Adult vaccination claims across the US experienced an expected seasonal decline in the first quarter (Q1) of 2025 compared to the previous quarter. Yet, Q1 vaccination claims were notably higher compared to the same period in 2024 — across insurance coverage markets, racial and ethnic groups, and healthcare access points. Examining local-level trends is critical to understanding drivers of these national patterns and uncovering community-level differences that may not be apparent when reviewing national data alone.

Vaccine Track data across different metro areas offer valuable insights into these local variations, enabling targeted public health initiatives tailored to specific community needs. 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.

Wide Variation in Vaccination Claims Across Local Communities

While most metro areas experienced increases in adult vaccination claims in Q1 2025 compared to Q1 2024, approximately one in five experienced a decline, indicating the presence of barriers and opportunities to improve vaccination uptake.

Spotlight on Communities with Largest Year-Over-Year Changes

Across all metro areas in the country, Boise City, ID, had the greatest percentage increase in vaccination claims in Q1 2025 compared to Q1 2024 (+93%/+7,735 claims). By contrast, Midland, MI, had the greatest percentage decrease in vaccination claims (-50%/-1,316). This stark contrast highlights drivers of local variations, including:

• Insurance Market: Increases in Boise City were primarily driven by an increase in Medicare Part B claims (+1,019%/+5,684), while decreases in Midland were largely due to a decline in commercial claims (-63%/-1,138).
• Point of Access: Medical settings saw substantial shifts for both places. For Boise City, medical claims rose sharply by 328% (+5,742), in contrast to Midland’s steep drop of 85% (-1,305). On the other hand, pharmacy settings experienced less dramatic changes, with Boise City’s claims increasing by 30% (+1,993) and Midland’s claims remaining steady (-1%/-11).

There are also interesting demographic differences between Boise City and Midland. Boise City has more than double the uninsured rate but also a higher employment rate and median household income. While it is premature to conclude what impact — if any — these factors may have had on vaccination, delving deeper into demographic, policy and healthcare delivery differences across metro areas could potentially help uncover the specific drivers behind adult vaccination trends.

Implications for Public Health Efforts

Local variations underscore the need for tailored public health interventions. Communities experiencing declines may benefit from focused policy changes, improved healthcare access strategies, or targeted education and outreach. Conversely, areas showing significant increases may offer best-practice insights for replication in other communities.

Looking ahead, monitoring localized vaccination trends at the local level provides critical insights for public health stakeholders aiming to enhance adult vaccination coverage in communities. Continued attention to these localized data points can inform strategies and policies designed to improve community health outcomes nationwide.

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.

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.