Document Type
Article
Publication Date
11-13-2025
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.
Recommended Citation
Russo, Luigi; Farina, Sara; Macri, Raffaele Angelo; Pentecost, William Alan; Maio, Alessandra; Villani, Leonardo; Maio, Vittorio; Boccia, Stefania; and Ricciardi, Walter, "State-Level Progress and Setbacks in Influenza Vaccination Among Adults ≥65: A Fifteen-Season Analysis from 2009/10 to 2023/24" (2025). College of Population Health Faculty Papers. Paper 234.
https://jdc.jefferson.edu/healthpolicyfaculty/234
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Language
English
Comments
This article is the author's final published version in Vaccine, Volume 69, January 2026, Article number 127983.
The published version is available at https://doi.org/10.1016/j.vaccine.2025.127983. Copyright © 2025 The Authors.