Childhood Vaccination Practices and Parental Hesitancy Barriers in Rural and Urban Primary Care Settings

Abstract

The purpose of our study was to identify primary care providers’ (PCPs’) practices in promoting childhood vaccination and their perceptions regarding barriers to vaccination in a primarily rural state. In January-May 2022, we conducted a mail and online survey of PCPs across Montana (n = 829). The survey included modules on routine immunizations in children 0–2 years old and COVID-19 vaccination in children 5–17 years old. The survey response rate was 36% (298/829). We categorized PCPs as working in rural (n = 218) or urban areas (n = 80), based on Rural-Urban Commuting Area codes. We then compared responses between rural and urban PCPs using chi-square tests. Urban PCPs (90–94%, depending on vaccine) stocked routinely recommended vaccines more frequently than rural PCPs (71–84%), but stocked the COVID-19 vaccine less often than rural PCPs (44% vs. 71%, respectively, p < 0.001). A higher percentage of rural providers reported parental beliefs that vaccine-preventable diseases are not severe enough to warrant vaccination (48% vs. 31%, p = 0.01) and concerns that vaccination will weaken their child’s immune system (29% vs. 6%, p < 0.001). More rural (74%) compared to urban (59%) PCPs identified a social media campaign from local health departments promoting early childhood vaccinations as an effective strategy to increase childhood vaccination rates ( p = 0.01). We identified key differences in some childhood vaccination practices and barriers between rural and urban PCPs. Interventions to increase rural vaccination rates could include increasing the number of providers stocking all recommended vaccines, identifying strategies to address parents’ concerns regarding vaccine necessity, and collaborations with public health departments. Supplementary Information The online version contains supplementary material available at 10.1007/s10900-023-01226-4.

Has COVID-19 Affected DTP3 Vaccination in the Americas?

“…Last, policies should enhance public awareness about the importance of routine vaccinations and combating misinformation. Community-based interventions and social media campaigns can play a crucial role in increasing vaccine uptake [ 14 , 105 ].…”

“…Factors influencing disparities in vaccination rates include geographic location (urban vs. rural), socioeconomic status, educational level [ 11 , 12 ], and the regularity of maternal prenatal care [ 13 ]. Parents in rural areas believe vaccine-preventable diseases (VPD) are not severe enough to justify vaccination [ 14 ]. The emergence of the COVID-19 pandemic has placed an extraordinary burden on global healthcare infrastructures, potentially impacting the continuity of standard immunization efforts [ 15 , 16 , 17 , 18 , 19 , 20 ].…”

Parental perceptions, attitudes, and beliefs regarding vaccination of children aged 0–5 years: A qualitative study of hill-tribe communities, Thailand

“… 41–43 Providing effective communication and education, as well as raising public awareness through campaigns by trusted healthcare providers and community leaders, would reduce the vaccine hesitancy of hill tribe parents at the community level, helping limit the spread of rumors and distrust. 44 …”

Has COVID-19 Affected DTP3 Vaccination in the Americas?

“…Last, policies should enhance public awareness about the importance of routine vaccinations and combating misinformation. Community-based interventions and social media campaigns can play a crucial role in increasing vaccine uptake [14,79].…”

“…Factors influencing disparities in vaccination rates include geographic location (urban vs. rural), socioeconomic status, educational level [11,12] and the regularity of maternal prenatal care [13]. Parents in rural areas believe vaccine-preventable diseases (VPD) are not severe enough to justify vaccination [14]. The emergence of the COVID-19 pandemic has placed an extraordinary burden on global healthcare infrastructures, potentially impacting the continuity of standard immunization efforts [15][16][17][18][19][20].…”