Table 4.
Adjusted population attributable fraction (PAF)* of non-vaccination attributed to parental vaccine hesitancy for ≥1 dose influenza vaccination among children 6 months – 17 years by health and human services (HHS) region and state, National Immunization Survey-Flu, April-June interviews, 2018–2019
| % Hesitant among Non-Vaccinated (95% CI) | % Not Vaccinated Among Hesitant (95% CI) | % Not Vaccinated Among Non-Hesitant (95% CI) | PAF (95% CI) | Influenza Vaccination Coverage (%, 95% CI) | |
|---|---|---|---|---|---|
| National | 34.5 (33.4-35.6) | 60.9 (59.5-62.4) | 34.3 (33.5-35.0) | 14.9 (13.9-16.0) | 59.7(59.0-60.4) |
| HHS Region 1 | 36.1 (32.4-39.8) | 51.4 (46.5-56.2) | 21.4 (19.6-23.3) | 21.0 (17.5-25.1) | 72.7 (70.9-74.5) |
| Connecticut | 33.5 (26.8-40.9) | 47.1 (38.5-55.8) | 24.3 (20.6-28.4) | 16.2 (10.2-24.8) | 71.1 (67.3-74.5) |
| Maine | 44.9 (38.7-51.3) | 73.2 (66.5-79.1) | 32.5 (28.7-36.5) | 25.0 (19.5-31.4) | 57.0 (53.2-60.8) |
| Massachusetts | 33.9 (26.5-42.1) | 43.9 (34.6-53.6) | 17.0 (14.2-20.1) | 20.8 (13.9-30.0) | 78.2 (75.0-81.2) |
| New Hampshire | 39.1 (31.6- 47.2) | 67.9 (58.5-76.0) | 23.9 (20.0 -28.2) | 25.4 (18.6-33.5) | 68.0 (63.7-71.9) |
| Rhode Island | 40.3 (32.6- 48.4) | 44.1 (36.0-52.4) | 18.3 (15.0 -22.1) | 23.6 (16.0-33.4) | 76.2 (72.6-79.5) |
| Vermont | 31.4 (23.3 -40.9) | 69.0 (57.7-78.4) | 35.1 (29.1-41.7) | 15.4 (9.2-24.6) | 58.2 (52.6-63.7) |
| HHS Region 2 | 41.1 (36.9-45.2) | 53.9 (49.2-58.6) | 25.2 (23.0-27.4) | 21.9 (17.8-26.6) | 67.8 (65.6-69.9) |
| New Jersey | 37.9 (32.1-44.2) | 53.8 (46.4-61.1) | 25.1 (21.9-28.6) | 18.6 (13.1-25.7) | 68.5 (65.3-71.6) |
| New York | 42.5 (37.3-47.9) | 53.9 (48.0-59.7) | 25.2 (22.5-28.2) | 22.6 (17.5-28.7) | 67.4 (64.6-70.1) |
| HHS Region 3 | 32.8 (29.8-35.8) | 55.3 (51.3-59.4) | 28.8 (26.9-30.6) | 15.8 (13.1-18.9) | 66.1 (64.3-67.8) |
| Delaware | 31.5 (25.6-38.1) | 49.6 (40.9-58.3) | 30.2 (25.7-35.1) | 12.3 (7.2-20.4) | 65.5 (61.4-69.5) |
| District of Columbia | 35.0 (27.6-43.2) | 50.4 (40.8-59.8) | 24.6 (21.2-28.4) | 17.9 (11.4-26.9) | 71.4 (67.0-75.4) |
| Maryland | 36.5 (30.4-43.1) | 50.9 (42.7-59.1) | 23.9 (20.7 -27.4) | 19.4 (13.6-26.9) | 70.5 (67.2-73.6) |
| Pennsylvania | 35.8 (30.9-41.1) | 59.1 (52.6-65.2) | 27.6 (24.7-30.8) | 19.0 (14.6-24.5) | 66.1 (63.2-68.8) |
| Virginia | 25.9 (20.3-32.5) | 51.4 (41.9-60.8) | 31.7 (27.9-35.9) | 9.9 (5.6-17.0) | 65.0 (61.2-68.6) |
| West Virginia | 34.3 (29.5- 39.5) | 65.6 (58.5-72.0) | 39.6 (35.7-43.7) | 13.6 (9.6-18.8) | 54.1 (50.6-57.5) |
