Vaccine refusals

In a somewhat disappointing development, 27 per cent of families refused the polio vaccination in 40 out of the 85 high-risk union committees (UCs) of Karachi. The current campaign marks the first large-scale use of needle-free jet injectors to deliver fractional doses of inactivated poliovirus vaccine (f-IPV). This method was previously implemented on a smaller scale in Karachi in 2019. In March of this year, two new polio cases were reported in Balochistan within just two days, ending the province's polio-free status that had been maintained since 2021. This resurgence highlights the persistence of the disease and the ongoing challenges Pakistan faces in its fight against polio. The obstacles are numerous: extremist groups attacking polio workers due to misguided beliefs that vaccination efforts are foreign conspiracies; parental refusal to vaccinate; and the frequent movement of people across the porous Pakistan-Afghanistan border.

Pakistan and Afghanistan are the only two countries where the disease is endemic. Poliovirus has been found in several sewage samples nationwide. Although Pakistan has made notable progress in its polio eradication efforts, the path forward remains fraught with challenges. This is a life-changing disease. It is unacceptable that the number of children disabled by a completely preventable disease keeps increasing while the government fails to control or penalise those spreading false rumours and promoting vaccine rejection. There are good ethical grounds to penalise those who refuse the vaccine putting the future of their family and the nation in peril. There is also a dire need to formulate an effective communication strategy to target all demographics, as refusals have also been received from well-educated families in Karachi. The government needs to show significantly greater determination in its efforts to eradicate polio than it has recently if Pakistan is to achieve the status of a polio-free state.