Investigating the Frequency and Contributing Factors of Measles Vaccine Dropout in Super High Risk Union Councils (SHRUCS) District Peshawar, KPK, Pakistan

Abstract

Introduction: Measles is a highly contagious viral disease and remains a major public health concern, particularly in low- and middle-income countries like Pakistan. Despite the availability of an effective vaccine under the Expanded Programme on Immunization (EPI), gaps still exist between the first dose of measles-containing vaccine (MCV1) and the second dose (MCV2), leading to incomplete vaccination and increased risk of outbreaks. This study aimed to assess the prevalence of measles vaccine dropout and identify associated factors among children in Super High-Risk Union Councils (SHRUCs) of District Peshawar. Methodology: A descriptive cross-sectional study was conducted over a period of four months, including a sample of 345 children aged 9–59 months who had received MCV1. Data were collected through a structured questionnaire and analyzed using (SPSS) version 27. Results: The findings showed that coverage of MCV1 was 100%, while 83.2% of children received MCV2, resulting in a dropout rate of 16.8%. Awareness regarding measles and the need for two doses was 100%. However, factors such as forgetfulness, lack of effective reminder systems, and confusion during administration of multiple vaccines contributed to missed vaccinations. Community-level concerns, including poor sanitation and demand for additional free healthcare services, were also identified. Conclusion: Although awareness and access to vaccination services are high, a gap remains between knowledge and practice. The main reason of dropout was fear of AEFI, multiple vaccination at 9 months which leads to confusion, low importance of 2^nd dose (means 1^st dose is enough perception). The persistence of MCV2 dropout highlights the need for system-based interventions such as digital reminder systems by healthcare workers, and integration of immunization services with broader community support to improve vaccination completion rates.

Key Words: Measles, Vaccine Dropout, MCV1, MCV2, Immunization Coverage, Expanded Programme on Immunization (EPI)