| HHS Region 4 | 36.8 (34.6-39.1) | 63.7 (60.9-66.6) | 38.3 (36.6-40.0) | 14.7 (12.6-17.0) | 55.3 (53.8-56.8) |
| Alabama | 37.2 (32.3-42.4) | 63.7 (56.7-70.2) | 36.6 (32.9-40.4) | 15.8 (11.6-21.3) | 56.8 (53.5-60.1) |
| Florida | 36.7 (31.7- 42.0) | 69.0 (62.2-75.0) | 44.1 (39.8-48.5) | 13.2 (9.2-18.6) | 49.3 (45.6-53.0) |
| Georgia | 36.6 (32.0- 41.5) | 62.6 (56.1-68.7) | 41.3 (37.6-45.1) | 12.5 (8.6-17.8) | 53.3 (50.0-56.5) |
| Kentucky | 31.3 (24.6-39.0) | 49.2 (39.3-59.1) | 31.8 (27.0-37.0) | 11.1 (5.6-20.6) | 64.0 (59.4-68.3) |
| Mississippi | 39.0 (33.3-45.0) | 66.4 (59.2-73.0) | 43.9 (39.4-48.5) | 13.2 (8.7-19.5) | 49.2 (45.2-53.2) |
| North Carolina | 39.1 (33.7-44.7) | 63.3 (56.5-69.7) | 31.1 (27.6-34.9) | 19.9 (15.0-25.8) | 61.1 (57.7-64.4) |
| South Carolina | 33.0 (28.1-38.4) | 56.3 (49.1- 63.2) | 38.0 (34.1-42.0) | 10.7 (6.7-16.8) | 57.6 (54.2-61.0) |
| Tennessee | 31.0 (28.1-34.1) | 63.4 (55.0-71.1) | 32.3 (28.2-36.7) | 19.1 (13.5-26.3) | 60.4 (56.4-64.3) |
| HHS Region 5 | 34.2 (39.1-36.4) | 63.5 (60.5-66.6) | 36.7 (35.0-38.3) | 14.5 (12.5-16.6) | 57.1 (55.6-58.6) |
| Illinois | 35.9 (32.0-39.9) | 64.3 (58.8-69.4) | 35.8 (33.1-38.7) | 15.9 (12.5-19.9) | 57.4 (54.9-60.0) |
| Indiana | 34.9 (29.5-40.6) | 63.1 (55.2-70.4) | 38.9 (34.8-43.3) | 13.4 (9.0-19.4) | 55.4 (51.6-59.1) |
| Michigan | 37.2 (31.8-43.0) | 68.1 (60.6-74.7) | 40.9 (36.5-45.4) | 14.9 (10.5-20.7) | 51.8 (48.0-55.7) |
| Minnesota | 32.2 (24.8-40.5) | 59.0 (47.4-69.7) | 30.0 (25.4 -34.9) | 15.8 (9.8-24.5) | 64.6 (60.0-69.0) |
| Ohio | 31.2 (26.3-36.6) | 60.7 (53.0 -67.9) | 37.0 (33.2-41.0) | 12.2 (8.2-17.7) | 57.7 (54.2-61.2) |
| Wisconsin | 31.1 (25.8-36.9) | 62.3 (54.3-69.7) | 35.5 (31.5-39.7) | 13.4 (9.1-19.2) | 58.5 (54.8-62.2) |
| HHS Region 6 | 31.6 (29.3-33.8) | 58.2 (55.1-61.3) | 36.5 (34.8-38.2) | 11.8 (9.9-14.0) | 58.7 (57.2-60.2) |
| Arkansas | 34.3 (28.2-41.1) | 58.0 (49.6-66.0) | 28.2 (24.6-32.0) | 17.6 (12.3-24.6) | 65.8 (62.1-69.3) |
| Louisiana | 30.0 (25.0- 35.4) | 52.9 (45.6-60.1) | 39.7 (35.4-44.1) | 7.5 (3.8-14.3) | 56.8 (53.1-60.5) |
| New Mexico | 37.5 (31.5-43.8) | 51.3 (43.6-58.9) | 27.5 (23.9-31.4) | 17.4 (11.8-24.9) | 66.7 (63.2-70.1) |
| Oklahoma | 33.7 (29.0-38.6) | 66.3 (59.0-72.9) | 41.6 (37.7-45.5) | 12.6 (8.9-17.5) | 52.5 (49.1-55.9) |
| Texas | 31.0 (28.1-34.1) | 58.5 (54.2-62.6) | 36.8 (34.6-39.0) | 11.5 (9.0-14.5) | 58.6 (56.6-60.5) |
| HHS Region 7 | 32.9 (29.3-36.4) | 66.0 (61.0-70.9) | 33.7 (31.3-36.1) | 16.1 (13.2-19.5) | 60.0 (57.8-62.2) |
