COVID-19 vaccination coverage is higher in urban versus rural counties, according to research published in Morbidity and Mortality Weekly Report. Neil Murthy, MD, and colleagues analyzed county-level vaccine data among people aged 5 and older who received a first COVID-19 vaccine between December 14, 2020 and January 31, 2022 in 50 states and the District of Columbia to examine disparities between urban and rural populations. Coverage with one or more doses was lower in rural versus urban counties overall (58.5% vs 75.4%). By state, coverage varied with one or more doses. Higher coverage was seen in urban versus rural counties in 46 states, whereas one state had higher coverage in rural versus urban counties. Completion of the primary vaccine series was higher in urban counties, whereas urban and rural counties had similarly low receipt of booster or additional doses among recipients of the primary series. Compared with estimates from a previous study, these urban-rural disparities increased more than two-fold among those now eligible for vaccination: individuals aged 5 and older.