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

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