The big switch: eradicating polio

There’s a big, never before seen switch happening throughout the world. It’s the largest, fastest globally coordinated rollout of a vaccine into routine immunization programs in history and will help make polio a thing of the past.

The switch is happening from one type of polio vaccine to another. The older version of the vaccine contains a strain of the polio virus, type 2, which has been eradicated and no longer needs to be introduced to children. This means we are another step closer to ensuring children throughout the world are safe from the polio.

In the East Asia Pacific region, all but the four countries that already switched to the new vaccine are now delivering the new vaccines to health centres and to children.

The fact that the world is ready for the switch is a sign that we have come a long way in our journey to stop all polioviruses and that we are closer than ever to eradication – but there is still much work to be done.

Closing the gap

While it is important countries have access to the vaccines, it is also critical that every child is immunized. If this doesn’t happen, life-threatening outbreaks will continue to affect the most vulnerable.

A community in the remote hills of Laos are shown an educational video on polio vaccination. It happened at night to ensure maximum turnout
© UNICEF Laos/2016A community in the remote hills of Laos are shown an educational video on polio vaccination. It happened in the evening to ensure maximum turnout

But reaching every child in a place like East Asia and the Pacific, which is home to many mountains, thousands of islands and a huge variety of languages, isn’t easy. It takes time and resources and that’s why it’s important that governments are supported to ensure every child is fully immunized.

Unrelated polio outbreaks were recently seen in Laos and Myanmar, where hard to reach communities were affected by ‘vaccine-derived polio virus’. This virus is a rare but well-documented weakened strain of poliovirus used in the oral polio vaccine which is sometimes found when vaccination levels are low.

If people are fully immunized, they are protected against all forms of the virus. But in areas where there is low immunization coverage and where people do not have access to safe water and sanitation systems, there is a risk of fecal-oral transmission of this weakened virus to unimmunized people.

In response, UNICEF and partners worked with Governments in Laos and Myanmar to stop the polio outbreaks. This is being done by ensuring the availability of vaccine supplies, informing communities in some of the most remote areas on the need for children to be fully vaccinated, and by vaccinating those most at risk over multiple vaccination rounds.

Health staff went from door-to-door to vaccinate all children under five years old across Rakhine State, Myanmar, where two polio cases were reported in 2015. Across the country, the polio campaign reached over 4 million children
© UNICEF Myanmar/2016/Thiha HtunHealth staff went from door-to-door to vaccinate all children under five years old across Rakhine State, Myanmar, where two polio cases were reported in 2015. Across the country, the polio campaign reached over 4 million children

The only way to ensure that crippling polio virus is eradicated is by ensuring immunization coverage levels remains high.

It is well recognized that large investments and huge efforts will be needed to reach the geographically or socially hard-to-reach populations and communities, and in East Asia and the Pacific the challenge can hardly be bigger.

To make sure that the switch goes smoothly, independent monitors in each country will visit health facilities to check that the older trivalent oral polio vaccine is no longer in use, and the bivalent oral polio vaccine is used instead. In addition, dozens of global monitors/observers have been assigned and will be going to select countries to support and participate in the process. It is important that all countries make the switch during the same period to ensure that there is no risk of vaccine-derived type 2 polio virus spreading.

The switch is just the first step in the endgame toward global polio eradication.

The author
Abu Obeida Eltayeb is Immunization Specialist at UNICEF East Asia & Pacific

 

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