Compared to the first half of 2024, adult vaccination was up 15% in 1H 2025, according to Vaccine Track, a tool which shows patterns in adult vaccination across state and metro areas, expressed as the percent change over a user-specified time period. The increase extended across all insurance markets, races/ethnicities, points of access and age groups.

The greatest increase in claims was observed for adults 50-64 years of age, potentially driven by increased pneumococcal vaccinations, which were 2.8 times higher on average between October 2024-June 2025 for this age group compared to the previous year.

This likely resulted from an expanded recommendation from the Advisory Committee on Immunization Practices (ACIP), issued October 2024, which lowered the recommended age for pneumococcal vaccination to 50. Pneumococcal vaccinations for adults aged ≥65 years in 2024-2025 closely mirrored 2023-2024.

No Evidence for Rural-Urban Divide and a Win for Wenatchee

Adult vaccinations rose in more than 80% of metro areas (279/347) between 1H 2024 and 1H 2025. Among the less populated regions that don’t fall into an established metro area, claims increased in 83% (40/48), indicating no significant rural-urban gap.

The greatest percent increase was observed for Wenatchee-East Wenatchee, WA (+82%), while the greatest percent decrease was observed for Minot, ND (-39%).

Local governing decisions can influence local vaccination trends. For example, the increase in Wenatchee-East Wenatchee may reflect broad actions taken by the Chelan-Douglas Health Board, which governs the health district spanning Chelan and Douglas counties. The Board’s pattern of rejecting measures to end the health district’s vaccination programs indicates strong support for immunization by the governing body. Additionally, the Health District’s partnership with a third-party mobile clinic aims to expand access to preventive healthcare, including immunizations.

Wenatchee-East Wenatchee also underwent a digital healthcare transformation between 1H 2024 and 1H 2025 following the introduction of a new telehealth platform by a North Central Washington health system. This platform was integrated with patients’ electronic medical records, enabling greater opportunities for vaccination reminders.

Similar to the national data, pneumococcal vaccinations among the 50-64 age group appeared to be a major driver of the overall increase in Wenatchee-East Wenatchee. Total pneumococcal vaccinations in this age group even eclipsed that of the 65+ age group, which is particularly notable because ages 50-64 represent a smaller share of the population (17% versus 21%).

Some Metro Areas Defied Statewide Trends

In North Dakota, adult vaccinations declined 20% in 1H 2025 compared to the previous year—more than any other state, and Minot had the greatest decrease (-39%) of any metro area across the country.

Interestingly, Bismarck went in the opposite direction (+15%), offering an opportunity to delve into the factors that might be causing this divergence between the state and local level.

Since the demographic characteristics in Bismarck are similar to those observed statewide, the increase in vaccination is likely linked to local public health programming and infrastructure.

For example, the Bismarck-Burleigh Public Health Department has robust adult vaccination programs, including convenient drive-through vaccination clinics and online appointment scheduling. Additionally, as the capital, Bismarck has a greater density of health systems and pharmacies than most other parts of the state, which likely contributes to greater vaccine access.

Bismarck, like Wenatchee-East Wenatchee, provides insight into successful adult vaccination efforts that could be applied in other areas.

About Vaccine Track

Vaccine Track measures adult vaccinations through claims data.

Vaccine Track currently includes claims for adults ≥19 years of age who were vaccinated with host of adult vaccines, including hepatitis A, hepatitis B, tetanus-diphtheria (Td), tetanus-diphtheria-pertussis (Tdap), shingles, pneumococcal, influenza (flu) and respiratory syncytial virus (RSV).

Not all vaccines are indicated or recommended for all adults, and the inclusion of the full adult data set should not be interpreted as promoting or endorsing the use of any vaccine beyond its FDA-approved indication(s) or CDC recommendations.

Metro areas are delineated by Metropolitan Statistical Areas (MSAs), which are geographical regions defined by the US Census Bureau that consist of one or more urban centers and their surrounding communities connected by economic and social ties.

Vaccine Track provides race/ethnicity data stratification. Race/ethnicity data are self-reported and may not be available for all people who received a vaccination. These data may not be representative of the entire US population.