ADHERENCE TO CHILDHOOD VACCINATION SCHEDULES AND ITS BARRIERS AND ASSOCIATED FACTORS AMONG CAREGIVERS IN GAZA DURING THE WAR: A CROSS-SECTIONAL STUDY
Date
2026-05-12
Authors
Samar Alshorbaji
Yazid Abu Sheha
Aya Obaid
Lina Okasha
Ali Abu Sweireh
Yazan Abu Daqqa
Meram Mohammed Ali Azzani
Ayda Helles
Journal Title
Journal ISSN
Volume Title
Publisher
Deanship of Scientific Research - Al-Quds University
Abstract
Background: The ongoing armed conflict in Gaza has severely disrupted the healthcare system, creating major challenges to the delivery and utilization of essential health services, including routine childhood immunization. Extensive damage to health infrastructure, population displacement, insecurity, and transportation barriers have significantly limited access to vaccination services. Despite historically high immunization coverage prior to the war, these disruptions have increased the risk of missed and delayed vaccinations, thereby increasing children’s vulnerability to vaccine-preventable diseases. In such fragile settings, adherence to vaccination schedules is no longer determined solely by caregiver knowledge or attitudes, but is increasingly shaped by conflict-related barriers and shifting sociodemographic conditions.
Objectives: This study aimed to assess the prevalence of adherence to childhood vaccination schedules among caregivers in Gaza during the war, as well as its associated barriers and sociodemographic factors.
Methods: A cross-sectional study was conducted among 475 caregivers of children aged 0–24 months across multiple governorates in Gaza. Data were collected on sociodemographic characteristics, vaccine-specific adherence, overall vaccination adherence, and perceived barriers. Adherence was defined as each vaccine dose being administered within the recommended schedule, allowing a maximum delay of 30 days. Bivariate analysis using Pearson’s chi-square test was employed to examine associations between adherence and explanatory variables.