Missouri’s vaccination rates have long trailed the national average — and this year, data show they’re slipping even further. From childhood immunizations to flu and COVID-19 shots, fewer Missourians are rolling up their sleeves.
MU Health Care officials say they expect a “moderate” flu season this year, following an unusually severe one last winter that led to high hospitalization rates. Still, health experts are urging residents not to take chances.
Despite ongoing confusion over federal vaccination guidelines, COVID-19 shots remain available for adults 65 and older. Younger individuals can receive the vaccine with a signed consent form.
Experts say maintaining herd immunity — the protection that comes when most people in a community are vaccinated — is essential for preventing the spread of infectious diseases. But a KBIA analysis of data from Mid-Missouri and Boone County shows overall immunization rates are declining.
Vaccination rates dropping in Boone County
A KBIA analysis of data from the Columbia/Boone County Public Health and Human Services Department shows a continued decline in overall immunization rates.
In the first three weeks of October 2025, Boone County administered 51 COVID-19 vaccinations through its outreach clinics. That’s a 28% drop from the same period last year.
Flu shots are also less prevalent. So far this season, just 192 people in the county have received a flu vaccine at the county’s clinic, compared to 554 people this time last year.
The county’s five-year data of flu vaccination shows an overall downward trend with an exception in 2022-23 flu season.
Austin Krohn, a public health information specialist with the county, said the decline has not yet had a major measurable impact, but it raises concerns.
“If we go back to 2020, when the pandemic started, that’s really when we began to see those drops,” Krohn said. “Last year, we saw the biggest spike in flu cases since 2003. It could be a coincidence, but those spikes are more likely when fewer people are vaccinated.”
COVID-19 skepticism spills over to other vaccines
Public health experts say lingering skepticism and controversy surrounding the COVID-19 vaccine have fueled hesitancy toward other immunizations.
“The positive perceptions of the flu vaccine have been eroded by our experience with the COVID vaccine,” said Lynelle Phillips, president of the Missouri Coalition for Immunization (MCI). “For instance, the COVID vaccine generated a lot of feelings about mandates in workplaces, and there was a lot of pushback. Hospitals that have required flu vaccines for their staff for years are now facing new resistance. That’s an example of how attitudes toward the COVID vaccine have spilled over and affected other vaccines.”
Phillips said confusion over changing federal guidelines has further complicated outreach efforts.
“People might mix up what’s going on federally with COVID vaccines and apply that to the flu,” she said. “They might have the same concerns about the flu shot that they do about the COVID shot.”
MCI lost its federal funding from the Centers for Disease Control and Prevention in April and is now on the verge of shutting down its operations.
Central Missouri trends mirror state decline
According to data from the University of Missouri Extension, central Missouri’s COVID-19 vaccination rate was 60% in 2022–23 — consistent with the state average but below the national rate of 72%. Influenza vaccination rates were slightly lower, at 52%, compared to Missouri’s statewide average of 54%.
Flu immunization rates have declined steadily since 2019, except during the 2020–21 season, the peak of the pandemic.
Krohn said Boone County still fares better than much of the state when it comes to vaccination coverage.
“In the long term, we hope the vaccination rate starts trending upward again,” he said. “Columbia and Boone County are fortunate — we still have relatively strong community immunity in a state where overall vaccination rates are dropping pretty drastically.”
Missouri’s 2024–25 flu season was among the worst in recent years, with 12,503 reported cases across the state, many of them in central Missouri. So far this region counties have reported 19 influenza cases — down from 61 at the same time last year — though experts say it’s too early to draw conclusions.