PESHAWAR: The Khyber Pakhtunkhwa government has pinned hopes on doctors to stem tide of refusals by parents against oral polio vaccine as three-day campaign will be launched on Monday (today).

“All doctors including specialists and general cadre are hereby informed that the government is committed to eradicating polio and that every doctor shall contribute to the cause of polio eradication by effectively replying to queries of parents and convincing them to give oral polio vaccine (OPV) to their children below five years every time the polio team visits them,” said a circular issued to hospitals.

It said that Pakistan declared polio eradication an emergency in 2011 and as consequent efforts had been made to speed up the efforts. “Yet Wild Polio Virus (WPV) is still detected in the sewage water indicating that virus circulation could not be stopped completely and children still risked poliomyelitis, a lifelong disability,” it said.

Circular issued to hospitals for convincing parents to vaccinate their children

The circular said that polio eradication strategy was a multipronged approach including immunisation of children against poliomyelitis through expanded programme on immunisation (EPI) -- essential immunisation schedule -- and blocking WPV receptors in pharynx and intestine of all children in target age group through OPV Supplemental Immunisation Activities (SIAs) that were carried out in addition to putting in place a sensitive surveillance system for detection of WPV.

The only place for replication of WPV is gastrointestinal tract (GIT) of children. Its infectivity is not stable in sewage water (survives for months at +4°C and for several days at +30 °C). The OPV SIAs strategy is to block the receptors in GIT through vaccine and debar the WPV from finding susceptible children.

The WPV will thus die out in environment. However, empty guts of unvaccinated children in the community, missed due to any reason, provide opportunity to WPV for replication and survival.

It the past WPV affected scores of children in those areas that were inaccessible to polio teams. However, as soon as accessibility was ensured, the WPV circulation was stopped there. The WPV circulation has been stopped in 123 countries of the world infected in 1988.

A suggestion by prime minister’s polio cell to start joint campaign in KP and tribal districts has not been accepted as separate drives are scheduled in both the endemic areas. KP is concentrating on Peshawar where poliovirus is present in sewerage water mainly due to more than 3,000 refusals recorded against OPV in every campaign.

Bajaur and Khyber are the focus of vaccination in tribal region as both these districts had three polio cases of the total seven recorded countrywide this year so far.

To cope with the issue of refusals, the KP health department has also enlisted support of the religious scholars to prevail upon the people to immunise their children so that they could stay safe from the crippling ailment.

A few religious groups in Peshawar, one of three poliovirus reservoirs in the country, have been hampering the vaccination by asking t people to stay away from the OPV. They said that there was no need of medication when the disease hadn’t occurred.

The authorities are concerned about the situation as in every campaign they vaccinate 600,000 target children but only a small portion of children remain unvaccinated due to which the eradication of poliovirus stands a far dream.

Published in Dawn, November 12th, 2018