AIM: To investigate factors associated with caregiver failure to complete immunizations for their children in the parish of St. Mary, Jamaica. METHODS: A case-control study was conducted with 50 cases defined as caregivers who failed to immunize their children and 179 controls defined as caregivers of children who were properly immunized. The cases were caregivers of children who were randomly selected from clinic records of children who failed to complete their immunization within the study period. Controls were caregivers of children who were identified to have completed their immunization from a similar list. Cases and controls were visited at home and interviewed using a validated questionnaire. Cases and controls were compared in terms of socio-demographic, economic and other variables. RESULTS: Participants with less than secondary school education were more likely to be non-compliant (odds ratio [OR], 2.51, 95% confidence interval [CI], 1.06- 5.97), while participants who were aware of legislation against non-compliance with immunization (OR, 0.35; 95% CI, 0.17, 0.69) were less likely to fail to immunize their children. CONCLUSION: Policy-makers and programme managers need to use established educational and communication channels to increase awareness of childhood immunization especially among families with lower educational levels in the parish.