Bridging Gaps in Childhood Immunization: Socio-Economic Factors Shaping Vaccine Coverage in Pakistan

Abstract

Pakistan is one of the ten countries with the least vaccinated children, and remains to face continued challenges, including endemic polio and periodic measles outbreaks. This study examines the regional disparities of basic vaccination coverage and the impact of socio-economic factors on its improvement between 2006 and 2018 by utilizing the data from the Pakistan Demographic and Health Surveys (PDHSs). The findings divulge significant regional disparities, with children in Sindh, Khyber Pakhtunkhwa (KP), and Balochistan being 18, 13.5, and 21.6 percentage points less likely, respectively, to be fully immunized as compared to children in Punjab. Higher household wealth correlates with increased immunization likelihood, and children of educated mothers are significantly more likely to be fully immunized. Moreover, male children are more likely to be fully immunized than female children, and antenatal care and institutional births further enhance vaccination rates. A nonlinear decomposition analysis shows a 20.2 percentage point increase in coverage during this period, with given factors explaining 45% of this rise. These results underscore the need for targeted interventions in underserved regions, socio-economic support for low-income families, educational initiatives for mothers, and enhanced antenatal care and institutional delivery services to improve nationwide vaccination rates.