Pakistan's Childhood Immunization Crisis: A Retreating Success Story

Pakistan's public health sector is facing a severe setback as childhood immunization rates continue to decline. According to global data, 15.7 million children in 2023 received no routine vaccines, with Pakistan having the second-highest number of zero-dose children in South Asia, behind only India. This alarming trend has resulted in 419,000 children being left entirely unprotected from routine diseases. The reasons for this decline are complex, including the COVID-19 pandemic, unreliable infrastructure, understaffed and underpaid vaccinators, and low public trust in state vaccination campaigns. Rumors of vaccine-related harm or foreign conspiracy have further eroded trust, particularly in areas affected by conflict or displacement.

Key Takeaways:

• Pakistan has the second-highest number of zero-dose children in South Asia, with 419,000 children left unprotected from routine diseases.
• The country's immunization program was already under strain before the COVID-19 pandemic, with floods, fragile infrastructure, and political instability exacerbating the situation.
• Public trust in state vaccination campaigns remains low, with rumors of vaccine-related harm or foreign conspiracy contributing to the decline in immunization rates.
• The Expanded Programme on Immunisation (EPI) requires full federal commitment, integrated with provincial priorities and backed by real-time data.
• Mobile teams must be expanded, vaccinators protected and supported, and digital records linked to national ID databases for targeted outreach.
• International support from Gavi and UNICEF is available, but domestic political will is essential to address the crisis.

Statistics:

• 15.7 million children globally received no routine vaccines in 2023.
• Pakistan has the second-highest number of zero-dose children in South Asia, with 419,000 children left unprotected.
• 2023 vaccination rates have stalled globally, with the pandemic exacerbating the situation.