S. Stokley et al., Vaccination status of children living in rural areas in the United States - Are they protected?, AM J PREV M, 20(4), 2001, pp. 55-60
Objectives: To estimate the vaccination coverage levels of children living
in rural areas and identify statistically significant differences in covera
ge between children living in rural areas and their suburban and urban coun
terparts.
Methods: Children aged 19 to 35 months participating in the 1999 National I
mmunization Survey (NIS) were included in the study. Children were classifi
ed as living in a rural, urban, or suburban area based on their telephone e
xchange (area code plus the first three digits of the telephone number). St
atistically significant differences in vaccination coverage levels between
the rural population and their urban counterparts were determined for indiv
idual vaccines and vaccine series.
Results: Overall, 18% of the children included in the 1999 NIS lived in a r
ural area, 46% lived in a suburban area, and 36% lived in an urban area. Th
e characteristics of the rural population were: 72% were white, non-Hispani
c; 24% were below the poverty; level; 16% had a mother with < 12 years of e
ducation; and 30% received vaccinations from a public provider. Eighty perc
ent of rural children, 79% of suburban children, and 77% of urban children
completed the 4:3:1:3 series. The rural population had statistically signif
icantly lower (p <0.01) varicella coverage levels than their suburban and u
rban counterparts.
Conclusion: Results of this study suggest that children living in rural are
as are just as likely to receive the basic 4:3:1:3 vaccination series as th
eir suburban and urban counterparts. Uptake of the varicella vaccine appear
s to be slower in rural areas than urban areas, Further studies are recomme
nded to identify the risk factors for not receiving the varicella vaccine i
n rural areas.