Perceived Barriers to Childhood Immunization Among Rural Populations

Abstract

Recent statistics demonstrate a trend toward increasing numbers of underimmunized preschool children in rural areas of the United States. The problem has been particularly severe in three predominantly rural counties in the northwest region of South Carolina. A Department of Health and Environmental Control (DHEC) report indicated that the immunization rates for infants and toddlers in these counties were about 50% despite additional efforts to improve the situation. A local health department official and former colleague expressed concern about the low rates and the possible futility of additional efforts without more information related to the actual barriers creating such dismal immunization rates. Failure to immunize these young children leaves them vulnerable to preventable childhood diseases and sequelae. Literature exists related to barriers in urban settings (Clements, Wilier, MacCormack, Weigle, & Denny, 1990; Markland & Durand, 1976; Orenstein, Atkinson, Mason, & Bernier, 1990; Salsberry, Nickel, & Mitch, 1993), however, very little is known about barriers in rural settings.