# Project 3: Investigating barriers to timely early childhood vaccination in Montana

> **NIH NIH P20** · UNIVERSITY OF MONTANA · 2020 · $212,652

## Abstract

Project Summary/Abstract
Early childhood vaccinations are one of the most important public health interventions of the past century;
however, vaccine coverage in the rural U.S. has lagged behind urban areas. Montana, a largely rural state,
has suffered from persistently low vaccination rates and a resurgence of vaccine-preventable diseases among
young children. There is currently a lack of evidence explaining Montana's low early childhood vaccination
rates. Structural barriers may be a factor, including a high proportion of medically-underserved areas,
transportation obstacles, and a lack of systems for reminding parents to return for additional vaccine doses.
Our preliminary analyses suggest that parental vaccine hesitancy may also be on the rise in Montana, with an
increasing number of parents choosing to delay or refuse vaccines for their children. To effectively target
interventions to increase vaccination rates, there is a need to systematically distinguish how much of
Montana's undervaccination problem is due to structural barriers versus parental vaccine hesitancy, and
whether certain barriers are more common in certain areas of Montana. We will quantify the impact of
structural barriers versus parental vaccine hesitancy barriers on Montana's low early childhood vaccination
rates (Aim 1), identify factors associated with low vaccination rates in Montana, including whether specific
barriers to vaccination are geographically clustered (Aim 2), and identify interventions to increase vaccination
rates supported by the Montana medical community (Aim 3). These aims will be achieved through analysis of
immunization records in Montana's centralized immunization information system for children ages 0-3 years
who were born in Montana 2015-2017, and through a state-wide survey of pediatric and family medicine
providers. The proposed work is fundamental to improving Montana's vaccine coverage because interventions
to increase vaccine uptake differ based on the type of barrier being addressed. For example, structural barriers
may be addressed by recruiting additional vaccine providers, implementing reminder/recall programs, or
establishing vaccine clinics in non-traditional settings. In contrast, interventions to address vaccine hesitancy
include motivational interviewing, parent education programs, and interactive social media tools. Based on our
findings, we will pinpoint specific interventions to increase early childhood vaccine coverage in Montana, and
we will submit a R01 application to the National Institutes of Allergy and Infectious Diseases to implement and
test such interventions. This work is an important step toward eliminating national rural-urban disparities in
early childhood vaccination rates.

## Key facts

- **NIH application ID:** 9853535
- **Project number:** 1P20GM130418-01A1
- **Recipient organization:** UNIVERSITY OF MONTANA
- **Principal Investigator:** Sophia Raff Newcomer
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $212,652
- **Award type:** 1
- **Project period:** — → —

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9853535

## Citation

> US National Institutes of Health, RePORTER application 9853535, Project 3: Investigating barriers to timely early childhood vaccination in Montana (1P20GM130418-01A1). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9853535. Licensed CC0.

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