ArticlePediatric reports2026
Understanding Motivating Factors for COVID-19 Vaccination in Families Defaulting from Childhood Immunization: A Mixed-Methods Study in Pakistan.
Article in Pediatric reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe COVID-19 pandemic significantly disrupted health systems, including the delivery of childhood immunizations. This study assessed COVID-19 vaccination coverage in families of children with incomplete routine immunization and explored why adults accepted COVID-19 vaccines despite skipping routine vaccination for their children in the district of Swat, Khyber Pakhtunkhwa, Pakistan.
methodsA mixed-methods study was conducted in Swat District during March 2022-April 2023. A cross-sectional survey assessed COVID-19 vaccination in household members of children under 2 years of age for whom vaccination registries showed missed routine vaccinations. In-depth interviews with 18 household members explored motivations for vaccine acceptance through thematic analysis.
resultsAmong 249 families of children with incomplete immunization found through vaccination records, 237 families (88% response) were interviewed. Among 382 children below 2 years of age in these families, 29.5% (n = 113) were fully vaccinated, 67.5% (n = 258) were incompletely vaccinated according to age, and 2.9% (n = 11) had not received any vaccine. Data from 237 of the defaulter children-one per household-was included in further analysis. Among household members above 12 years of age, 87% (964/1103) of males and 82% (n = 901/1093) of females were vaccinated against COVID-19. Households with at least one fully vaccinated child were significantly more likely to have vaccinated family members. Multivariable analysis showed maternal COVID-19 vaccination (AOR 2.08, 95% CI: 1.15-3.76) and urban residence (AOR 2.08, 95% CI: 1.14-3.79) were associated with full childhood vaccination. In-depth interviews revealed that key motivators for COVID-19 vaccination included the perception that it was mandatory, house-to-house vaccination, and fear of hospitalization or death.
conclusionsVaccine requirements and ease of access to vaccination services enhanced coverage with COVID-19 vaccines among families of children with incomplete routine immunization. Ethical use of vaccine requirements and community education to enhance levels of risk perception of vaccine-preventable diseases could potentially improve childhood immunization.
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