The immunization questionnaire for understanding unwellness (TIQUU): Fun learning about vaccination using an innovative storytelling approach

Waqaas A. Butt, Faizan G. Mustafa, Zeeshan Ahsan, Shaharyar Salim, Hasan Nawaz Tahir, Asad I. Mian

Research output: Contribution to journalArticlepeer-review


Background: Vaccination is a pivotal tool in public health. In LMICs like Pakistan, challenges hinder high immunization rates. This study addresses gaps in vaccination knowledge among school children through innovative educational interventions. The study aims to enhance vaccination awareness and contribute to health education discourse. Methodology: This quasi-experimental study was conducted in 4 private schools in Karachi, Pakistan, from February to May 2021. Children aged 8–12 years in grades 2–5 were enrolled. An interactive discussion on vaccine safety and immunization was conducted using a bilingual pictorial storybook. Group-I experienced traditional Urdu book reading, while Group-II engaged with a digital animated video in English. A pre-test was conducted to assess baseline knowledge about immunization followed by an interactive discussion and immediately a post-test. Test scores were analyzed using paired sample t-test using Stata 17.0 version. Results: The study enrolled 400 students in Karachi, Pakistan. Both groups exhibited significant knowledge shifts regarding vaccine-related topics. Group-I (Analog Urdu) showed changes in understanding sickness reasons, vaccine timing, newborn protection, sports injury response, and memory impact. Group-II (Digital English) displayed shifts in illness understanding, recommended actions, injection and vaccine knowledge, safety perceptions, measles prevention, and management during sports injury. A statistically significant improvement in mean scores was observed. Conclusion: As a proactive and early strategy to alleviate the societal burden of under-immunization, cost-effective educational interventions can be integrated into school curricula. Our approach through bilingual pictorial storybooks and animated videos has been proven effective and helps one grasp immunization's importance.

Original languageEnglish
Publication statusAccepted/In press - 2024


  • Healthcare
  • Immunization
  • Innovation
  • LMICs
  • Pediatric
  • Storytelling
  • Vaccination


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