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September 2010, Volume 60, Issue 9

Student's Corner

Improving childhood vaccination: roadblocks and hurdles

Madam, immunization, when administered according to specified recommendations in an age-appropriate setting, helps save millions of lives from the scourge of death and disease. The maxim that prevention is better than cure holds true hitherto and vaccination is perhaps one of the most pivotal tools in the paraphernalia for preventing disease in childhood. Vaccination, as a preventive stratagem, is sine qua none for reducing childhood mortality in developing countries. Many of these regions are still struggling to cope with the burden of infectious diseases, which account for at least two thirds of childhood mortality.1 Although additional areas such as sanitation, supply of safe water, nutrition1 and maternal health need to be adequately addressed in future public health policies, vaccination nevertheless remains a cost-effective strategy that deserves immediate attention of the health care and allied systems.
It is important to identify the challenges that vaccination programmes are facing today so that specific plans can be tailored to target these challenges. Subsequently, the performance of these vaccination programmes can be optimized. In a survey-based study, barriers towards childhood immunization in a rural population were identified as living in health professional shortage areas, negative beliefs and attitudes regarding childhood immunizations, accessibility problems, and perceived inadequate support from the immunization clinic.2 Another study from Istanbul reported lack of knowledge about vaccination as a barrier for vaccination.3 Misdemeanor against vaccination campaigns and health personnel by certain religious segments in developing countries like Afghanistan and Pakistan is also an emerging and important reason undermining the success of vaccination programmes in these areas.4 All of these barriers are very pertinent to a developing country like Pakistan where accessibility and availability of health care professionals are suboptimal. Health education messages delivered to parents by primary level health care facilities and media are important to increase the vaccination status of children in the country.5 It is also important to engage religious scholars in dialogue to help dispel misconceptions of the public about vaccinations.4
Every child has an irrefutable right to life and vaccination can help realize that right. However, it is important that future campaigns be devised keeping these challenges in mind.
Taimur Saleem
Medical College, Aga Khan University, Stadium Road, Karachi, Pakistan.


1.Mehnaz A. Infectious diseases in children - still leads. J Pak Med Assoc 2009; 59: 425-6.
2.Gore P, Madhavan S, Curry D, McClung G, Castiglia M, Rosenbluth SA, et al. Predictors of childhood immunization completion in a rural population. Soc Sci Med 1999; 48: 1011-27.
3.Torun SD, Bakirci N. Vaccination coverage and reasons for non-vaccination in a district of Istanbul. BMC Public Health 2006; 6: 125.
4.Warraich HJ. Religious opposition to polio vaccination. Emerg Infect Dis 2009; 15: 978-9.
5.Anjum Q, Omair A, Inam SN, Ahmed Y, Usman Y, Shaikh S. Improving vaccination status of children under five through health education. J Pak Med Assoc 2004; 54: 610-3.

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