With so much focus on the coronavirus pandemic, it’s understandable that flu shots aren’t top of mind. The flu virtually disappeared in the U.S. in the 2020-21 season as mask-wearing, social distancing and virtual schooling were the norms.
In that 2020-21 flu season — the latest in which full data is available — 52.1% of eligible Americans received a flu vaccine, a nearly identical rate as the previous season. The flu didn’t stay hidden for long, though. Flu cases started making a swift return in the ongoing 2021-22 season, topping pre-pandemic levels in December.
- More than half of Americans ages 6 months and older received a flu vaccine during the 2020-21 influenza season. 52.1% received the vaccine — nearly identical to the 51.8% in 2019-20.
- New England states have the highest flu vaccination rates in the U.S. Massachusetts (66.5%), Rhode Island (66.4%), Connecticut (62.3%), New Hampshire (60.7%) and Vermont (59.9%) top the 2020-21 list.
- Southern states have the lowest flu vaccination rates in the U.S. Florida (41.7%) and Mississippi (42.1%) are at the bottom of the list, with Georgia (43.1%) not far away.
- Flu vaccination rates rose in 27 states between the 2019-20 and 2020-21 flu seasons. The biggest jumps were in Massachusetts (9.7%) and Illinois and Rhode Island (both 9.0%).
- In the 2020-21 season — the first full year amid the COVID-19 pandemic — older Americans ages 65 and older leapfrogged over the youngest Americans (younger than 5) to become the most vaccinated group. In fact, the two groups nearly swapped flu vaccination rates.
National flu vaccination rate remains above 50%
Despite pandemic distractions, the national flu vaccination rate remained above 50% in the 2020-21 season — the latest in which full data is available. However, even though 52.1% of Americans ages 6 months and older received a flu vaccine in 2020-21, it was only a small increase (0.6%) from 2019-20, when 51.8% of people in the same age group received the flu vaccine.
That said, flu vaccinations are on the rise — even if that increase is slower than in past seasons. There was a much bigger increase in flu vaccination rates between 2020-21 and two seasons before (5.9%) and an even more significant increase from 10 seasons prior (21.2%).
National flu vaccination rates
Source: Centers for Disease Control and Prevention (CDC).
According to the Centers for Disease Control and Prevention (CDC), recent studies show that getting a flu vaccination can reduce the risk of flu illness between 40% and 60% during flu season.
When the CDC refers to the U.S. flu season, it’s referring to the fall and winter, when flu viruses are most common. Flu activity peaks between December and February, though it’s still possible to contract the flu year-round.
With this high level of effectiveness, why aren’t vaccination numbers on the rise? It’s hard to say, but Robin Townsend — a ValuePenguin technical writer whose focus is health and life insurance — thinks there are myriad reasons behind a lack of interest in the flu vaccination.
"Many adults are still hesitant about the flu vaccine because they believe it doesn't work all that well," Townsend says. "Other reasons adults say they skip the shot is because they never get the flu, believe it’s not serious, or worry the vaccine will cause side effects or even give them the virus."
New England states have highest flu vaccination rates, while Southern states have lowest
When it comes to states with the highest vaccination rates, New England states top the 2020-21 list — Massachusetts (66.5%), Rhode Island (66.4%), Connecticut (62.3%), New Hampshire (60.7%) and Vermont (59.9%). Maine is the only New England state that didn’t land in the top five, but it didn’t fall far behind at 16th (56.4%).
States with the highest and lowest flu vaccination rates in 2020-21
|Rank||State||Vaccination rate||Rank||State||Vaccination rate|
Source: Centers for Disease Control and Prevention (CDC).
On the flip side, Southern states have the lowest flu vaccination rates in the U.S. Florida (41.7%) and Mississippi (42.1%) are at the bottom, and Georgia (43.1%) isn’t far behind.
Flu vaccination rates rise in 27 states between 2019-20, 2020-21
In more than half of the states across the U.S. (27, to be exact), flu vaccination rates rose between the 2019-20 and 2020-21 flu seasons. The states with the biggest increases were Massachusetts (9.7%) and Illinois and Rhode Island (both 9.0%). Massachusetts jumped from 60.6% to 66.5%.
