About the Author: Zoya Aslam is a healthcare professional with 9.5 years of clinical nursing experience and patient-centered care. She has served as a Clinical Nurse 1, an Infection Control Nurse, and an OPD Team Leader, gaining extensive experience in clinical management and patient safety. She is currently pursuing a Master of Science in Nursing at Aga Khan University Hospital. Through her writing, she aims to promote evidence-based healthcare awareness and contribute to improving public health outcomes in Pakistan.

Immunization in Pakistan: A Pathway to Good Health and Well-Being in Pakistan

Immunization is an effective and affordable way to improve public health, yet many children worldwide still do not get protection from vaccine-preventable diseases. Under the United Nations Sustainable Development Goal 3 (SDG 3), Good Health and Well-Being, immunization is recognized as essential to reducing child mortality and supporting strong healthcare systems. In Pakistan, a country of over 230 million people, gaps in immunization remain, especially for vulnerable and under-resourced groups such as women in conservative areas, communities, and families living in poverty. Addressing immunization inequity is not merely a public health priority, but it is a matter of human rights, social justice, and national development. For nurses and healthcare workers, addressing these gaps is essential to provide effective and culturally sensitive, equitable care across Pakistan's diverse communities.

Pakistan still struggles to reach full immunization coverage. According to the World Health Organization and Global Polio Eradication Initiative (GPEI), Pakistan reported 6 wild poliovirus cases in 2023, reflecting persistent gaps in vaccination reach, particularly in conflict-affected regions of Khyber Pakhtunkhwa and Balochistan (Mbaeyi et al., 2024). The global coverage for the DTP3 vaccine among one-year-olds was 85% in 2024, below the WHO target of 90%, leaving a large proportion of children at risk (World Health Organization [WHO] & UNICEF, 2025).

 Vaccine hesitancy is a significant contributing factor; some communities expressed reluctance toward routine vaccination for their children, often due to safety concerns and misinformation linked to cultur Well-being Immunization Immunizational and religious beliefs. Multicultural dimensions and language barriers further complicate immunization efforts, even when resources are available. An analysis from 2023, based on data from 6.2 million children in the Sindh Electronic Immunization Registry, shows that children in Sindh face gender-based differences in vaccine coverage, which can increase health inequalities among vulnerable groups (Siddiqi et al., 2023). According to the EPI report (2023), measles incidence rose drastically in Punjab and Sindh, with a 30.38% increase in cases compared to 2022, disproportionately affecting unvaccinated malnourished children (EPI Punjab, 2024), underscoring how poverty and poor vaccine uptake intersect to amplify health inequities. Nurses, midwives, and Lady Health Visitors (LHV) serve as frontline community health advocates in closing these gaps by building trust and offering culturally sensitive support to families across Pakistan.

The consequences of low immunization coverage extend far beyond individual illness, threatening Pakistan's progress toward multiple SDG 3 targets, including reducing under-five mortality, fighting infectious diseases, and achieving universal health coverage. Nurses, midwives, and LHVs, as part of the healthcare workforce, are uniquely positioned to lead community immunization campaigns, identify vaccine-hesitant groups, and advocate for health equity across different cultures and languages. Strengthening cold chain infrastructure, expanding community health worker training, and integrating health education that is sensitive to cultural differences are essential policy priorities. Additionally, empowering women with health literacy, especially in regions where gender inequality limits maternal decision-making, can significantly improve vaccine uptake in households. Every child in Pakistan, regardless of ethnicity, geography, or socioeconomic status, deserves the protection that immunization offers, because healthy lives and well-being begin with a vaccine.

Call to Action

        Don't wait; protect your child today and ensure they are fully vaccinated. Your voice and actions can help create change. What immunization barriers are you witnessing in your district or healthcare facility? We want to hear from nurses, midwives, community leaders, and policymakers. Share your reflections below, because immunization equity is a goal we can only reach together.

References

Expanded Programme on Immunization [EPI] Punjab. (2024, June 6). Per-million measles incidence on the rise over last three years [Report cited in news article]. Dawn. https://www.dawn.com/news/1838069

Mbaeyi, C., ul Haq, A., Safdar, R. M., Khan, Z., Corkum, M., Henderson, E., Wadood, Z. M., Alam, M. M., & Franka, R. (2024, September 12). Progress toward poliomyelitis eradication—Pakistan, January 2023–June 2024. MMWR. Morbidity and Mortality Weekly Report, 73(36), 788–792. https://www.cdc.gov/mmwr/volumes/73/wr/mm7336a2.htm

Siddiqi, D. A., Iftikhar, S., Siddique, M., Mehmood, M., Dharma, V. K., Shah, M. T., Setayesh, H., & Chandir, S. (2023). Immunization gender inequity in Pakistan: An analysis of 6.2 million children born from 2019 to 2022 and enrolled in the Sindh Electronic Immunization Registry. Vaccines, 11(3), 685. https://doi.org/10.3390/vaccines11030685

World Health Organization, & UNICEF. (2025, July 15). Global childhood vaccination holds steady, yet over 14 million infants remain unvaccinated [Press release]. https://www.who.int/news-room/fact-sheets/detail/immunization-coverage