Imperial College London


Faculty of MedicineSchool of Public Health

Prof of Infectious Disease & Vaccine Epidemiology



+44 (0)20 7594 3264n.grassly Website




G36Medical SchoolSt Mary's Campus






BibTex format

author = {Imran, H and Raja, D and Grassly, N and Wadood, MZ and Safdarq, RM and O'Reilly, KM},
doi = {inthealth/ihx067},
journal = {International Health},
pages = {84--91},
title = {Routine immunization in Pakistan: comparison of multiple data sources and identification of factors associated with vaccination},
url = {},
volume = {10},
year = {2018}

RIS format (EndNote, RefMan)

AB - BackgroundWithin Pakistan, estimates of vaccination coverage with the pentavalent vaccine, oral polio vaccine (OPV) and measles vaccine (MV) in 2011 were reported to be 74%, 75% and 53%, respectively. These national estimates may mask regional variation. The reasons for this variation have not been explored.MethodsData from the Multiple Indicator Cluster Surveys (MICS) for Balochistan and Punjab (2010–2011) are analysed to examine factors associated with receiving three or more doses of the pentavalent vaccine and one or more MVs using regression modelling. Pentavalent and OPV estimates from the MICS were compared to vaccine dose histories from surveillance for acute flaccid paralysis (AFP; poliomyelitis) to ascertain agreement.ResultsAdjusted coverage of children 12–23 months of age were estimated to be 16.0%, 75.5% and 34.2% in Balochistan and 58.0%, 87.7% and 72.6% in Punjab for the pentavalent vaccine, OPV and MV, respectively. Maternal education, healthcare utilization and wealth were associated with receiving the pentavalent vaccine and the MV. There was a strong correlation of district estimates of vaccination coverage between AFP and MICS data, but AFP estimates of pentavalent coverage in Punjab were biased toward higher values.ConclusionsNational estimates mask variation and estimates from individual surveys should be considered alongside other estimates. The development of strategies targeted towards poorly educated parents within low-wealth quintiles that may not typically access healthcare could improve vaccination rates.
AU - Imran,H
AU - Raja,D
AU - Grassly,N
AU - Wadood,MZ
AU - Safdarq,RM
AU - O'Reilly,KM
DO - inthealth/ihx067
EP - 91
PY - 2018///
SN - 1876-3405
SP - 84
TI - Routine immunization in Pakistan: comparison of multiple data sources and identification of factors associated with vaccination
T2 - International Health
UR -
UR -
VL - 10
ER -