ReviewPreventive medicine reports2022
Barriers to and facilitators of early childhood immunization in rural areas of the United States: A systematic review of the literature.
Review in Preventive medicine reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- The effect of mHealth on childhood vaccination in Africa: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Gaps in Routine Childhood Immunization Among Low-Income Children at 24 Months (2019-2024).AJPM focus · 2026Article
- Clusters of Concern - Spatial Link between Childhood Undervaccination and Measles Outbreaks in South Carolina.The New England journal of medicine · 2026Article
- Barriers to Childhood Immunisation in Selected Zero-Dose Communities in Gauteng Province: A Qualitative Study.Vaccines · 2026Article
- Examining wealth-related inequality in childhood vaccination in Fiji using the UNICEF Multiple Indicator Cluster Survey 2021.International health · 2026Article
- Bridging the gap: a review of the factors contributing to differences in vaccination coverage among rural and urban adults.Vaccine · 2026Review
- Zero-Dose Childhood Immunization in Conflict-Affected PSNP Districts of Ethiopia: A Comparative Cross-Sectional Study.Gates open research · 2026Article
- The future impact of zero-dose children in inaccessible conflict-affected areas of Somalia: aligned with the immunization agenda 2030.Tropical medicine and health · 2025Article
- Article
- Influenza Vaccine Coverage Lower in Foreign-Born Middle Eastern and North African Children Compared to Other Groups: Results from the 2005-2018 National Health Interview Survey.Journal of racial and ethnic health disparities · 2025Article
- Article
- Parental Barriers and Sociodemographic Disparities in Childhood Vaccination Post-COVID-19 in Tennessee.Vaccines · 2025Article
- Assessing Prevalence and Regional Disparities in Zero-Dose Immunization Among Children Aged 12-23 Months in Somalia.Journal of epidemiology and global health · 2025Article
- Early Childhood Vaccination Coverage and Patterns by Rural-Urban Commuting Area.American journal of preventive medicine · 2025Article
- Rural-urban disparities in human papillomavirus vaccination: Findings from a cross-sectional survey of 13 southern US states, December 2019-January 2020.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Regional Disparities and Maternal Sociodemographic Determinants of Full Immunization Coverage Among Children Aged 12-23 Months in Nigeria: Insights from NDHS 2018.Pediatric health, medicine and therapeutics · 2025Article
- Rotavirus vaccine dose-two dropout and its associated factors among children who received rotavirus vaccine dose-one in Sub-Saharan African countries: A multilevel analysis of the recent demographic and health survey.Human vaccines & immunotherapeutics · 2024Article
- Article
- Article
- Individual and Geospatial Determinants of Health Associated With School-Based Human Papillomavirus Immunization in Alberta: Population-Based Cohort Study.JMIR public health and surveillance · 2024Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
Early childhood vaccination rates are lower in rural areas of the U.S. compared with suburban and urban areas. Our aim was to identify barriers to and facilitators of early childhood immunization in rural U.S. communities. We completed a systematic review of original research conducted in the U.S. between January 1, 2000-July 25, 2021. We searched PubMed, Cumulative Index for Nursing and Allied Health Literature, and Web of Science. We included studies that examined barriers to and facilitators of routine immunizations in children <36 months old in rural areas. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, we reported studies' methodologies and targeted populations, definitions of rurality, and common themes across studies that reflected barriers to or facilitators of vaccination. Ultimately, 17 papers met inclusion criteria for review. The majority of studies (10/17) were conducted within one U.S. state, and the same number (10/17) were conducted prior to 2005. Facilitators of vaccine uptake in rural communities identified across studies included reminder/recall systems and parents' relationships with providers. Parental hesitancy, negative clinic experiences, referrals outside of primary care settings, and distance to providers were identified as barriers to vaccination in rural settings. This review revealed a limited scope of evidence on barriers to and facilitators of early childhood immunization in rural communities. More investigations of the causes of low vaccine coverage and the effectiveness of interventions for increasing vaccine uptake are urgently needed in rural pediatric populations to address persistent rural-urban immunization disparities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.