Table 2.
Extracted data from each selected paper: first author/year/citation number, location, study population, methodology, immunization focus, and sample size.
| First Author (year) | Location | Study Population | Methodology | Immunization focus | Sample size | |
|---|---|---|---|---|---|---|
| 1 | Albright (2014) | 14 counties in Colorado (4 rural, 10 non-rural) | HCP | Mixed methods study utilizing Colorado IIS for reminder/recall. Conducted HCP and staff interviews and surveys about provider experiences, attitudes, and current utility of reminder/recall systems. | IMM not specified Age: 19–35 months |
253 surveys; 82 interviews |
| 2 | Bardenheier (2004) | Manhattan, Detroit, San Diego, and rural Colorado (made up of 4 counties) | Parents/ caregivers |
Cross-sectional household surveys gathered demographic information and parental knowledge of and experiences with early childhood immunization. | DTP/DTaP, Polio, Hib, HepB Age: 3 months |
847(New York)771 (Detroit)843 (San Diego)1091 (Colorado) |
| 3 | Daley (2005) | 2 large rural areas in Colorado & Denver, Colorado for urban | HCP | Survey to assess vaccine recommendations providers used during vaccine shortage and when supply was adequate. | PCV7 Age: 0–5 years*, focused on <2 years |
32 (rural)52 (urban pediatricians)129 (urban family medicine) |
| 4 | Deutchman (2000) | Colorado (across 52 rural counties) | HCP | Mailed questionnaire to HCPs about their perception of immunization challenges in their community and current vaccine practices at their facility. | Early childhood IMM Age: <2years |
158 |
| 5 | Fagnan (2011) | Rural Oregon | HCP | Mailed survey to HCPs about immunization practices, barriers to immunization, and their opinions and perceptions of early childhood immunizations. | DTaP, Polio, MMR, Hib, HepB, PCV, VAR, Influenza, HepA Age: <36 months |
407 |
| 6 | Glazner (2001) | Rural Colorado | HCP | Quantitative study. Cost assessment of reimbursement rates. Selected clinics tracked time spent on vaccine-related tasks over a month. Data were assessed from multiple private practices, health departments, and FQHCs. | DTaP, MMR, Hib, HepB, Polio, VAR, DTaP-Hib Age: <36 months |
13 clinics (6 private practice, 4 health departments, 3 FQHC) |
| 7 |
Hicks (2007) |
Rural northeast Colorado | Parents/ caregivers |
Quantitative study of reminder-recall in a Family Health Center. The intervention included reminder cards in preferred language and posters in exam rooms. Vaccines rates were quantified pre and post intervention among Latinx patients. | DTaP, Polio, Hib, HepB, MMR, VAR Age: 13–35 months |
240 baseline, 263 post-intervention |
| 8 | Kempe (2001) | Rural south-central Colorado (Alamosa and Rio Grande Counties) | Data source: Registry Study population: Children |
Quantified immunization rates after implementation of a regional immunization registry. | DTP, Polio, Hib, HepB, MMR Age: 3–35 months |
876 |
| 9 | Kettunen (2017) | Rural Ashtabula County in Ohio | Parents/ caregivers |
Survey sent to Amish parents to collect information about parental experience with and knowledge of early childhood immunizations. | * | 84 |
| 10 | Mical (2021) | Not specified, rural focused | Parents/ caregivers |
Qualitative improvement study that evaluated provider-level interventions to decrease parental hesitancy and increase vaccine uptake in a rural clinic setting. Participants were provided a pre and post intervention survey to determine a level of vaccine hesitancy. | All recommended childhood vaccinations, excluding influenza Age: 2 months-5 years |
70 |
| 11 | Newcomer (2021) | Analysis of children’s vaccination status throughout Montana, rural and non-rural communities included | Data source: Registry Study population: Children |
Quantitative study that analyzed data from state immunization registry to investigate vaccine timeliness and under-vaccination patterns. | Combined 7-vaccine series (DTaP, Polio, MMR, HepB, Hib, VAR, PCV) Age: 0–24 months |
31,422 |
| 12 | Renfrew (2001) | 5 sites in rural Northeast Colorado and 5 sites in south-central Colorado (San Luis Valley) | Data source: Registry Study population: Children |
Quantified changes in immunization rates at primary care sites based using chart reviews to update immunization status at primary care facilities. Used to assess potential effects of a regional immunization registry. | DTP, HepB, Hib, Polio, MMR Age: 12–18 months, 24–30 months |
1533 |
| 13 | Rosenthal (2004) | Urban sites: Detroit, New York, San Diego Rural site: rural Colorado |
Parents/ caregivers |
Interviews collected data about parental perception of early childhood immunizations, their use of immunization services, participation in federally funded programs, resource availability (e.g., transportation), and demographic information. A quantitative analysis assessed relationships of child immunization status and parental/family characteristics collected during the interview. | DTP, Polio, MMR, Hib, HepB Age: 12–35 months |
502(Detroit),520 (New York) 555(San Diego) 713 (Colorado) |
| 14 | Saville (2014) | 7 counties in Colorado, urban and rural counties |
Parents/ caregivers |
Mailed survey about parents’ reminder/recall preferences. | Early childhood IMM recommended by ACIP (influenza excluded) Age: 19–35 months |
178(rural) & 156(urban) |
| 15 | Stokley (2001) | U.S., urban and rural | Data source: Registry Study population: Children |
Quantitative study that analyzed National Immunization Survey-Child data to compare suburban, urban, and rural vaccine coverage. | DTP, Polio, MCV, Hib, HepB, VAR Age: 19–35 months |
25,521 |
| 16 | Thomas (2004) | Semi-rural community in Bakersfield, California | Parents/ caregivers |
Door-to-door surveys and follow-up focus groups. Participants were asked about barriers, perceptions, and attitudes about their experiences with early childhood immunizations. Mixed-methods study. | Polio, DTP, Hib, HepB, MMR, VAR Age: <3years |
18(focus group) & 207 (surveys) |
| 17 | Wilson (2000) | Rural Missouri | Parents/caregivers | Qualitative study using phone or in-person interviews with parents which described experiences with child IMM and assessed parental knowledge. | IMM recommended to children under 4 years by CDC Age: 2 months-4 years |
12 |
Abbreviations (non-vaccines): Health Care Provider (HCP); Immunization (IMM); Immunization Information System (IIS); Advisory Committee on Immunization Practices (ACIP); Parent/caregiver (P/CG); Federally Qualified Health Center (FQHC). Abbreviations (vaccines): Diphtheria, Tetanus, Pertussis (or acellular Pertussis) (DTP, DTaP); Measles, Mumps, Rubella (MMR); Varicella (VAR); Hepatitis B (HepB); Hepatitis A (HepA); Haemophilus influenzae type b (Hib); Meningococcal conjugate vaccine (MCV); Poliovirus (Polio); Pneumococcal conjugate vaccine (PCV7).
*Kettunen et al. (2017) did not specify immunizations. They refer to childhood immunizations and mention pertussis, rubella, measles, varicella, and Hib and the recommended vaccine schedule for early childhood immunizations.