Peer-reviewed article
Understanding Motivating Factors for COVID-19 Vaccination in Families Defaulting from Childhood Immunization: A Mixed-Methods Study in Pakistan.
Kifayat Ullah, Chukwuma Mbaeyi, Javeria Saleem, Muhammad Ishaq, Muhammad Rana Safdar et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined why families in Pakistan who had not completed routine childhood vaccinations for their children were willing to accept COVID-19 vaccines for themselves. Researchers surveyed 237 families with incompletely vaccinated children and interviewed 18 household members. High COVID-19 vaccination coverage (87% of males and 82% of females) was found despite low childhood immunization completion. Key motivators included perception that COVID-19 vaccination was mandatory, easy access through house-to-house vaccination, and fear of severe illness or death.
Key points
- Among 237 families with incompletely vaccinated children, 29.5% of children under 2 were fully vaccinated, 67.5% were incompletely vaccinated, and 2.9% had received no vaccines
- COVID-19 vaccination coverage was high: 87% of males and 82% of females above 12 years of age were vaccinated
- Maternal COVID-19 vaccination and urban residence were significantly associated with children receiving full childhood vaccination
- Perceived vaccine mandates, house-to-house vaccination services, and fear of hospitalization or death motivated COVID-19 vaccine acceptance
- Households with at least one fully vaccinated child were significantly more likely to have vaccinated family members
Limitations
The study was conducted in one district during a specific time period and may not be generalizable to other regions of Pakistan or different contexts. The reasons for vaccine hesitancy regarding childhood immunization versus acceptance of COVID-19 vaccines are explored qualitatively but causal mechanisms cannot be definitively established.
Abstract
BACKGROUND: The 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. METHODS: A 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. RESULTS: Among 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. CONCLUSIONS: Vaccine 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.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Understanding motivators for COVID-19 vaccine acceptance through mixed-methods research combining survey data and in-depth interviews
- Population
- 237 families in Swat District with children under 2 years of age who had incomplete routine immunization; 18 household members participated in in-depth interviews
Key finding
87% of males and 82% of females in vaccine-defaulting households received COVID-19 vaccination
Ullah et al. · PubMed (US National Library of Medicine) · 5 Feb 2026