Pakistan stands at a critical juncture in its fight against vaccine-preventable diseases. With a population of over 255 million and approximately 29 million children under the age of five, the country bears a significant responsibility to protect its youngest citizens from deadly infections like measles. Yet, despite notable progress, immunization gaps persist—leaving millions of children vulnerable to illnesses that could easily be prevented through timely vaccinations.
The Expanded Programme on Immunization (EPI) in Pakistan was launched with the goal of shielding every child against twelve life-threatening diseases. These include diseases like measles, polio, diphtheria, pertussis, and hepatitis B. However, the reality on the ground tells a different story. While the infrastructure exists, barriers such as lack of awareness, vaccine hesitancy, logistical challenges, and disparities between urban and rural regions continue to undermine the programme’s effectiveness.
To achieve herd immunity, the World Health Organization (WHO) recommends that at least 95% of children receive their second dose of the measles-containing vaccine (MCV2). Encouragingly, Pakistan has made considerable strides, with MCV2 coverage rising from 30% in 2009 to 80% in 2023, according to WUENIC Pakistan. However, third-party verification (TPVICS report 2023) paints a less optimistic picture, estimating coverage at just 65.6%. This discrepancy highlights the urgent need to strengthen and verify immunization efforts on the ground to ensure that reported coverage reflects the real situation.
Provincial disparities remain a pressing concern. For instance, Punjab leads the way with relatively higher immunization rates, while Balochistan continues to lag behind. These disparities are not merely statistical—they translate into real-world consequences, including preventable outbreaks, hospitalizations, and deaths. With a birth cohort of 5–6 million children annually, approximately 1 to 2 million children miss their second dose of measles vaccine each year. Without strategic intervention, this number is projected to rise, putting millions of children at risk.
Pakistan’s education system presents a remarkable yet underutilized opportunity to bridge the immunization gap. With over 56 million students enrolled in approximately 300,000 schools and madrassas nationwide, educational settings can serve as critical access points for healthcare interventions. Schools have the infrastructure, the reach, and the trust of communities—making them ideal platforms to integrate health initiatives alongside education.
A simple, practical intervention could change the trajectory of Pakistan’s immunization efforts: implementing mandatory health screenings before preschool or madrassa admissions. A basic health questionnaire covering age, immunization status, general health, and speech development would help identify unvaccinated or under-vaccinated children. Given that only about 25% of children complete the full MCV2 course, such a screening initiative could identify and help the 75% who might otherwise fall through the cracks.
This strategy hinges on coordinated partnerships between the Ministries of Health, Education, and Religious Affairs. Schools and madrassas should be digitally linked via GPRS to the nearest immunization centers, ensuring that any child flagged as unvaccinated can be promptly referred for necessary vaccines. Admission should be conditional upon proof of vaccination—an approach already successfully implemented in several countries worldwide to ensure high coverage rates.
Measles outbreaks, developmental delays due to vaccine-preventable illnesses, and the burden on the healthcare system are not abstract concerns. They are harsh realities that Pakistani families live with every day. Each unvaccinated child represents a potential outbreak, an avoidable hospitalization, or a lifelong disability that could have been prevented.
Addressing the immunization gap is not merely a bureaucratic responsibility; it is a profound moral duty. We owe it to our children to provide them with the protection they deserve. Practical, decisive action is needed now more than ever. By utilizing the existing educational infrastructure, fostering inter-ministerial collaboration, and enforcing vaccination requirements at the point of school admission, we can close the immunization gap once and for all.
This initiative is not just about meeting immunization targets—it is about investing in a healthier, more prosperous Pakistan. A child protected against preventable diseases is a child with a better chance at education, development, and contribution to society. It is a promise to the future, ensuring that no child is left behind due to preventable causes.
The time to act is now. With unwavering resolve and collective action, we can build a stronger and healthier nation—one child at a time. Let us come together to bridge the immunization gap and secure a brighter future for generations to come.
