14 Children, Years of Refusal, One Breakthrough

In Chishtia Abad, a remarkable breakthrough was achieved on 12 August 2026 when 14 chronically Zero-Dose children, many of whom had remained unvaccinated for three to four years, were successfully vaccinated through sustained community engagement and persistent follow-up by the MERF team at CD Akhunabad.

The journey began with the RCC Committee, where the team reviewed the persistent refusal cases, identified the households that had repeatedly been missed, and developed a structured, action-oriented plan to reach them. Recognizing that previous formal interventions, including an ADC visit had not changed the families’ decisions, the team deliberately adopted a different approach based on trust, patience and dialogue rather than pressure or confrontation.

Zubair Ahmad (COW) and Rahman Ullah (Support Staff), under the guidance and monitoring of Dr. Shandana Malik, began regular and periodic visits to the refusal households, making repeated attempts to establish communication and understand the reasons behind their resistance. A key breakthrough came through engagement with Scholar Akbar Khan, an influential member of the Ahl-e-Hadith community, whose involvement helped open a trusted channel of communication with families who had remained resistant to vaccination. The team did not approach these households simply to deliver another vaccination message; instead, they sat with families, listened to their concerns, allowed them to explain their beliefs and experiences, and then shared the health team’s perspective through respectful two-way conversations.

This process helped the team identify and address misinformation and misconceptions surrounding vaccines, including concerns about vaccine safety, perceived harms and the need for immunization. Rather than dismissing these concerns, the team addressed them patiently, explaining the scientific basis, benefits and protective value of vaccines and correcting misinformation through repeated counseling. Religious concerns were also discussed openly, with the team using relevant Islamic teachings and religious scriptures around the protection of life, prevention of harm and responsibility toward children, supported by engagement with trusted religious/community voices. Importantly, the engagement was not limited to routine daytime visits; whenever required, the team conducted evening and night-time meetings to accommodate families and create opportunities for more informal and meaningful dialogue.

Some visits ended without acceptance, but the team continued returning, maintaining communication and demonstrating through their persistence that their objective was not to force families but to protect their children. Gradually, repeated listening, counseling, misinformation management, religious dialogue and engagement with trusted community influencers began to change the relationship from resistance to dialogue and from dialogue to trust. During subsequent follow-up, the families who had previously refused vaccination for years finally agreed to cooperate and, most significantly, requested the vaccination team to visit their homes to vaccinate their children.

On 12 August 2026, this willingness translated into action, as Dr. Shandana Malik, Zubair Ahmad (COW), Rahman Ullah (Support Staff), Hasnain (Vaccinator) and Nosheen (COW) successfully vaccinated 14 chronically Zero-Dose children in Chishtia Abad. The achievement represents much more than 14 vaccinations; it demonstrates that persistent refusal can be transformed when health teams move beyond one-time counseling and invest in sustained relationships, regular follow-up, active listening, respectful dialogue, misinformation correction, culturally and religiously appropriate communication, and trusted community engagement. The Chishtia Abad experience demonstrates a powerful pathway from refusal to dialogue, dialogue to trust, trust to acceptance, and acceptance to vaccination, showing that when pressure fails, patience, empathy and persistent community engagement can succeed. This success was achieved under the Gates Foundation-supported MERF immunization and community outreach project, with a focus on reaching chronically missed and Zero-Dose children and strengthening sustainable community demand for routine immunization.