ATLANTA — A U.S. government report finds rural counties are behind urban counties in their coronavirus vaccination efforts, a gap that could slow the fight against the coronavirus.

The Centers for Disease Control and Prevention reported Tuesday that 39% of adults in rural counties had received at least one shot compared to 46% in urban counties as of April 10. The rural lag holds up in women, men and both younger and older adults.

Polling suggests rural Americans are more likely than others to say they’ll avoid vaccination. The CDC report says rural Americans may have more trouble traveling to distant vaccination sites.

Early in the pandemic, the coronavirus hit large cities. By September, it spread throughout the country and case rates in rural areas eventually surpassed urban centers. Some research suggests rural Americans may be more vulnerable to serious infection and death from COVID-19.

The CDC says public health departments should work with doctors, pharmacies, faith groups and employers in rural areas to address the gap in coverage.