THE deaths of 144 children from measles and diphtheria in Karachi during the first seven months of the year expose a grave failure of routine immunisation. That failure is evident in the large number of children who receive their earliest vaccines but are never brought back for the doses needed to complete their protection. Officials may cite a decline in reported cases, but that offers little comfort when hospitals continue to record such a devastating toll. The steep drop in vaccination coverage after birth is especially troubling: many children receive initial doses but miss later ones, leaving them only partially protected. Parents must take responsibility for completing vaccination schedules, but the state cannot reduce the crisis to parental negligence. Missed doses also reflect weak follow-up, poor counselling, misinformation, shortages of trained staff and uneven access in low-income and informal settlements. Healthcare providers share responsibility too. Every consultation with a child should include a check of immunisation status, counselling for caregivers and, where appropriate, administration of missed doses.

The response must move beyond occasional campaigns. Sindh needs a reliable digital immunisation register linked to birth records, with reminders before each dose and follow-up when appointments are missed. Mobile teams should regularly visit low-coverage neighbourhoods, while schools, clinics and hospitals should be required to verify vaccination records. Area-wise coverage and mortality data must be published so that gaps can be identified and district officials held accountable. Each vaccine-preventable death should be investigated to determine whether the failure involved access, misinformation, delayed referral or poor treatment. Community health workers, teachers and religious leaders should be enlisted to counter myths, while vaccine stocks, diphtheria antitoxin and referral systems must remain dependable. Above all, the government should treat routine immunisation as a permanent door-to-door public service rather than an emergency exercise launched after outbreaks.

Published in Dawn, August 5th, 2026