so most of this list is a near-tie; the two states above them are nearly seven points clear of third place.
Nine of the 10 states below appear on the CDC’s 2026 measles jurisdiction list, which now runs to 3,134 confirmed cases nationally as of Sept. 3, more than the 2,289 logged in all of 2025. The CDC’s own explanation is that pockets of unvaccinated people exist inside states with high statewide coverage. A state average tells a physician very little about the block their panel lives on.
Chip Lupo, a WalletHub analyst, said the spread of misinformation makes public education about vaccines “more crucial now than ever.”
For independent practices, the operational picture has gotten harder in the same period. More than one childhood schedule is in circulation after federal recommendations were narrowed in January and stayed by a federal court in March; the AAFP published its own 2026 schedules that align with the American Academy of Pediatrics’. Three CPT codes for immunization counseling on days when no shot is given, 90482 through 90484, took effect Jan. 1. CMS does not pay them, and most commercial payers do not either.
