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Awareness and Fears Regarding Immunization Among Guardians of Children Visiting HBS General Hospital Islamabad

Authors

Ameena Saba
Associate Professor
Mahwish Rabia
Professor and HOD
Tooba Riaz
Assistant Professor
Samia Mehmood
Assistant Professor
Rabia Iqbal
Senior Registrar, Department of Pediatrics, HBS Medical and Dental College, Islamabad

Abstract

Objective: To assess awareness and fears among the guardians regarding immunization and to determine the causes responsible for none/partial immunization of children.
Study Design: Descriptive Cross-sectional.
Place and Duration of Study: HBS General Hospital Islamabad, 06 months (July to December 2024).
Methodology: Total 200 guardians of none or partially immunized children according to expanded Programme of immunization (EPI) were interviewed from indoor and outpatient department. They were asked about demographic details, reasons for none or partial immunization, and their attitude and misconceptions regarding immunization were assessed. Data was analyzed using SPSS version 19 to calculate descriptive statistics.
Results: Maximum children (87%) were partially immunized and only 13% were unimmunized. Polio coverage was maximum among all the vaccines. However, the reported coverage of pentavalent vaccine was 2% and it was minimum among all the vaccines. Difficult access, careless attitude, unawareness, refusal by males, adverse effects; child sickness and misconceptions regarding vaccine source and fear of infertility were identified as accountable reasons for poor vaccine coverage. Almost half of the guardians (54.5%) had no idea about vaccine preventable diseases. Nearby EPI center was available to only 49.5% of study population.
Conclusion: This study revealed that difficult access, carelessness and unawareness are leading causes of lack of immunization. People have misconceptions regarding source, adverse effects and indication. Awareness raising strategies are needed in community.
Keywords: Awareness, Fears, Guardians, Immunization, Misconceptions, Practices, Vaccination.

How to cite this article

Saba A, Rabia M, Riaz T, Mehmood S, Iqbal R. Awareness and Fears regarding Immunization among Guardians of Children Visiting HBS General Hospital Islamabad. HMDJ. 2025 December; 05(02): 74-78.
DOI: https://doi.org/10.69884/hmdj.5.2.1501

