The purpose of this study is to assess the quality of pediatric healthcare provided to rural minorities using timeliness of immunization receipt as a marker for quality. Findings include: 1) Children living in rural areas are less likely to receive newly recommended vaccines within the first two years after introduction of the recommendation.; 2) There are no significant differences in the percentages of children up-to-date with their immunizations between Whites, Blacks, and Hispanics living in urban and rural areas.; 3) By 2001 lack of health insurance was the strongest predictor for children not receiving their immunizations in a timely manner.; 4) When using national surveys, there is significant year-to-year variation in the percentage of children who are up-to-date with their immunizations.