Introduction:

Vaccine-preventable diseases remain one of the main causes of infant mortality, despite advances in immunization. Globally and in the Region of the Americas, vaccination coverage has decreased, falling below the recommended 95%. In Paraguay, low vaccination rates reflect barriers that compromise public health.

Objective:

To determine the coverage, vaccination opportunity, and the main reasons for non-vaccination in children under 5 years of age in Fernando de la Mora, Paraguay, in 2023.

Methodology:

Descriptive cross-sectional study carried out in 318 children selected by two-stage probability sampling. Vaccination coverage for BCG, pentavalent, and MMR were analyzed. Data were collected using questionnaires designed in Epi.Info 7.2, recording sociodemographic variables, vaccination status, coverage, opportunity, source of information on vaccines, reasons for non-vaccination, knowledge, attitudes, practices, and sources of information, analyzed with descriptive statistics such as frequency and percentages.

Results:

53% of children had complete vaccination schedules. Vaccination coverage was high for BCG (98.43%) and low for MMR-2 (37.02%). Vaccination opportunity was complete for BCG, but decreased for MMR-1 (42.01%). The main reasons for not vaccinating were lack of knowledge about the schedule (38.9%), erroneous beliefs (21.48%) and lack of time on the part of parents (21.48%). 77% of that responsible received information about vaccination, with television, radio and print media being the most frequent sources (42.5%).

Conclusion:

Although the initial BCG and pentavalent coverage are high, there is still a marked decline in the continuity of the schedules and the opportunity to vaccinate. Lack of knowledge and erroneous beliefs are the main barriers identified, which highlights the need to strengthen educational and awareness-raising strategies to improve coverage.