Objectives: To find the coverage and factors associated with low immunization with respect to user and provider in urban and rural areas of Peshawar.

Material and Methods: This cross-sectional study was conducted in selected areas of Peshawar from 9th to 19th of June 2010. 486 children, aged 4 years and below, were included in the study. Infants below 9 months were excluded. Parents were asked about demographics, measles vaccination status, reasons for non vaccination and their views on
immunization. A separate questionnaire was used for 40 health personnel regarding reasons for low coverage. Pearson’s chi-square test was used for statistical testing, a P value of < 0.05 was considered significant.

Results: Measles vaccination coverage was 67.1%. The reasons for non-immunization by parents/guardians were no awareness (25.62%), busy/family problems (24.37%), centre too far (23.75%), wrong idea/sterility (11.88%), sick child (6.88%) and fear of reactions (1.25%). The problems faced by EPI staff were lack of awareness (32.5%), load shedding (20.0 %), poor transport facilities (10.0%), lack of timely availability of vaccines (10.0%) and security (10.0%).

Conclusion: Our study revealed that low vaccination coverage was due to low awareness regarding its importance. Low awareness, inadequate equipment and security are main problems faced by immunization staff.

Keywords: Childhood, immunization, measles, vaccine.