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A qualitative study can help in understanding the unpolluted perspectives of key stakeholders involved in the vaccination practices and can explore vital factors that could influence vaccination-related behaviors and their utilization. This study aims to document the perceptions of caretakers, community members and healthcare service providers related to childhood vaccination practices in slums under the national immunization program (NIP) of India.

This was a qualitative community-based cross-sectional study. Focus group discussions with caretakers, community members and healthcare service providers were used to build a holistic, detailed description and analysis of the factors associated with childhood vaccination practices within its real-world context.

Lack of awareness, fear of adverse events following immunization, inappropriate timing of vaccination sessions, loss of daily earnings, migration, lack of good behavior of health staffs, shortage of logistics and vaccines, limited resources and infrastructures and high expectations of beneficiaries were some of the vital barriers impacting vaccination practices in slums.

Though this study provides significant good information on the indicators that can be considered to improve the vaccination practices in any slum settings, it has is also a limitations too due to its setting. Therefore, one needs to be cautious while generalizing these results to other settings like rural. In addition, Though we believe that these strategies could be useful in any setting, it is also important to tailor these observations them as per the need of the society and the population. Also, this is a self-reported qualitative study and therefore the perspectives reported in this study need to be taken with caution. Further, low vaccination, poor awareness, compromised healthcare services, high expectations could be considered as a stigma/fear among the responders and therefore there is always a chance of underreporting. Thus, it would be important in future to conduct a study involving a broader group of people in society and to establish factors associated with the vaccination coverage. that can help in improvement of vaccination.

Initiatives such as regular interactions at different levels, effective communication including reminders, behavior interventions, the continued supply of vaccines and logistics, additional resources for the vaccination program, incentives and recognition, extended sessions and people-friendly healthcare delivery system could be helpful to strengthen the routine vaccination practices in slums.