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Background: vaccinations play an important role in protecting children against life threatening infections. During the past years, parents expressed concerns about the safety of routine vaccinations; resulting in non-compliance. Objective: this study aimed to assess the attitudes, beliefs and behaviors of parents towards vaccinations and the effects on vaccination practice in Najran region. Methods: this is a cross sectional study was carried out by distributing questionnaire among the general public in Najran City, Saudi Arabia. The questionnaire consisted of the following sections: demographic profile, knowledge, beliefs, behaviors and open-ended questions regarding vaccination. Results: 668 parents were participated in this study; out of them 61.8% reported compliance with the vaccination schedule. Factors that were significantly associated with compliance included older age (p = 0.001), high education (p = 0.022) and better knowledge of the benefits of immunization. The main concerns about vaccinations were fear of weakening the child's immunity and non-necessity of some vaccinations. Causes that prevented compliance with vaccinations were lack of knowledge about their benefits (48.1%), illness of the child at time of vaccination (13.5%), travel (9.6%) and fear of side effects (7.7%). Sources of information that effectively changed parent’s attitude included flyers (31.4%), social media (26.8%) and TV (25.9%). Conclusion: most parents had an acceptable and good knowledge of the importance of vaccinations. However, fears and misconceptions resulted in non-compliance of a substantial percentage of the responders. Educational programs should address these causes of non-compliance and stress the importance of routine child vaccinations to improve knowledge, beliefs and attitude of parents.
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