The leading pediatric experts have called for coordinated measures to address persistent gaps in Pakistan’s immunization system, including vaccine hesitancy, missed vaccinations, and delayed protection against measles in early infancy.
Addressing a webinar titled “Beyond Access: Tackling Hesitancy, Dropouts, and Missed Vaccination” which was organized by the University of Child Health Sciences (UCHS) and The Children’s Hospital Lahore in collaboration with the Pakistan Pediatric Association (PPA) Lahore Chapter, Prof. Sajid Maqbool reaffirmed that vaccination remains one of the most effective and safest public health interventions. He emphasized the need to tailor immunization strategies according to local disease patterns and programmatic realities. He also noted that the COVID-19 pandemic significantly disrupted routine immunization services, contributing to increased vaccine hesitancy and missed vaccinations. He estimated that approximately 325,000 children in Pakistan miss routine immunization each year.
Prof. Maqbool identified misinformation, cultural misconceptions, mistrust, and social influence as major drivers of vaccine hesitancy. He clarified that only severe allergic reactions constitute true contraindications to vaccination, while common conditions such as mild illness, malnutrition, prematurity, antibiotic use, and breastfeeding should not delay immunization.
The session was inaugurated with a welcome address by Prof. Tipu Sultan, Medical Director of The Children’s Hospital Lahore and Vice President PPA Punjab. Prof. Masood Sadiq, Vice Chancellor UCHS and President PPA, highlighted the importance of Immunization Awareness Week and emphasized the crucial role of pediatricians in improving vaccine acceptance through advocacy, caregiver counseling, and strengthened community engagement.
Dr. Wajiha Rizwan and co-moderated by Dr. Mehtab focused on both clinical and system-level challenges affecting immunization coverage. Prof. Nasir Rana highlighted frequent measles cases presenting in emergency departments and emphasized the need for earlier preventive strategies to reduce disease burden.
Prof. Imran Iqbal presented epidemiological data from Punjab showing continued measles transmission, with approximately 30 percent of cases occurring in children under nine months of age. He highlighted a critical vulnerability in the current immunization schedule, which administers the first measles dose at nine months, leaving younger infants unprotected.
He strongly advocated for introducing a measles vaccine dose at six months of age as a “zero dose” strategy to bridge this immunity gap. He noted that vaccine efficacy at six months is approximately 94 percent and suggested that earlier vaccination could significantly reduce measles incidence, decrease mortality in young infants, and improve completion of routine immunization schedules.
The discussion also addressed human papillomavirus (HPV) vaccination. Dr. Kaleem Malhi stressed the need for a unified national strategy, stronger physician-led advocacy, school-based vaccination programs, and culturally sensitive messaging that frames HPV vaccination as cancer prevention.
Dr. Abdul Qayyum from Gujrat, highlighted broader systemic gaps, including inadequate supervision of immunization services, inconsistent training of vaccinators, and growing public mistrust. Experts emphasized strengthening communication skills among healthcare providers and increasing pediatrician involvement in routine immunization delivery.
Prof. Junaid Rahid and Madam Hina Ayesha reaffirmed institutional commitment to strengthening immunization systems, while Prof. Tahir Masood underscored the urgency of expanding outreach to underserved and hard-to-reach populations to improve national vaccine coverage.
In his concluding remarks, Prof. Masood Sadiq assured full institutional support for research initiatives, including serological studies to generate local evidence for potential revisions in the national immunization schedule.
The participants reached consensus on the urgent need to strengthen immunization systems in Pakistan, with a focus on reducing missed vaccinations, addressing hesitancy, and closing early-life protection gaps. Key recommendations by participants of webinar from UCHS and PPA included introducing a measles vaccine dose at six months of age to reduce early measles burden, strengthening pediatrician-led advocacy, improving vaccinators’ communication skills, and enhancing community engagement to address vaccine hesitancy.