History

Background: Childhood immunization, or the application of vaccines to initiate immunity, is thought to be crucial for increasing a child's chance of survival. The most economical global health approach to lower child death and disability related to contagious diseases is immunization, which is a fundamental health care preventive practice. Objectives: To find out the proportion of defaulters from the immunization program in the urban areas, and to compare it with the proportion in the rural areas and to determine the relationship between other variables and immunization status (Parents occupation and educational levels, child order in his family, marital status of the mother, presence of PHC centers in the area, etc.). Methods: A cross-sectional study (household survey) was carried out on 1800 under five years old children living in the urban and rural areas of Erbil governorate, Kurdistan, Iraq. The questionnaire was developed by the researcher. The data were analyzed by SPSS, version 26, software. A p-value of ≤ 0.05 was considered, statistically significant. Results: The defaulter rate was 36.2% in Erbil governorate (60.3 % in rural areas, 24.2% in urban areas). The high defaulter rate was associated with low rank occupations like unskilled and semi-skilled mothers (the rates were 72.7% and 40% respectively), and with low educational levels (52.5% among illiterate mothers, and 43.2% among women who can just read and write or graduates of primary schools) (p < 0.001). Conclusions: The rate of defaulters was high, particularly in rural areas. Factors including mothers' poor educational levels and low-status employment that are linked to children skipping vaccinations have a significant impact on the default rate.