PESHAWAR: Following a successful experience in Bannu and Dera Ismail Khan districts, the health department has sought full administrative support to cope with the problem of refusals against oral polio vaccine (OPV) and wants involvement of the district governments in immunisation campaigns to eradicate the crippling childhood disease from the province.

“In the past few weeks, we have been successful to reduce the number of refusals in Bannu and Dera Ismail Khan districts due to full support of the deputy commissioners and their assistants,” relevant officials said.

They claimed that they had cut down refusals against OPV from 16,000 to 6,000 only in Bannu because the district administration was very strict on the parents who defied vaccination.

In a meeting held early this month, Khyber Pakhtunkhwa chief secretary Amjad Ali Khan had taken exception to the problems faced by the Expanded Programme on Immunisation (EPI) in vaccinating children against polio and directed the DCs to ensure immunisation of every child in their respective areas.

Officials say refusal cases successfully cut with admin’s support in Bannu, DI Khan

“It was the first time we received such serious instructions from a chief secretary and the results are encouraging,” said a Dera Ismail Khan-based health official. He said that the health department didn’t have any administrative powers to prevail on the defiant parents and give their children OPV through use of force.

“In every campaign we were recording 35,000 chronic refusals in the province. This is a fraction of the over 5.2 million population, but in the presence of unvaccinated children we couldn’t eradicate the disease,” he said.

The officials said the chief secretary had also directed the district governments to fully activate polio eradication committees at the union council and district levels to identify refusals against polio and initiate measures to administer OPV to children below five years of age. The health department has so far been trying to cover refusals through different strategies. For example, people arguing that OPV is forbidden in Islam, are persuaded through local religious leaders while the misconception held by some parents that the vaccine is designed to render recipients impotent or infertile, are convinced by doctors, they said.

“The strategy will not work until full administrative support, like we have been getting in Dir, Shangla, Peshawar and Nowshera,” they said.

Pakistan has 227 polio cases, including 148 from Fata and 44 from Khyber Pakhtunkhwa in 2014 so far.

The officials, however, say that more cases could emerge in coming weeks from Khyber Pakhtunkhwa mainly because of poor quality vaccination.

“We desperately need administrative support to run effective campaigns in all the districts,” they said. In Nowshera, the campaign quality has been very effective due to such support, they said.

The officials said that though the government didn’t have any law to penalise the parents for refusing vaccinating of their children, it can still cover the refusals through administrative means.

“We need the government to swing into action and pave the way for smooth-sailing of the vaccination campaigns,” said the health officials. “The people refuse OPV because we can’t take any action against them. Even Afghan refugees defy vaccination,” a senior vaccinator told Dawn. He said that vaccination programmes faced similar problems even in China, India and other countries, but strict administrative measures were adopted to cope with those creating obstacles to their national programme.

The officials said that over 50,000 children who were left out of vaccination in every campaign because of inaccessibility could also be covered through administration, which could provide security to the health workers in hard areas. “Despite vaccinating millions of children, we can’t eliminate polio until a single virus exists,” they said.

Published in Dawn, October 30th , 2014