Pakistan’s Campaign to Contain Polio in Face of Vaccine Hesitancy

By Ashfaq Yusufzai Reprint | | Print |

Authorities in North Waziristan district in Pakistan, vaccinate children against polio. With one case reported, intensified efforts to eradicate the disease are underway. Credit: Ashfaq Yusufzai/IPS

PESHAWAR, Pakistan, May 12 2022 (IPS) - Pakistan’s North Waziristan district authorities have launched an aggressive vaccination drive after a polio case surfaced after 15 polio-free months in the country.

The disease was detected in a 15-month-old toddler about 15 kilometers away from the Afghanistan border. This area was considered a Taliban militant’s hub until 2014.

The Taliban were against polio vaccinations, but immunization drives restarted after the militants were evicted in 2014.

The boy’s family says he had been vaccinated.

“The boy has been vaccinated in every door-to-door polio vaccination campaign, but even then, he developed the crippling disease. We aren’t opposed to polio drops,” says Naheedullah, the toddler’s uncle. “We are religious people but never defied vaccination.”

However, the authorities dispute the family’s version and say the newly infected child hadn’t received oral polio vaccines (OPV) because his family was among those they call “silent refusals”.

“Silent refusals are those whose families argue that their children below five years have been inoculated, but they remain unvaccinated,” Dr Shamsur Rehman, a health official in the region, told IPS. In Khyber Pakhtunkhwa, 18,349 children remain unvaccinated due to refusal by their families during the March 2022 campaign. This is down from 19,874 recorded in December 2021.

Vaccinators also face threats from the defiant parents – and as a result, often record the children as vaccinated to stay safe from reprisals. More than 50 people have been killed, allegedly by militants, since 2012 in various anti-polio drives, mainly in Khyber Pakhtunkhwa, which remained a hotspot of the virus for many years, Pakistan’s oldest newspaper Dawn reported.

Religious scholar Muhammad Sami says polio vaccines aren’t allowed in Islam, and therefore, there is polio vaccine hesitancy. He said his group had “information” that the vaccination was a plot to “render the recipients incapable of producing children and cut down the population of the Muslims.”

However, others in the same area have a different opinion.

“We have been persuading parents to administer OPV to their kids as it is their religious responsibility to protect their offspring from diseases,” says Maulana Sagheer, adding that it was false information that the vaccines caused sterility and infertility.

Zulfiqar Babakhel, spokesperson for Pakistan Polio Programme, told IPS that the detection of this latest case of wild poliovirus wasn’t unexpected.  The Pakistan programme had anticipated this risk and put in place contingency plans to enable a rapid response, he said.

It continues to intensify its efforts to eradicate all remaining residual transmission of any strain of poliovirus.

“The ‘last mile’ has always proven to be the toughest phase of national eradication efforts in all countries. Although challenges remain, the programme is capitalizing on the momentum of recent success and continues to strive for zero-polio. This is the most critical time for the programme,” Babakhel said.

It is important to emphasize that the number of polio cases has been significantly reduced this year due to health workers’ unwavering commitment and communities’ and various stakeholders’ support, he said.

It is the third case of wild polio to be reported globally in 2022. Others were reported from Afghanistan and Malawi.

Pakistan had reported one case last year with onset on January 27, 2021, in Killa Abdullah district, Balochistan province.

Health Secretary Dr Aamir Ashraf told IPS that this was a tragedy for the child and his family. It is also regrettable both for Pakistan and polio eradication efforts worldwide.

“We are disappointed but stay undeterred. The case appeared in Southern Khyber Pakhtunkhwa where the poliovirus was detected late last year and where an emergency action plan is already being implemented,” he says.

“The National and Provincial Polio Emergency Operations Centres have deployed teams to conduct a full investigation of the recent case, while emergency immunization campaigns are underway to prevent further spread of the wild poliovirus in Pakistan,” he says.

Repeated immunizations have protected millions of children from polio, allowing almost all countries to become polio-free, besides the two endemic countries of Pakistan and Afghanistan.

The next sub-national Polio vaccination campaign, expected from 23 – 27 May 2022, will target over 24 million under-five children.

The polio programme had identified Khyber-Pakhtunkhwa as the area most at risk after wild poliovirus was detected in environmental samples in the last quarter of 2021.

“This validates the programme’s concerns about virus circulation in Southern KP and strengthens our resolve to reach every child with the polio vaccine,” said the National Emergency Operations Centre (NEOC) coordinator for polio, Dr Shahzad Baig.

To address the challenges in Southern KP, the Government and global polio partners had already initiated an emergency action plan to address the challenges in this part of the province, he explained.

In 2020, the province of Khyber-Pakhtunkhwa reported 22 cases, while no wild poliovirus cases were recorded in the area last year.

Substantial progress has been made recently, with most areas accessible to implement immunization campaigns, but deep-rooted problems and security concerns remain in a few places. Despite the challenges, the programme’s frontline workers continue to reach children with the life-saving vaccine.

The programme is capitalizing on the momentum gained last year and continues to strive for zero-polio. Parents must continue to vaccinate their children during every immunization round until they reach the age of five.

Pakistan remains one of only two countries globally with circulating wild poliovirus, together with Afghanistan. Polio is a highly infectious virus. Until this last epidemiological block wipes out polio, children worldwide remain at risk of life-long paralysis or fatality by the poliovirus.

IPS UN Bureau Report

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