Immunization is critical for reducing vaccine-preventable disease morbidity and mortality, yet coverage disparities persist in low-resource settings.This mixed-methods study describes characteristics of childhood immunization defaulters and explores barriers to vaccine adherence in Khyber Pakhtunkhwa, Pakistan.We recruited 380 caregivers from three tehsils from District Kohat of Khyber Pakhtunkhwa from February to July 2023 whose children under two years had not completed the EPI-recommended schedule.Quantitative data from validated questionnaires and immunization cards underwent descriptive and regression analyses; qualitative interviews explored non-adherence reasons.Most respondents were fathers (96.05%); 41.84% resided in rural areas.Initial coverage was high for BCG (97.89%) and OPV0 (100%) but declined for Penta3 (26.05%) and Measles2 (4.21%).Most children (73.95%) were under four months.Rural defaulters were more prevalent than urban (41.84% vs. 34.47%,p5km from facilities.
Ashfaq et al. (Mon,) studied this question.