| Iowa | 34.9 (27.9-42.6) | 59.9 (49.5-69.4) | 31.9 (27.6-36.5) | 16.3 (10.5-24.4) | 61.9 (57.5-66.1) |
| Kansas | 32.0 (24.9-40.1) | 69.3 (58.9-78.0) | 30.8 (26.2-35.9) | 17.7 (12.0-25.4) | 62.9 (58.1-67.4) |
| Missouri | 31.4 (26.2-37.2) | 69.5 (60.9-76.9) | 38.5 (34.4-42.7) | 14.0 (9.9-19.5) | 55.4 (51.5-59.1) |
| Nebraska | 36.3 (28.5-44.9) | 61.6 (48.6 -73.0) | 26.8 (22.8-31.1) | 20.5 (13.7-29.6) | 66.7 (62.2-70.8) |
| HHS Region 8 | 31.8 (28.7-34.9) | 65.4 (60.8-70.0) | 35.3 (33.0-37.7) | 14.6 (12.0-17.7) | 58.6 (56.5-60.7) |
| Colorado | 36.4 (30.4-42.9) | 58.8 (50.3-66.7) | 28.0 (24.3-32.0) | 19.1 (13.6-26.1) | 65.5 (61.8-69.0) |
| Montana | 39.9 (33.6- 46.6) | 76.4 (68.6-82.8) | 36.9 (32.2-41.9) | 20.6 (15.4-27.1) | 53.6 (49.1-58.0) |
| North Dakota | 37.1 (28.5-46.5) | 72.0 (61.0-81.0) | 26.4 (22.4-30.9) | 23.5 (16.5-32.4) | 65.2 (60.4-69.7) |
| South Dakota | 32.9 (25.9-40.7) | 61.1 (50.1-71.2) | 29.3 (25.2-33.7) | 17.1 (11.3-25.1) | 65.0 (60.7-69.0) |
| Utah | 24.7 (20.2-29.9) | 70.2 (61.5-77.7) | 45.2 (40.8-49.7) | 8.8 (5.7-13.3) | 50.4 (46.4-54.4) |
| Wyoming | 32.1 (25.8-39.1) | 76.7 (68.8- 83.1) | 51.6 (46.7-56.5) | 10.5 (6.7-16.0) | 42.3 (37.9-46.8) |
| HHS Region 9 | 32.9 (28.6-37.2) | 61.9 (56.2-67.6) | 36.3 (33.2-39.4) | 13.6 (10.2-17.7) | 58.1 (55.2-60.8) |
| Arizona | 35.5 (30.0-41.4) | 70.7 (63.1-77.3) | 40.7 (36.5-45.1) | 15.0 (10.7-20.7) | 52.0 (48.1-55.9) |
| California | 31.9 (26.6-37.7) | 60.2 (52.6-67.3) | 35.3 (31.6-39.3) | 14.9 (10.4-21.0) | 59.4 (55.9-62.9) |
| Hawaii | 43.0 (35.2-51.2) | 61.9 (54.5-68.7) | 29.8 (23.9 - 36.5) | 22.3 (14.8-32.1) | 61.1 (56.1-65.9) |
| Nevada | 34.6 (28.5-41.3) | 62.2 (49.5-73.5) | 42.6 (37.1-48.2) | 10.9 (5.7-20.0) | 52.8 (47.9-57.8) |
| HHS Region 10 | 37.1 (33.4-40.7) | 66.6 (61.6-71.6) | 33.9 (31.4-36.4) | 18.2 (15.0-22.0) | 58.7 (56.4-61.0) |
| Alaska | 33.5 (27.8-39.7) | 71.1 (63.4-77.8) | 43.7 (38.7-48.8) | 12.9 (8.6-18.9) | 50.7 (46.3-55.0) |
| Idaho | 38.1 (31.4- 45.3) | 71.0 (60.9-79.3) | 42.6 (37.7-47.6) | 15.2 (10.1-22.3) | 49.9 (45.3-54.6) |
| Oregon | 42.6 (36.0-49.5) | 70.9 (60.9-79.3) | 32.7 (28.2-37.6) | 23.0 (17.0-30.3) | 58.1 (53.6-62.4) |
| Washington | 33.9 (28.3-40.1) | 61.6 (53.3-69.3) | 31.3 (27.6-35.2) | 16.7 (11.8-23.0) | 62.3 (58.7-65.7) |
*
PAF = p (rr-1)/rr), where p is the proportion of hesitant individuals among the not vaccinated group of individuals and rr denotes the relative risk comparing the proportion of those who are not vaccinated among the hesitant group with the proportion of those who are not vaccinated among the non-hesitant group.