Blue Cross Blue Shield Association Study Shows Significant Increase in Children Who Receive All Recommended Vaccines

- Proportion of children receiving all CDC recommended vaccines increases 12 percent over seven years - Variations exist in vaccine rates between states and cities - Skipped well-child visits contribute most to missed vaccinations

Chicago – Childhood vaccination rates climbed 12 percent among Blue Cross and Blue Shield (BCBS) young commercially insured members from 2010 through 2016, according to a new study of medical claims by the Blue Cross Blue Shield Association (BCBSA). Data show 69 percent of young BCBS members born in 2010 were up-to-date on their CDC-recommended vaccinations by the age of 2 years and 3 months compared to 77 percent of children born in 2013.

For children who are not completely vaccinated, missed well-child visits* were the largest reason for under vaccination, accounting for 62 percent of under-vaccinated cases for children born in 2013.

The report, “Early Childhood Vaccination Trends in America,” represents a comprehensive study of outpatient medical claims from BCBS members who were vaccinated by 2 years and 3 months of age between 2010 and 2016.**

The study also finds that:

  • For children born in 2013, variation by state ranges from 86 percent in North Dakota to 63 percent in Nevada. Variation by metropolitan statistical area ranges from a high of 92 percent in Fargo, N.D., to a low 56 percent in Albany, N.Y.
  • Medical claims coded with a parental vaccine refusal climbed from 2.5 percent for children born in 2010 to 4.2 percent for children born in 2013. Refusal rates were highest in the states of New York at 8.4 percent, Washington at 7.0 percent, Oregon at 6.8 percent, New Jersey at 6.5 percent and Arizona at 6.4 percent.
  • The three metropolitan statistical areas with the highest refusal rates are all in New York. They include Nassau-Suffolk at 14.2 percent, Dutchess County at 10.3 percent and New York-Newark at 10.1 percent. The county with the highest refusal rate was Richmond County (Staten Island) in New York at 25.6 percent. 

“While new advances in medicine are important, this report reminds us that vaccinations remain a fundamental health care innovation that substantially reduces morbidity and mortality for Americans,” said Dr. Trent Haywood, senior vice president and chief medical officer for BCBSA. “Continued public health efforts can increase childhood vaccination rates by simply touting the benefits of attending regular children’s checkups. This report demonstrates that vaccine use among commercially insured people in the U. S. is increasing in the right direction. The data, however, also show large regional variation, indicating there are further improvements to be made.”

This is the seventeenth study of the Blue Cross Blue Shield: The Health of America Report® series, a collaboration between BCBSA and Blue Health Intelligence, which uses a market-leading claims database to uncover key trends and insights into health care affordability and access to care. Analysis was performed by and also includes medical claims data from HealthCore, a wholly owned and independently operated health outcomes subsidiary of Anthem, Inc.

For more information, visit
*American Academy of Pediatrics (AAP) recommends 10 visits to the pediatrician by age two.
**Study includes continuously insured members from birth.


About BHI
Blue Health Intelligence (BHI) is the nation’s premier resource for data-driven insights about healthcare trends and best practices, promoting healthier lives and more affordable access to safe and effective care. BHI leverages a team of analytics experts and advanced technology, coupled with access to the greatest number of healthcare claims—172 million lives—gathered over 10 years in a safe, HIPAA-compliant, secure database. The resulting conformed, reliable data set has the broadest, deepest pool of integrated medical and pharmacy claims, reflecting medical utilization in every ZIP code. Blue Health Intelligence (BHI) is an Independent Licensee of the Blue Cross Blue Shield Association. BHI is a trade name of Health Intelligence Company, LLC.

About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of 34 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through The Health of America Report series and the national BCBS Health Indexsm. For more information on BCBSA and its member companies, please visit We also encourage you to connect with us on Facebook, check out our videos on YouTube and follow us on Twitter.

The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.