References

  1. 1. Zhou F, Jatlaoui TC, Leidner AJ, et al. Health and Economic Benefits of Routine Childhood Immunizations in the Era of the Vaccines for Children Program — United States, 1994–2023. MMWR Morb Mortal Wkly Rep 2024;73:682–685. Doi: http://doi.org/10.15585/mmwr.mm7331a2.
  2. 2. Memon Z, Fridman D, Soofi S, Ahmed W, Muhammad S, Rizvi A, Ahmed I, Wright J, Cousens S, Bhutta ZA. Predictors and disparities in neonatal and under-5 mortality in rural Pakistan: cross-sectional analysis. Lancet Reg Health Southeast Asia 2023;15:100231. Doi: https://doi.org/10.1016/j.lansea.2023.100231 PMID:37614356 PMCID:PMC10442969.
  3. 3. Umer MF, Zofeen S, Hu W, Qi X, Zhuang G. Spatiotemporal clustering analysis of Expanded Program on Immunization (EPI) vaccination coverage in Pakistan. Sci Rep 2020;10:10980. Doi: https://doi.org/10.1038/s41598-020-67839-0.
  4. 4. Global Polio Eradication Initiative. Endemic countries [Internet]. Geneva: World Health Organization; 2020 [cited 2025 Mar 29]. Available from: https://polioeradication.org/where-we-work/pakistan/.
  5. 5. Health Department Punjab. Expanded Programme on Immunization (EPI) [Internet]. Lahore: Government of Punjab; 2015 Jan 7 [cited 2025 Mar 29]. Available from: http://health.punjab.gov.pk.
  6. 6. Vellingra A, Depoorter A, Van Damme P. Vaccination coverage estimates by EPI cluster sampling survey of children (18–20 months) in Flanders, Belgium. Acta Paediatr 2002;91:599–603. Doi: https://doi.org/10.1111/j.1651-2227.2002.tb03283.x.
  7. 7. Ullah K, Saleem J, Zakar R, et al. Exploring the reasons for defaulting from childhood immunization: a qualitative study in Pakistan. BMC Public Health 2024;24:408. Doi: https://doi.org/10.1186/s12889-024-17926-y.
  8. 8. Kuuyi A, Kogi R. Factors contributing to immunization coverage among children less than 5 years in Nadowli-Kaleo District of Upper West Region, Ghana. PLOS Glob Public Health 2024;4(8):e0002881. Doi: https://doi.org/10.1371/journal.pgph.0002881.
  9. 9. Nelson KN, Wallace AS, Sodha SV, Daniels D, Dietz V. Assessing strategies for increasing urban routine immunization coverage of childhood vaccines in low- and middle-income countries: a systematic review of peer-reviewed literature. Vaccine 2016 Nov 4;34(46):5495–5503. Doi: https://doi.org/10.1016/j.vaccine.2016.09.038.
  10. 10. Expanded Programme of Immunization, Ministry of Health, Government of Pakistan. Fact file of EPI Pakistan [Internet]. Islamabad: Government of Pakistan; [cited 2025 Jun]. Available from: http://www.epi.gov.pk.
  11. 11. Khan A, Azam N, Javaid R, Riaz M, Mughal FAR, Iqbal S. Immunization status of children in urban slums of Rawalpindi and barriers to immunization. Pak Armed Forces Med J 2024;74(4):1152–6. Doi: https://doi.org/10.51253/pafmj.v74i4.7959.
  12. 12. Butt M, Mohammed R, Butt E, Butt S, Xiang J. Why have immunization efforts in Pakistan failed to achieve global standards of vaccination uptake and infectious disease control? Risk Manag Healthc Policy 2020 Feb 12;13:111–24. Doi: https://doi.org/10.2147/RMHP.S211170 PMID:32104117 PMCID:PMC7024803.
  13. 13. Ullah K, Saleem J, Zakar R, et al. Exploring the reasons for defaulting from childhood immunization: a qualitative study in Pakistan. BMC Public Health 2024;24:408. Doi: https://doi.org/10.1186/s12889-024-17926-y.
  14. 14. Riaz A, Husain S, Yousafzai MT, Nisar MI, Shaheen F, Mahesar W, Dal SM, Omer SB, Zaidi S, Ali S. Reasons for non-vaccination and incomplete vaccinations among children in Pakistan. Vaccine 2018;36(35):5288–93. Doi: https://doi.org/10.1016/j.vaccine.2018.07.024.
  15. 15. Imtiaz M, Alam A, Mulk FU. Community perception and constraints to the Expanded Program on Immunization (EPI) in Peshawar, Pakistan: a public health perspective. THE PROGRESS: A J Multidiscip Stud 2025;6(2):56–65. Doi: https://doi.org/10.71016/tp/nch35s79.
  16. 16. Alsuwaidi AR, Hammad HAA, Elbarazi I, Sheek-Hussein M. Vaccine hesitancy within the Muslim community: Islamic faith and public health perspectives. Hum Vaccin Immunother. 2023;19(1):2190716. Doi: https://doi.org/10.1080/21645515.2023.2190716 PMID:36914409; PMCID:PMC10038058.
  17. 17. Soofi SB, Vadsaria K, Mannan S, Habib MA, Tabassum F, Hussain I, et al. Factors associated with vaccine refusal (polio and routine immunization) in high-risk areas of Pakistan: a matched case-control study. Vaccines 2023;11(5):947. https://doi.org/10.3390/vaccines11050947.
  18. 18. Centers for Disease Control and Prevention. Possible side effects from vaccine [Internet]. Atlanta: CDC; 2024 Jul 31 [cited 2025 Jun 30]. Available from: https://www.cdc.gov/vaccines/basics/possible-side-effects.html.
  19. 19. Beni A, Mazzilli S, Bellino E, Costagliola G, Ferretti E, Lopalco PL, et al. Uptake of vaccinations among children with chronic diseases is affected by knowledge gaps and implementation challenges in Italy. Vaccines 2021;9(11):1217. Doi: https://doi.org/10.3390/vaccines9111217.
  20. 20. Khan SA, Ashfaq M, Ayub A, Jamil A, Badshah J, Ullah I, Shahabuddin A, Khalid F. Developing a three-dimensional narrative to counter polio vaccine refusal in Charsadda. J Glob Health. 2020 Dec;10(2):021301. Doi: https://doi.org/10.7189/jogh.10.021301. PMID:33312515; PMCID:PMC7719351.