In the crowded camps of Cox’s Bazar, over one million Rohingya refugees—known officially as Forcibly Displaced Myanmar Nationals (FDMN)—call Bangladesh home. Here, vaccination is more than a medical service; it’s a shield of hope against preventable childhood diseases such as diphtheria, measles, and polio. A 2025 scoping review published in Frontiers in Public Health has brought valuable insights into what drives or hinders these life-saving vaccinations among Rohingya children.

The study, conducted by a global team including researchers from Bangladesh and the World Health Organization (WHO), examined 21 studies and reports to understand both barriers and drivers behind immunisation uptake in the camps. Guided by the COM-B framework—which looks at capability, opportunity, and motivation—the review explored both the refugee caregivers’ and health service providers’ perspectives.

The review found that motivation and physical opportunity were the most influential factors. Many caregivers understood the importance of vaccines but struggled with access or faced confusion about schedules and sites. Trust and knowledge emerged as key determinants. As one health worker shared, “Once parents understood that vaccines don’t harm, but protect, they came willingly.”

Parents’ previous exposure to vaccination also mattered. Those living in registered camps or longer in Bangladesh showed higher vaccination rates compared to newer arrivals in makeshift camps. This reflects how confidence and familiarity grow with time.

Another strong driver was the role of female vaccinators and community health workers, who provided culturally sensitive care and helped women feel more comfortable. The study noted that social and religious leaders played a powerful role—both as influencers and educators—when they actively promoted vaccination after receiving training from NGOs and health partners.

Among the most common barriers were lack of information about when and where vaccines were offered, language gaps, and misinformation about vaccine safety. Some families feared that multiple vaccines could harm their children. Others faced practical issues such as long queues or distant vaccination sites.

Still, the overall trend is positive. The review reported rising trust and participation as communities saw no serious side effects and recognised the benefits. Regular communication through mosque announcements, community meetings, and home visits has proven effective in building that trust.

The experience in Cox’s Bazar offers lessons for Bangladesh’s national immunisation goals. While the country already boasts over 92% full immunisation coverage, the remaining zero-dose and under-immunised (UI) children—both in host communities and among refugees—remind policymakers that awareness and trust are as vital as access.

Engaging fathers is another key to success. The study highlighted that families with educated or employed fathers showed higher vaccine uptake. Fathers’ involvement in decision-making can reduce zero-dose cases, supporting the Country Learning Hub’s mission to ensure no child is left behind.

From makeshift shelters to mobile clinics, Bangladesh’s dedication to equitable immunisation continues to inspire. Strengthening community engagement, involving both parents, and training more female vaccinators can build lasting confidence. As one community worker reflected, “When parents trust the vaccine, they trust the future.” In Cox’s Bazar and beyond, that trust is turning every vaccine into a promise of protection—and every child into a symbol of resilience. 

References: 

Yusuf Z, Reda S, Hanefeld J, Jackson C, Chawla BS, Jansen A, et al. Barriers and drivers to childhood vaccinations in Forcibly Displaced Myanmar Nationals (FDMN)/Rohingya refugees in Cox’s Bazar, Bangladesh: a scoping review. Front Public Health [Internet]. 2025;13:1592452. Available from: http://dx.doi.org/10.3389/fpubh.2025.1592452