In the quest to ensure comprehensive immunisation coverage for children across Bangladesh, a recent Lot Quality Assurance Sampling (LQAS) survey sheds light on concerning trends in certain geographic pockets. The study, conducted to gauge the prevalence and factors associated with zero-dose (ZD) and under-immunised (UI) children, reveals significant challenges in selected areas, urging targeted interventions for improved immunisation rates.

Published findings indicate that approximately 32% of children surveyed in these specific locales were either ZD or UI. Notably, urban slums emerged as particularly vulnerable, with a staggering 59% prevalence of ZD/UI. Furthermore, areas like the ‘haors’ (wetlands) exhibited a considerable 32% prevalence of ZD/UI, underscoring the need for tailored strategies in such environments.

Crucially, the possession of proper health documents for children surfaced as a pivotal determinant, emphasising the importance of administrative processes in ensuring immunisation coverage. Analysis of the data highlighted various contributing factors, including proximity to immunisation centres, availability of essential documentation like the EPI card, caregiver demographics such as age and education level, as well as household characteristics like the number of earning members.

The study’s comprehensive approach, encompassing both quantitative analysis and nuanced exploration of associated factors, offers valuable insights for policymakers and program managers. By delineating the landscape of ZD and UI prevalence across different geographic strata, the research enables targeted interventions tailored to the unique challenges faced by each community.

The global imperative of immunisation equity, epitomised by Gavi’s vision of “leaving no one behind with immunisation,” resonates deeply within Bangladesh’s public health agenda. Despite strides made at the national level, persistent disparities underscore the need for localised interventions to reach marginalised populations effectively.

The Government of Bangladesh’s commitment to providing childhood vaccines free of cost underscores the nation’s dedication to eradicating vaccine-preventable diseases. However, challenges exacerbated by factors like the COVID-19 pandemic necessitate adaptive strategies to ensure uninterrupted immunisation services, particularly in hard-to-reach and underserved communities.

Moving forward, the study’s findings serve as a compass for policymakers and practitioners, guiding the design and implementation of targeted interventions to bridge immunisation gaps. By prioritising geographic pockets with high prevalence of ZD/UI children and addressing associated factors, Bangladesh can progress towards achieving universal immunisation coverage, safeguarding the health and well-being of its youngest citizens. The Lot Quality Assurance Sampling survey provides a critical snapshot of immunisation challenges in select areas of Bangladesh, illuminating pathways towards equitable vaccine coverage and ultimately, healthier communities as a whole.


Das H, Jannat Z, Fatema K, Momo J-E-T, Ali MW, Alam N, et al. Prevalence of and factors associated with zero-dose and under-immunized children in selected areas of Bangladesh: Findings from Lot Quality Assurance Sampling Survey. Vaccine [Internet]. 2024;42(13):3247–56. Available from:

  • More Details

  • Type: Research Paper
  • Theme: Extended Programme for Immunisation (EPI)
  • Publisher:
  • Author:
  • Language: Bangla
  • Country: Bangladesh
  • Location: Bangladesh

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