The World Health Organization confirmed on 4 September that over 187,000 children in Gaza under the age of ten had been vaccinated with novel oral polio vaccine type 2 (nOPV2). This is the first phase of a two-round vaccine campaign against polio in Gaza that was initially estimated to target 157,000 children. Due to population movement towards central Gaza, more children than expected were able to receive the vaccine. Vaccinators also travelled to hard-to-reach areas and areas just outside the agreed zones for the humanitarian pause to maximise outreach.
This campaign comes at a critical time. In early August, the UN health agency reported poliovirus had been found in Gaza’s wastewater, and weeks later the first confirmed case of polio in Gaza was reported in a ten-month-old boy. This vaccination campaign takes advantage of the current humanitarian pause zone to aid in delivery, protect healthcare workers, and also expand coverage with mobile teams that reached families who could not travel to the fixed vaccination sites.
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The goal of this polio vaccine campaign is to achieve 90% vaccination coverage. Polio control has been achieved in this region before, and the maintenance of zero circulating virus is possible with high vaccine coverage. This campaign aims to stop the current outbreak, prevent the international spread of polio, and reduce the risk of re-emergence in the Gaza Strip due to the severely disrupted health, water, and sanitation systems in this region.
The poliovirus type currently spreading in Gaza is derived from the oral polio vaccine (OPV), which can, in very rare cases, revert back to a virus that can spread and cause disease. These OPVs are used to quickly protect populations against polio, and the risks of these vaccines are outweighed by the risks of allowing polio outbreaks to continue to spread while using the relatively safer inactivated polio vaccine (IPV) by injection. The nOPV2 used for this campaign is safe and effective against variant poliovirus type 2, the most prevalent form of poliovirus, and will protect against paralysis and community transmission. This vaccine is a modified version of the type 2 monovalent oral polio vaccine but uses a more genetically stable virus that is less likely to revert to a form that can cause paralysis. In theory, this will guard against future outbreaks of polio in the region.
OPVs have been used in other contexts with good results. In India and South Korea, GlobalData epidemiologists report more than 90% coverage, with over 98% of children aged six months in South Korea having received at least three doses of this vaccine. According to leading data and analytics company GlobalData‘s epidemiologists, China, which uses a combination of OPV and IPV, reports that 99% of children aged six months have received at least three doses of the vaccine.
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Historically, vaccine campaigns have been very effective in controlling outbreaks, and in some settings, have achieved eradication. Wild poliovirus has been eradicated in every country except Pakistan and Afghanistan thanks to efforts from worldwide mass vaccination campaigns. Despite ongoing political instability in Afghanistan, polio vaccine efforts continue, and only 14 cases have been reported so far this year, potentially painting a hopeful picture for the future eradication of wild poliovirus. Smallpox was famously declared eradicated in 1980 after the last known natural case in Somalia in 1977. This was only possible because of a mass vaccination campaign and smaller, targeted vaccine campaigns designed to eliminate this disease.
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By GlobalDataWhile the extent of the ongoing polio outbreak in Gaza remains to be seen, the current vaccine campaign is reaching more children than expected. The campaign concluded on 11 September, and ongoing surveillance for polio will continue in the region.
