Vaccination status of children living in rural areas in the United States - Are they protected?

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.