Abstract
When the Global Polio Eradication Initiative began in 1988, wild poliovirus (WPV) transmission was occurring in 125 countries; currently, only WPV type 1 (WPV1) transmission continues, and as of August 2021, WPV1 transmission persists in only two countries (1,2). This report describes Pakistan's progress toward polio eradication during January 2020-July 2021 and updates previous reports (3,4). In 2020, Pakistan reported 84 WPV1 cases, a 43% reduction from 2019; as of August 25, 2021, Pakistan has reported one WPV1 case in 2021. Circulating vaccine-derived poliovirus (cVDPV) emerges as a result of attenuated oral poliovirus vaccine (OPV) virus regaining neurovirulence after prolonged circulation in underimmunized populations and can lead to paralysis. In 2019, 22 cases of cVDPV type 2 (cVDPV2) were reported in Pakistan, 135 cases were reported in 2020, and eight cases have been reported as of August 25, 2021. Because of the COVID-19 pandemic, planned supplementary immunization activities (SIAs)* were suspended during mid-March-June 2020 (3,5). Seven SIAs were implemented during July 2020-July 2021 without substantial decreases in SIA quality. Improving the quality of polio SIAs, vaccinating immigrants from Afghanistan, and implementing changes to enhance program accountability and performance would help the Pakistan polio program achieve its goal of interrupting WPV1 transmission by the end of 2022.
Highlights
To achieve the dual goals of eliminating wild poliovirus type 1 (WPV1) and halting circulating vaccinederived poliovirus type 2 (cVDPV2) transmission, efforts are warranted to increase the quality of polio SIAs by further decreasing the number of children who were repeatedly missed in the WPV1 reservoirs
Accelerated implementation of the proposed program transformation would improve management and accountability at all levels of the program. This includes prioritizing the recruitment and training of frontline workers who are empowered to provide culturally relevant leadership that is accepted by the local communities
The program must act with urgency to take advantage of the opportunity presented by the slowing of poliovirus circulation in 2021 to eliminate all virus transmission from the country by the end of 2022 [9,10]
Summary
Gavi, the Vaccine Alliance, indicated that the proportion of fully immunized children aged 12–23 months, by province, ranged from 37.5% in Balochistan to 88.9% in Punjab. During 2020, four national immunization days (NIDs) and two subnational immunization days (SNIDs) targeting children aged
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