Nepal's cities lag rural areas in vaccinating children

In Nepal's remote Dolpa region, immunisation workers undertook arduous four-day journeys, traversing snow-covered trails and high mountain passes, to administer the human papillomavirus (HPV) vaccine to girls in Chharka Bhot. These health workers walked up to 14 hours daily, carrying vaccine doses to the settlement at 4,350 meters.

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We did not have any other option except to walk.

Officials reported high vaccine acceptance and successful campaigns in these rural areas, with all eligible girls receiving the HPV vaccine. This contrasts sharply with the concerning picture in Nepal's urban centers, where vaccination rates lag significantly.

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Our health workers walked across barren alpine terrain and valleys, through snow-covered trails, and crossed the Bhola Parchung and Chhoila passes at elevations of over 5,100 meters and 5,000 meters, respectively, and completed the campaign successfully.

Data from the Ministry of Health and Food Safety reveals a median full immunization rate of only 64 percent in metropolitan areas, compared to 95 percent in rural municipalities. The nationwide full-immunization rate has declined to 92 percent in the fiscal year 2024-25 from 96 percent in 2023-24.

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Children living in urban settings or metropolises not receiving all recommended doses of routine vaccines does not mean they are getting zero doses. But the coverage rate of routine immunisation is much better in rural settings compared to big cities and metropolises.

Experts note that while urban children may not be receiving zero doses, the overall coverage for routine immunizations is considerably better in rural settings. The government offers 14 types of vaccines free of charge, covering a range of diseases. However, an immunisation expert suggests the actual number of children missing doses in urban areas could be higher than official figures indicate, as data relies solely on official urban population estimates.

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The data maintained by the health ministry is based only on the official population figures for urban settings. The actual number of children missing doses of routine vaccines could be much higher.