The trust for America's Health says most states got failing grades on their outbreak readiness.
Some failed on vaccination rates for known disease threats, such as flu or whooping cough.
Some did not have enough lab capacity, and some are not giving enough funding.
New Jersey was one of the worst in the country - scoring just 2 points on a 10-point score.
Pennsylvania scored 6 out of 10 and Delaware scored 7 out of 10.