While nine states increased their rates by at least 5%, not all states saw rising flu vaccination rates. Vaccination rates dropped by 15.0% in Oklahoma and 9.9% in Wyoming. Kentucky had the third-largest decline at 8.3%. Overall, 10 states had declines of at least 5%.
Change between flu vaccination rates in 2019-20 and 2020-21
2019-20 vaccination rate
2020-21 vaccination rate
|District of Columbia||57.6%||58.3%||1.2%|
Source: ValuePenguin analysis of Centers for Disease Control and Prevention (CDC) data.
Most vaccinated group now older Americans
Seasonal flu vaccination rates vary considerably by age. In the 2020-21 season — the first full year amid the COVID-19 pandemic — Americans ages 65 and older vaulted over the youngest Americans to become the most vaccinated group.
The two groups essentially swapped rates, with those 65 and older having the highest vaccination rate at 75.2%, up from 69.8% the prior year. Meanwhile, children younger than 5 had the second-highest vaccination rate at 68.0%, down from 75.2%.
Seniors having the highest flu vaccination rates could be related to the availability of COVID-19 vaccines to seniors during the 2020-21 season, while the vaccine had not been made available to younger children. Consumers can choose to get vaccinated for both the coronavirus and the flu at the same time, which many may have chosen to do for convenience’s sake.
Some additional interesting findings surrounding age include:
- Overall, flu vaccination rates among youths ages 6 months to 17 dropped from 63.7% to 58.6%.
- Adults between 18 and 49 have the lowest annual vaccination rates at just 37.7%.
- Vaccination rates of everyone older than 18 rose slightly to 50.2% from 48.4%.
Flu vaccination rates by age group
|65 and older||69.8%||75.2%|
|6 months to 4||75.2%||68.0%|
|5 to 12||64.5%||59.0%|
|6 months to 17||63.7%||58.6%|
|50 to 64||50.6%||54.2%|
|13 to 17||53.3%||50.8%|
|18 and older||48.4%||50.2%|
|18 to 49||38.4%||37.7%|
Source: Centers for Disease Control and Prevention (CDC). Notes: Age groups, which are ranked by the vaccination rate in the 2020-21 flu season, overlap.
The location where people can get a flu shot may also impact the decision to get one. The majority of youths ages 6 months to 17 — 68% — who got vaccinated for the flu in the 2020-21 season did so in a doctor’s office. Meanwhile, 39% of adults 18 and older received theirs at a pharmacy. An additional 8% of adults were vaccinated at work.
"In some states, only a doctor or nurse can vaccinate children younger than 6," Townsend says. "Along with that, many children receive flu shots as part of other routine health care visits. These numbers are not likely to change based on the pandemic."
Adults, on the other hand, may have lost access to convenient opportunities to get their flu shots since the pandemic began.
"Fewer consumers got flu shots at work as the pandemic forced alternative work arrangements for many employees," Townsend says. "As or if the pandemic wanes and employees return to in-person work settings, we expect to see an increase in the rate of vaccines received at work."
Adult women more likely than adult men to get vaccinated for flu
It appears that women are more likely to get their flu shot than men, as 53.9% of adult women were vaccinated in 2020-21, compared to just 46.3% of adult men.
This divide becomes fairly nonexistent for seniors — 75.6% of women 65 and older were vaccinated for the flu, versus 74.6% for men in that age group. When it comes to children, there also wasn’t a notable gender difference regarding flu vaccination rates.
How much does a flu shot cost?
Insured Americans typically don’t need to pay for a flu shot. The Affordable Care Act mandates that health insurance companies cover flu shots and other vaccines without a copayment or coinsurance charge. Check with your insurance company to find out if you need to get your flu vaccination from a specific facility to get it for free.
Townsend acknowledges that some uninsured consumers may skip a flu shot for fear of having to pay a high out-of-pocket cost, but they shouldn’t worry.
"There are ways to get free flu shots such as health clinics and the Vaccines for Children Program," Townsend says. "If you’re on Medicare and use a participating doctor, your flu shot is covered in full, and many pharmacies administer flu vaccines free of charge to any age group."
ValuePenguin analysts used Centers for Disease Control and Prevention seasonal influenza vaccination rate data for the flu seasons from 2010-11 to 2020-21. ValuePenguin analysts used data from the 2019-20 and 2020-21 flu seasons to calculate the percentage change in the vaccination rates.