Nepal is facing challenges in achieving full vaccination coverage for children in its cities, lagging behind rural areas. Officials cite difficulties in reaching specific populations as the primary obstacle. These vulnerable groups include individuals with fluid living situations—such as migrant workers and slum dwellers—and those experiencing constant mobility. Ensuring equitable vaccine access requires targeted strategies to locate and immunize these often-overlooked communities. The issue highlights a disparity in healthcare access within the country, despite overall progress in national vaccination campaigns. Overcoming these urban hurdles is crucial for protecting children and preventing outbreaks. Reaching these populations will necessitate innovative solutions and increased resources allocated to urban public health initiatives.