Vaccine refusals

Parents' refusal to administer the poliovirus vaccine to their children remains a major challenge, particularly in the major urban centres of Karachi and Hyderabad. The disease vectors are no longer centred on the movement of people between Pakistan and Afghanistan. It is now in our cities. While inaugurating the latest national anti-polio drive, the Sindh CM said 10.6 million children under five across 30 districts of the province would be provided with oral polio vaccine (OPV) to protect against the debilitating disease. In Sindh, the highest number of refusals are from Karachi, which accounts for 85% of all refusals in the province. Pakistan has seen a surge in polio cases this year, recording 41 so far in 2024 compared with six in 2023. The reasons for vaccine refusals in Pakistan are complex and intertwine cultural, religious and socio-political factors. Misinformation has played a big role in the refusals, with a 'foreign agenda' further feeding into the environment of distrust.

An urban centre such as Karachi, experiencing continuous cycles of migration, is host to diverse communities. Misinformation spreads rapidly, often overshadowing medical facts. Although efforts have been made to counter such narratives, people remain susceptible and often offer resistance. The second major obstacle to a polio-free Pakistan is attacks by militants on polio teams. On Tuesday, a policeman guarding a vaccination team in Orakzai was shot dead. The teams have often come under attack and as a consequence, the vaccination campaign is suspended in the volatile areas, depriving thousands of children of the two small drops that can save them from the disease. The authorities need to go on a war footing if they hope to control the current situation. Public health campaigns must prioritise transparent communication, focusing on building trust within communities. Engaging local leaders, religious figures and healthcare workers as advocates for vaccination can help bridge the gap. At the same time, security must be bolstered and those behind the attacks should be brought to justice.