The 10 least vaccinated states in 2026

More to read: The 10 most vaccinated states in 2026

Idaho exempted 17.5% of its kindergartners from at least one required vaccine in the 2025-2026 school year, the highest rate in the country and more than four times the national figure. Its MMR coverage, 75.2%, is the lowest of any state. Nationally, exemptions rose in 41 states and the District of Columbia, and 24 states now sit above 5%.

WalletHub scored the 50 states and Washington, D.C., on 16 vaccination metrics across three weighted dimensions, covering children and teenagers, adults and older adults, and the disparities and access factors behind uptake. Each metric was graded on a 100-point scale. The data were collected as of Aug. 12, 2026. The 10 states below finished 42nd through 51st. Washington, D.C., is scored alongside the states and finished 30th, so it appears in neither list.

WalletHub is measuring 16 things at once, and 12 of them concern teenagers, adults or access conditions rather than the shots a state requires for kindergarten entry. A state can hold high kindergarten coverage and still finish last here. One of the 10 below does exactly that, which is a reason to reach the final slide before repeating the composite.

Eight of these 10 states appear on the CDC's 2026 measles jurisdiction list. So do nine of the 10 states at the top of the same ranking. Statewide coverage is not what determines whether an outbreak reaches a particular practice; local clustering is.

Chip Lupo, a WalletHub analyst, framed the stakes in geographic terms, saying the states that vaccinate the most minimize the likelihood that the next outbreak "will begin or spread there."

Practices in these states absorb the cost of that environment. Vaccine counseling now runs longer, and the three CPT codes built to capture it, 90482 through 90484, took effect Jan. 1 without payment from CMS and with uneven recognition from commercial payers. Sarah C. Nosal, M.D., FAAFP, president of the American Academy of Family Physicians, told Medical Economics that family physicians are still giving vaccines, "but they are expensive, and the most common concern is reimbursement rates." Coverage itself has not changed: the Affordable Care Act's first-dollar requirement for ACIP-recommended vaccines remains in force, and AHIP member plans have committed to covering ACIP-recommended immunizations with no cost sharing through the end of 2027.