PolioPlus Update – December 2019

Another not pretty week:  two (2) in Afghanistan and seven (7) in Pakistan bringing this year’s total to 125 vs. 29 last year at this time.  Of this year’s total, 24 are in Afghanistan and 101 in Pakistan, illustrating the magnitude of the problem we have in the latter (almost assuredly attributable to the interruption in vaccination campaign occurring earlier in the year).

The cVDPV cases are also of concern, as we’ve seen sporadic outbreaks in various countries as detailed below.  Remember that these cases aren’t caused by the vaccine, but are caused when the weakened virus sheds from those who have been immunized (and in turn providing some inoculation to unvaccinated individuals) but circulates in a relatively unvaccinated community long enough that the virus mutates back to a virulent form which causes paralysis.

Why don’t we just use the monovalent inactivated vaccination which would prevent cVDPV cases (the type of injected vaccination we use in the United States)?  There are at least three good reasons:  (1) the weakened live virus used in the drops does provide some additional “halo” vaccination effect – as long as it doesn’t circulate long enough and mutate; (2) the distribution chain difficulties (maintaining cold storage long enough, volume of material being transported) isn’t robust enough to allow distribution of the injectable; and (3) cost and skill …. Almost anyone can squeeze a couple of drops of the weakened live virus vaccination; providing training sufficient to allow use of the injectable, along with the significant added cost of the vaccine, syringe, needles, sterile supplies and cleaning agents – is simply not possible.  There are other reasons, to be sure, but these are the primary ones.

The solution for now is to maintain immunization efforts even in those areas without endemic wild polio virus cases to assure that the community “herd immunity” is enough to prevent the circulation of the weakened live virus.  While the primary focus of our efforts are in Pakistan and Afghanistan to eliminate the endemic polio, we must remain vigilant elsewhere, too.  This is why we must continue to raise funds and awareness for the eradication of polio.

Pakistan still remains problematic for carrying out the government’s freshly-renewed mandate of vaccination campaigns:  it was reported yesterday that gunmen shot and killed two police officers escorting a polio vaccination team.  The campaign has been temporarily suspended in the Peshawar, Lower Dir district area.  While fortunately none of the vaccination team were injured, the loss of the policeman is tragic.

Please share with your clubs and districts the importance of continuing this fight until it is complete.  For those looking to make year end donations, this is a good topic to raise.

While it is easy to focus on the difficulties of Pakistan and Afghanistan and become discouraged, remember that we have successfully eliminated polio everywhere else in the world except for these two countries.  It was long thought that the African continent would never be polio free, and yet we know it has not been declared polio-free.  Our will, commitment and fortitude has led directly to that result.  And I’m confident that with your continued help, we’ll have the same result in due course in Pakistan and Afghanistan!

I wish you the best of the holiday season (including Christmas, Hanukkah, Kwanzaa, Las Posadas, Winter Solstice and of course Festivus for everyone else!).

–Ken

Ken Howell
PDG District 5400 ’15-16, Zone 27 End Polio Now Coordinator