A research study while finding refusals by 22 percent of parents in vaccination of children in Peshawar metropolis, has laid stress on urgent need for a comprehensive approach to tackle vaccine hesitancy. The study, aimed to assess prevalence, associated factors, and perceptions related to parental refusal of vaccines in Peshawar, is conducted under the supervision of Prof Zia Ul Haq, Professor of Public Health and Vice Chancellor of the Khyber Medical University (KMU), Peshawar and Dr. Saima Afaq from University of York, UK Research, published in BMC Public Health with support by Integral Global Health, found several factors including maternal employment, logistical challenges such as distance to vaccination centres, associated costs, and concerns about vaccine necessity and safety as reasons behind refusals. The finding highlighted urgent need to address vaccine hesitancy and improve immunization coverage in Pakistan. Titled as “Prevalence and Associated Factors of Parental Refusal Rates for Routine Immunization: A Cross-Sectional Study in Peshawar, Khyber Pakhtunkhwa, Pakistan”, the study was designed and conducted by Dr. Muhammad Hakim a PhD Scholar Public Health (IPH&SS)-Khyber Medical University (KMU), Peshawar with Co-author by Dr.Farhad Ali Khyber College of Dentistry Peshawar, Zala and Dr.Aslam Pervaiz, sheds light on the alarming rates of parental refusal for routine childhood immunization. The findings revealed that 22% of parents refused vaccines for their children, with the highest refusal rate of 41% recorded in Shaheen Muslim Town. Misinformation and safety concerns play a critical role in vaccine hesitancy while socioeconomic factors, such as income and employment status, impact vaccine acceptance. Parents who lacked trust in vaccine programs were more likely to refuse vaccinations the community support from religious and political leaders positively influenced vaccine uptake. In the study 340 parents of children aged 0–59 months across different tehsils of Peshawar were surveyed by using a structured Vaccine Hesitancy Survey Tool by the WHO’s Strategic Advisory Group of Experts (SAGE), the researchers employed a multistage stratified cluster sampling method to ensure a representative sample. One of the most significant findings of the study was that employed mothers were over three times more likely to refuse vaccines compared to unemployed mothers. The study also found that parents who refused vaccination were significantly less likely to believe in the protective benefits of vaccines, with only 77% acknowledging their importance compared to 98% among those who accepted immunization. Misinformation and concerns about vaccine safety were also prevalent, with 43% of vaccine-refusing parents expressing doubts about the necessity of vaccines. In addition, 40% of respondents cited logistical challenges, such as long travel distances and financial constraints, as barriers to immunization. The researchers emphasized that vaccine hesitancy is not only driven by individual concerns but also influenced by broader socioeconomic and cultural factors. While 84% of parents believed that community leaders supported vaccinations, mistrust of government health programs and exposure to misinformation continued to hinder immunization efforts. The study highlighted that areas classified as Super High-Risk Union Councils (SHRUCs) by Pakistan’s National and Provincial Emergency Operations Centres for Polio Eradication had the lowest immunization rates, further underscoring the need for targeted interventions in these regions. To address these challenges, the authors recommend deploying mobile vaccination units in high-refusal areas, introducing workplace vaccination programs to accommodate working parents, and engaging religious and political leaders to promote vaccine acceptance. Additionally, public awareness campaigns should be strengthened to counter misinformation and reassure parents about vaccine safety and effectiveness. The study also advocates for extending clinic hours and providing flexible vaccination services to mitigate logistical barriers faced by many families. The findings of research study highlight urgent need for a comprehensive approach to tackle vaccine hesitancy. Implementation of targeted vaccination policies and robust community engagement strategies will be vital to guarantee that every child has access to life-saving vaccines in the country, the study added.