"In many of these areas," they write, "rural hospitals have been closing at an alarming rate, leaving people to travel farther for care. The population is also older. Public transportation that could help poor or elderly residents reach hospitals is rare, and distance and geography, such as mountain roads, can mean driving to those sites takes time."
Another obstacle is rural Americans themselves. Their thinking about vaccines is "influenced by media and word of mouth, politics and religion, as well as previous experience with vaccinations," the professors wrote, noting a Kaiser Family Foundation poll in December that found about 35% of rural Americans said they probably or definitely would not get a vaccine, higher than the 27% nationwide.
"Getting accurate information about the vaccine and how to receive it into rural areas has also proved difficult," the professors write. "Many rural counties still have limited access to broadband internet connections, smartphone service and other technologies. That often means residents rely on television, newspapers and radio for news, which can limit the depth and scope of information."