State-level progress and setbacks in influenza vaccination among adults ≥65: A fifteen-season analysis from 2009/10 to 2023/24.
Publication/Presentation Date
1-1-2026
Abstract
INTRODUCTION: Influenza is a contagious respiratory infection with substantial health and economic consequences worldwide. Annual vaccination is the most effective preventive strategy; however, coverage among older adults remains suboptimal and varies considerably across the United States. This study aimed to examine state-level trends in influenza vaccination coverage among adults aged ≥65 years across fifteen influenza seasons (2009/10-2023/24).
METHODS: State-level vaccination coverage data for adults aged ≥65 years were obtained from the CDC FluVaxView platform, which reports annual estimates by influenza season. The analysis covered the 2009/10 through 2023/24 influenza seasons. Joinpoint regression was used to assess temporal trends and estimate Annual Percent Change (APC) and Average Annual Percent Change (AAPC) in vaccination coverage.
RESULTS: In the 2023/24 season, all but one state reported coverage rates of at least 50 %; however, only 10 of 51 states reached the 75 % target. Coverage ranged from 49.8 % in Mississippi to 80.6 % in Massachusetts. Over the study period, AAPC significantly increased in three states (Rhode Island, District of Columbia, and Washington) and decreased in four states (Alabama, Mississippi, Louisiana, and Nevada). The COVID-19 pandemic coincided with a temporary increase in coverage in 48 states, but by the 2023/24 season, 44 states had coverages within ±10 % of their pre-pandemic 2019/20 baselines.
CONCLUSIONS: Influenza vaccination coverage among older adults remains uneven across states. Although the pandemic prompted short-term gains in vaccine uptake, these improvements were not maintained over time. The findings underscore the need for persistent, state-specific public health strategies to improve coverage in this vulnerable population.
Volume
69
First Page
127983
Last Page
127983
ISSN
1873-2518
Published In/Presented At
Russo, L., Farina, S., Macri, R. A., Pentecost, W. A., Maio, A., Villani, L., Maio, V., Boccia, S., & Ricciardi, W. (2026). State-level progress and setbacks in influenza vaccination among adults ≥65: A fifteen-season analysis from 2009/10 to 2023/24. Vaccine, 69, 127983. https://doi.org/10.1016/j.vaccine.2025.127983
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41237563
Department(s)
Administration and Leadership
Document Type
Article