With the national resurgence of measles making headlines in recent weeks, Colorado’s latest health report card highlights the state’s vulnerabilities to such infectious diseases.

The state lost ground on toddler immunizations since last year, moving from 18th to 30th on the report card’s state-by-state ranking. That drop is based on a continuing decline in the percentage of Colorado toddlers who are up to date on six key vaccinations. (In 2013, 69.2 percent of toddlers got the six immunizations, down from 75.8 percent in 2011.)

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Immunization rates are one of five indicators that figured into Colorado’s C grade—the same as last year– on the “Healthy Beginnings” category of the 2015 report card, which is published by the Colorado Health Foundation in partnership with the Colorado Health Institute. (The Colorado Health Foundation is a funder of Chalkbeat Colorado).

Update: See what the head of the Colorado Health Institute had to say about immunization rates here

Analysts from the Institute said Colorado would have earned a C+ this year if its immunization ranking had stayed at 18th. Others indicators in the “Healthy Beginnings” category include prenatal health care, smoking status during pregnancy, low birth weight, and infant mortality.

The state also earned a C in the “Healthy Children” category for the second year in a row. Overall, there was little change in that category’s indicators, which include insurance coverage, obesity rates, poverty status, and dental care. Compared to other states, Colorado ranks particularly poorly when it comes the percentage of children without health insurance (7.1 percent) and the percentage with a medical home (55.3 percent).

Given the state’s lackluster grades in the two earliest life stages, the report card’s authors recommended a focus on improving the health of babies and children in the state. Three older groups received better grades, with “Healthy Adolescents” earning a B, “Healthy Adults” a B+ and “Healthy Aging” an A-.