Low vaccine coverage during COVID-19 pandemic has caused rise in cases of Diphtheria as hospitals in Khyber Pakhtunkhwa are receiving noticeable number of children infected with this rare and serious infection that usually affects mucous membranes of the nose and throat. The paediatric ward of KP’s largest hospital, Lady Reading, is over crowded with children infected with Diphtheria, a vaccine preventable fatal infectious disease that is caused by the toxin-producing bacteria, Corynebacterium diphtheria. According to data, around 212 patients have arrived in Lady Reading Hospital till October month of current year 2024. The situation further aggravates due to shortage of Diphtheria Antitoxin Serum (DAS), a medication made up of antibodies used in the treatment of complication in diphtheria patients. Complications in most of the cases are because of late arrival of patients to hospitals, says Dr. Amir Muhammad of Paediatric department LRH. The alarming situation in Diphtheria re-emergence is that around 80 percent patients are zero dose who have not received any vaccination, observed Dr. Amir Muhammad. “In Khyber Pakhtunkhwa total number of Diphtheria cases are around 383 till November 16, 2024 out of which around 26 patients died,” informed Director Expanded Programme on Immunization (EPI), Dr. Asghar Khan. Taking to APP, Dr. Asghar informed that more than 85 percent of Diphtheria patients are above five years of age which represents the zero dose cohort of children who missed vaccination in 2019 and 20 due to COVID-19 pandemic, diverting all the focus of Health department on vaccination of the corona virus. Earlier most of the diphtheria cases were reported in Southern districts where coverage is low due to law and order situation. While now, maximum number of cases are reported in Peshawar, followed by Mardan, Charsadda, Nowshera, Swabi. He said the national immunization programme of the country provides vaccinations free of cost to children from day one to 15 months for prevention of 12 perilous diseases including diphtheria. Among these vaccination, doses of Pentavalent is also given to children three times at different ages starting from birth to 15th month. The Pentavalent vaccines protects children from five life threatening diseases including Diphtheria, Tetanus, Pertussis (DPT), Hepatises B and Haemophilus influenza. “Vaccine hesitancy especially about Pentavalent is observed among parents because of its reaction in shape of fever and swelling,” observed Dr. Arif Coordinator EPI Peshawar. After administering first dose of pentavalent, parents usually express reluctance over the second dose because of vaccine fear, he added. Dr. Arif said the vaccinators and Lady Heath Workers are assigned the job of counselling parents about importance of pentavalent in saving life of children and about mild reaction of the vaccine. Meanwhile, Dr. EPI Dr. Asghar informed that `Big Catch Up’ programme has been launched in the country with the objective of immunization of children after the recommended age. In the first phase of Big Catch up programme launched in October 2024, around 124,000 children with zero doses or those who have not completed immunization have been covered in eight districts of KP, Dr. Asghar added. The second phase of the programme will be started from December 2, next covering more children in other districts. Dr. Asghar also informed that within few months administration of Booster dose of Diphtheria would be started in the province to protect children from this deadly disease.