Another Dubious Distinction: Texas Tops Unvaccinated List
By David Doolittle


Let’s start with the bad news: As you’re no doubt aware, Texas leads the nation in uninsured residents.

And now, the bad news: Texas is the second least-vaccinated state in the union.

There should be no applause.

That’s right. According to WalletHub, Texas is No. 50 on its “2019's States that Vaccinate the Most” report, which also includes the District of Columbia.

The report analyzed 18 key metrics – from share of vaccinated children to people without health insurance, and reported outbreaks such as measles – to determine each state’s ranking.

Texas’ rankings, in which 1 is best and 25 is the average, included:

  • 21 – Share of teenagers 13 to 17 years old with Meningococcal vaccination;
  • 27 – Influenza vaccination rate in children 6 months to 17 years old;
  • 32 – Share of adults with tetanus vaccination;
  • 33 – Share of children 19 to 35 months living in poverty with combined 7-vaccine series;
  • 38 – Share of adults 60 and older with shingles vaccination;
  • 40 – Share of teenagers 13 to 17 years old with up-to-date human papillomavirus (HPV) vaccination;
  • 42 – Share of children under 6 years old participating in an immunization information system;
  • 49 – Flu vaccination coverage rate among adults;
  • 51 – Share of civilian noninstitutionalized population without health insurance coverage.

Texas’ high uninsured rate certainly played a factor in the state’s poor showing on this vaccination list. Vaccine hesitancy and an increase in vaccine exemptions for reasons of conscience also play key roles in Texas’ poor vaccination rates.

Since 2003, when Texas began allowing conscientious objections to required public school vaccines, exemptions have soared more than 2,000% from 2,314 in 2003 to 64,176 today, according to the Department of State Health Services (DSHS). In addition the number of Texas children exempted from vaccination for non-medical reasons jumped 13% in 2018-19, which doesn't take into account factors such as population growth and school survey participation, according to DSHS.

Texas physicians can help boost the state’s vaccination numbers by knowing how to communicate the benefits of vaccination effectively, including sharing personal stories, or finding people in the community who could persuade patients to get vaccinated.

In addition, the Texas Medical Association’s Be Wise – ImmunizeSM program works with physicians, medical students, and TMA Alliance members to improve vaccination rates through education and hands-on immunization clinics.

Be Wise – Immunize is a joint initiative led by TMA physicians, medical students, and the TMA Alliance. It is funded in 2019 by the Texas Medical Association Foundation thanks to H-E-B, TMF Health Quality Institute, Pfizer Inc., and gifts from physicians and their families. 

Be Wise – Immunize is a service mark of the Texas Medical Association.

Last Updated On

October 11, 2019

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David Doolittle


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Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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