Polio resurgence in Pakistan: Over 1 million children missed vaccines

Polio, once on the brink of elimination in Pakistan, is making a dangerous comeback, with over 1 million children missing their vaccinations last month, according to a report by CNN.

In October alone, Pakistani authorities reported more than a dozen new polio infections, raising this year’s total to 39, a significant increase from just six cases in 2023. The resurgence comes as the country struggles with vaccination gaps and rising security threats against health workers.

Vaccination gaps and misinformation

Ayesha Raza, focal person to the Pakistani prime minister on polio eradication, attributed the rise in cases to low vaccine coverage. "About 1 million children missed their polio vaccinations in September, widening the immunity gap that has grown since Covid-19 disrupted immunisation efforts," she told CNN.

Polio, a highly infectious viral disease that primarily affects children under five, can cause irreversible paralysis, respiratory complications, and death. Spread through contaminated food and water, the disease has no cure but is preventable with a vaccine. Thanks to global immunisation efforts, polio cases have dropped by over 99 per cent since the 1980s.

Pakistan and Afghanistan are the only countries where polio remains endemic, according to the World Health Organization (WHO). However, the United Nations health agency has recently expressed concerns over a possible resurgence of the disease in Gaza, following heavy Israeli bombardment.

Challenges of eradication in Pakistan

Despite ongoing efforts to eradicate polio, Pakistan’s vaccination programmes face several challenges. Trust issues surrounding foreign health initiatives have persisted since 2011, when reports revealed that US intelligence had used a fake vaccination drive in Abbottabad to locate Osama bin Laden. This event sparked widespread suspicion, particularly in remote areas.

Religious beliefs, lack of awareness, and rampant misinformation further complicate the situation. In southwestern Balochistan, which borders Afghanistan, misinformation has led to hesitancy among parents to vaccinate their children, according to local officials. Most of the new cases have been reported in this province, where reluctance to complete the four doses of the polio vaccine is common.

“Most of the children recently infected had been partially vaccinated but didn’t complete their full vaccination,” Raza noted, adding that cases are expected to rise as surveillance efforts increase.

Security concerns hinder polio campaigns

The resurgence of polio coincides with increasing militant violence targeting vaccination clinics and security forces. For years, anti-polio campaigns in Pakistan have been undermined by militant attacks, as extremists spread the false claim that vaccines are a Western plot to sterilise children.

This year alone, there have been 27 recorded attacks on polio workers in Khyber Pakhtunkhwa province, according to local police and a CNN tally. In September, armed militants shot and killed a police officer guarding a vaccination site in Bannu, triggering protests. That same month, a police officer and a polio worker were killed in another attack in Bajaur.

Aftab Kakar, a representative from the Emergency Operation Center in Balochistan, highlighted how security threats, protests, and community boycotts have disrupted vaccination campaigns. “These disruptions have left a group of missed children who could sustain virus transmission,” Kakar said.

He also pointed out that some health workers had mistakenly marked children as vaccinated, contributing to the rise in infections.

Hopes for eradication despite setbacks

Despite these major challenges, Pakistani authorities remain hopeful. A nationwide polio vaccination campaign, set to launch on October 28, aims to inoculate 45 million children under five.

"Polio eradication is Pakistan’s top priority," stated a post from the Pakistan Polio Eradication Programme. "A unified plan with provinces aims to stop polio transmission by 2025."