[Analysis] Where Do People Go the Longest Between COVID-19 Vaccine Doses?

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COVID-19 is back on the rise, with a winter spike driven by the new JN.1 variant that led to as many as 10,000 deaths in December 2023, according to the director-general of the World Health Organization.

And with the help of the 2022 National Health Interview Survey — the most recent release from a comprehensive annual health survey conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics — we can look at where and when American adults are getting vaccinated.

In 76% of the more than 27,600 responding households, adult respondents indicated that they had received at least one dose of a COVID-19 vaccine and were able to provide information about the month and year of their last vaccination. The largest numbers of those respondents received their most recent vaccine dose in the final months of 2021.

Of those respondents, 28% had their most recent vaccine dose in the three months prior to their survey interview, and just over 52% had been vaccinated no more than six months before their interview. Only 1 in 6 vaccinated respondents had gone more than a year between their last dose and their survey interview.

The southern region of the U.S. lagged behind the rest of the country on several vaccination-related metrics, though. In 2022, it was the only region where less than half of vaccinated respondents had received a dose within six months before their interview. Southern respondents were also the least likely to have received multiple doses of the vaccine (28%) and the most likely to indicate that they had not yet been vaccinated (22%).

Southern states have also been particularly slow to adopt the updated 2023-2024 COVID-19 vaccine, according to data from the Centers for Disease Control and Prevention. Of the 17 states in the South Census region, Fewer than 20% of adults had received the new vaccination in 13 of the 17 states located in the Census’s South region as of the end of December, including the 10 lowest coverage rates by state.

Southern states also had the highest rates of adults who were either probably or definitely planning not to receive the updated vaccine, with six states where more than half of adults were not planning to receive the new shot (although Wyoming has by far the highest rate, with over 70% of adults planning not to receive the new vaccine).

That’s a troubling trend for a region that includes four of the 10 highest COVID death rates by state in the country over the last three months: Kentucky, West Virginia, Oklahoma and Mississippi — all of which have vaccination coverage below 20%, non-vaccination intent above 50%, or both.

Data source

Data on the time between vaccine doses comes from the National Center for Health Statistics’ 2022 National Health Interview Survey, which interviewed 27,651 households about various facets of their health. We compared the months in which respondents were interviewed to the months and years of the most recent COVID-19 vaccine dose they reported (and the second most recent), where applicable, and broke the results down by region as specified by the U.S. Census Bureau.

Data on coverage and intent for the updated 2023-2024 COVID-19 vaccine comes from the Centers for Disease Control and Prevention’s COVIDVaxView dashboard, which uses weekly random-sample surveys to report vaccine coverage. Vaccination coverage is defined as the percentage of adults that have received at least one new vaccine dose since September 14, 2023.

Data on COVID-19 death rates by state comes from the CDC’s COVID Data Tracker.