Background: Universal immunization against major vaccine-preventable diseases is one of the most cost-effective means of reducing under-five child morbidity and mortality. Yet 1.5 million children die every year from vaccine preventable diseases. Lack of information and knowledge, and fear of vaccine adverse effects among the mothers is a major barrier to vaccination coverage. Objectives of the study were to assess the knowledge of mothers about EPI (Expanded Programme on Immunization) and their infant's vaccination status. Socio-demographic factors associated with mothers' knowledge and the children’s immunisation status were also assessed.

Methods: A cross-sectional survey was conducted in a tertiary care hospital in Karachi. 165 mothers with at least one child between 1-2 years were interviewed to assess their knowledge and attitudes towards EPI vaccination. Infant's immunisation status was also assessed through mothers’ recall.

Results: The proportion of mothers who could name the EPI diseases were as follows; Tuberculosis (26%), Diphtheria (25.2%), Pertussis (5.4%), Tetanus (4.2%), Measles (57.5%), Polio (66.7%) and Hepatitis B (26.6%). 62% children had completed all the vaccine doses. Mothers' education was found to be positively associated with a child’s immunisation status. The most common barriers to complete immunisation were domestic work and distance to the health centre. Healthcare providers were the mothers’ main source of information regarding vaccination.

Conclusions: Mothers' knowledge about EPI vaccination was quite low but the vaccination rate was good. Factors associated with a child’s vaccination status included mothers' educational level, and place of delivery. Distance to the health facility was a major barrier to getting complete vaccination. Healthcare providers need to communicate more effectively with mothers regarding childhood vaccination.