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United States Value:
Percentage of adults age 65 and older who reported receiving a seasonal flu vaccine in the past 12 months
Percentage of adults age 65 and older living in metropolitan areas who reported receiving a seasonal flu vaccine in the past 12 months
74.2% - 69.6%
69.5% - 67.8%
67.7% - 63.6%
63.5% - 61.1%
61.0% - 52.3%
No Data
US Value: 63.4 %
Top State(s): Massachusetts: 73.7 %
Bottom State(s): Idaho: 52.3 %
Definition: Percentage of adults age 65 and older who reported receiving a seasonal flu vaccine in the past 12 months
Data Source and Years(s): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, 2023
Suggested Citation: America's Health Rankings analysis of U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2026.
Immune defense systems weaken with age, putting older adults at increased risk of developing serious health complications from influenza (the seasonal flu). The influenza vaccine helps protect against the flu virus, lowering the risk of infection and lessening the severity of symptoms in those who do get sick. During the 2019-2020 flu season, the flu vaccination prevented approximately 7 million illnesses, 3 million medical visits, 100,000 hospitalizations and 7,000 deaths in the United States related to influenza.
The rate of flu-related deaths is highest among older adults: It is estimated that 50%-70% of seasonal flu-related hospitalizations and 70%-85% of seasonal flu-related deaths occur among those age 65 and older.
Based on research from a 2021 study, flu-vaccinated adults hospitalized with the flu have a 26% lower risk of ICU admission and a 31% lower risk of death compared with unvaccinated individuals.
The average annual economic burden of influenza among older adults in the U.S. is $2.4 billion, including direct medical costs and loss of productivity. Flu vaccination is a cost-effective intervention, with direct savings estimated at more than $100 for every older adult who receives the vaccine.
According to America’s Health Rankings analysis, the prevalence of receiving a seasonal flu vaccine is higher among:
It is recommended that everyone older than 6 months get a flu shot every flu season (usually starting in September or October) unless told otherwise by a doctor. Three formulations of the flu vaccine are preferentially recommended for adults age 65 and older: Fluzone High-Dose Quadrivalent, Flublok Quadrivalent and Fluad Quadrivalent. Evidence suggests that these formulations are more effective than the standard flu vaccine in older adults.
Medicare covers the cost of one flu shot every flu season. Efforts to provide flu shots to populations of older adults with low vaccination coverage involve delivering vaccines in informal and trusted community-based settings. This approach may also help to reduce racial and ethnic disparities in flu vaccination rates.
The Centers for Disease Control and Prevention offers many flu resources, including treatment and prevention strategies, as well as guidance to help manage flu outbreaks in long-term care facilities.
Healthy People 2030 has a goal to increase the percentage of people who receive an annual influenza vaccine.
Duncan, Ian G., Michael S. Taitel, Junjie Zhang, and Heather S. Kirkham. “Planning Influenza Vaccination Programs: A Cost Benefit Model.” Cost Effectiveness and Resource Allocation 10, no. 1 (2012): 10. https://doi.org/10.1186/1478-7547-10-10.
Putri, Wayan C. W. S., David J. Muscatello, Melissa S. Stockwell, and Anthony T. Newall. “Economic Burden of Seasonal Influenza in the United States.” Vaccine 36, no. 27 (June 22, 2018): 3960–66. https://doi.org/10.1016/j.vaccine.2018.05.057.
Shenson, Douglas, Mary Adams, Julie Bolen, Karen Wooten, Juliana Clough, Wayne H. Giles, and Lynda Anderson. “Developing an Integrated Strategy to Reduce Ethnic and Racial Disparities in the Delivery of Clinical Preventive Services for Older Americans.” American Journal of Public Health 102, no. 8 (August 2012): e44–50. https://doi.org/10.2105/AJPH.2012.300701.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.
