Background
This annual report shows immunization coverage from 2021-2024 among Vermont children, based on data in the Vermont Immunization Registry (IMR). It highlights changes from year to year and helps the Immunization Program focus their efforts to improve the health of Vermonters.
Ages used in this report are calculated as of December 31, 2024 and rates are based on immunizations given through that date.
About the IMR
The IMR is a secure, centralized health information system that contains immunization histories for Vermonters. While reporting all immunizations given in Vermont is required by state law, the valuable resource of individual records is used across the state by health professionals. For example, its easy and secure access allows providers to determine if you need a tetanus shot when you show up in the emergency room with a cut finger. The data in the system also informs public health officials on the immunization rates of Vermonters by demographics, locations and immunization type.
2024 IMR Basic Statistics
As of December 31, 2024:
- Total Number of Patients with Immunization Records: 1,076,463 (increase of >199,463 since 2020)
- Total Number of Immunizations in the IMR: 15,176,392
- Number of Immunizations added in 2024: 881,908
- Hospitals reporting to the IMR in 2024: All VT hospitals and Dartmouth Hitchcock Medical Center in NH
- Percent of Chain Pharmacies reporting in 2024: 100%
- Number of Provider Sites (all types) reporting in 2024: 436
- Percent of Public Schools using the IMR in 2024: 99%
Immunization Coverage by the Age of Two
Traditionally, immunization coverage is assessed in young children after the age of 18 months, by which time Centers for Disease Control and Prevention (CDC) recommends children should have received:
- Four doses of DTaP (Diphtheria, Tetanus, Pertussis)
- Three doses of Polio
- One dose of MMR (Measles, Mumps, Rubella)
- Four doses of Hib (Haemophilus Influenza Type B)
- Three doses of HepB (Hepatitis B)
- One dose of Varicella
- Four doses of PCV (Pneumococcal)
Collectively, these are termed the Childhood Seven Series. In 2024, 75% of Vermont two-year olds were up to date for the Childhood Seven Series.
The table below shows rates by immunization series. Overall, immunization rates have remained stable since 2021. Of note, the DTaP series and the PCV series, both of which require four doses, continue to have the lowest rates.
Immunization rates (%) for 2 year olds are stable since 2021
Childhood Seven Series (age 2)
The below graph shows variability in the county level coverage for 2024. These ranged from a low of 51% in Essex County to a high of 79% in Franklin County.
The table in the second tab compares county coverage rates over time, from 2021 to 2024. Essex County consistently has the lowest Seven Series completion rate among all Vermont counties. Variability in coverage rate over the years is higher in smaller counties (e.g., Essex and Grand Isle) compared to larger counties (e.g., Chittenden) as changes are likely influenced by small population sizes.
By County 2024
By County 2021-2024: % complete (total immunized)
Coverage Among Vermont Teens by Age 15
Measuring immunization coverage in teens focuses on specific immunizations recommended from age 11 years forward, including:
- Human Papilloma Virus (HPV)
- Meningococcal vaccine
- Tdap (Tetanus, Diptheria, Pertussis)
Coverage rates of these three immunizations among teens (15 years old) were stable from 2021 to 2024 (see below figure), though rates are consistently lower for Meningococcal and HPV vaccine compared to Tdap.
Immunization rates (%) among 15 year olds are stable since 2021
Tdap, Meningococcal, HPV Vaccine by age 15, by County, 2024
HPV
HPV immunization is routinely recommended for adolescents at age 11-12. Adolescents who receive the first dose by the age of 15 need only one more dose to complete the series. Those who start after age 15 need a third dose to be protected. Two-thirds (66%) of Vermonters received at least one dose of HPV by age 15, with a low of 57% in Bennington County and a high of 80% in Grand Isle County (below map, HPV 1+ dose).
Statewide, 54% of Vermont youth aged 15 completed the HPV immunization series, well below the coverage goal of 80%. In only two Vermont counties, more than 60% of 15-year-olds have completed the series (below map, HPV 2+ doses). These include Grand Isle and Orange Counties. Teens who are immunized with HPV vaccine are protected against cervical, oral, genital and rectal cancers caused by this virus. In other areas of the state, immunization coverage is lower: Bennington, Essex, Windham and Windsor are all below 50%.
Meningococcal
Teens are recommended to receive two doses of Meningococcal vaccine. The first dose between age 11-12 years and the second dose at age 16. Meningococcal coverage is assessed by measuring how many teens have received at least one dose of Meningococcal vaccine by age 15. Meningococcal coverage by age 15 in Vermont in 2024 was 73%. The below map (Mening 1+ dose) shows coverage varies by county, with Addison, Caledonia, Franklin, Grand Isle, Orange, and Orleans Counties achieving over 75% coverage. Essex and Windham Counties have coverage under 70%.
Tdap
Tdap coverage by age 15 is over 78%, but Windham County is more than five percentage points below the state rate (below map, Tdap 1+ dose).
Note: Tdap, Meningococcal, and HPV immunizations are all recommended for teens in this age group by the Advisory Committee for Immunization Practices (ACIP).
Hover mouse over counties to see %
HPV 1+ dose
HPV 2+ doses
Mening 1+ dose
Tdap 1+ dose
Summary table, by county
Hepatitis A Immunization Coverage, Various Age Groups
The immunization for Hepatitis A is a two-dose series beginning at 12 months old, with a second dose at least six months after the first. If the immunization is missed in their early years, children should complete the two-dose series before they turn 18.
The below figure shows rates for Hepatitis A immunization. Rates have increased over time among all age groups, with the largest improvement in the 2-4 year olds, from 73% in 2021 to 77% in 2024.
Hepatitis A immunization uptake is improving among all age groups, 2021-2024
Conclusion
Overall, immunization rates among children and teenagers in Vermont have remained stable from 2021 through end of 2024. There continues to be significant differences in immunization rates between some counties in the state. The Vermont Immunization Registry and Immunization Program will continue working together to understand and address these disparities.
Limitations
We are reporting these data using an IMR based denominator. We believe this is the most accurate way to report, since our numbers are based on actual individuals and not annual census estimates. We acknowledge this can make our denominators too large (and our rates, subsequently somewhat lower), as it is difficult to identify and exclude individuals who did live in Vermont but have now moved out of state. To control for this we have excluded individuals who have not received any immunizations in 10+ years.
Registry Data Sources
The Vermont Department of Health uses several data sources when reporting on vaccine data. This report only includes data from the Vermont Immunization Registry. Depending on the source, there are differences in how data are collected and who is represented. This may impact the rates reported. For example, in this data set, vaccination rates may be underreported, particularly along the New Hampshire border, because people may receive vaccinations in another state and we may or may not have their information in the IMR. Information on vaccinations provided to Vermont residents outside of Vermont include: People seeking care in New Hampshire at Dartmouth Hitchcock Medical Center and people who are vaccinated in New York.
As of December 31, 2024, there were 1,076,463 individuals, and 15,176,392 immunizations in the Vermont Immunization Registry.
Approximately 91% of the 881,908 immunizations added to the IMR in 2024 came directly from electronic health records in provider offices and hospitals. Another 4% were loaded as flat files – many of these came from health insurers and others were historical information that medical practices and health clinics were able to provide. It is also possible for immunizers to directly enter information into the IMR, and this accounted for 5% of 2024 data.
Thank you to Vermont health care providers, hospitals, pharmacies and health insurers for their invaluable contributions to this health information system.