ISLAMABAD: As polio cases escalate in Pakistan, health officials nationwide are attributing the virus’s spread to several factors, including malnutrition, gaps in Routine Immunization (RI), parental refusals, and a newly raised concern about paralysis linked to injection neuritis, especially highlighted by health authorities in Khyber Pakhtunkhwa (KP).
In KP, officials have reported cases of injection neuritis, a condition where improper injection techniques by untrained practitioners harm nerves, leading to potential paralysis. Alongside this, concerns have emerged over the efficacy of the Oral Polio Vaccine (OPV) due to possible lapses in cold-chain storage, though the National Emergency Operations Centre (NEOC) reassures that strict cold-chain protocols are maintained to protect vaccine quality.
Federal Health Secretary Nadeem Mahbub recently visited KP to examine these claims, affirming that the government is using scientific methods, including nerve conduction and serology tests, to address local concerns.
In Sindh, which has seen 12 polio cases this year, authorities point to malnutrition as a key factor in the rise. They explain that malnourished children require additional vaccine doses to build immunity. Although malnutrition weakens immune responses, NEOC officials emphasize that repeated vaccination efforts through RI and door-to-door campaigns can mitigate this. However, Sindh’s polio program also highlights the challenge of parental vaccine refusals, particularly in Karachi and Hyderabad, where distrust remains prevalent. The program has criticized Unicef for insufficient community outreach, urging expanded awareness campaigns to dispel vaccine myths.
Balochistan, facing a severe situation with 22 polio cases, 17 of whom were zero-dose children, attributes its outbreak to security challenges, weak RI coverage, and data manipulation practices like false finger-marking. Local health authorities say limited healthcare access in remote regions enables the virus to thrive and spread.
The NEOC in Islamabad has cautioned against overemphasizing secondary factors as reasons for the outbreak. “Our primary challenge remains reaching the maximum number of children with the OPV,” explained an NEOC technical officer, stressing that full immunization coverage through thorough vaccination drives is essential.
Addressing KP’s injection neuritis concerns, NEOC clarified that this issue has not been observed in other provinces, and cold-chain maintenance protocols are designed to uphold OPV efficacy. They added that finding poliovirus among patients initially diagnosed with injection neuritis is common both within Pakistan and globally. In cases where the virus is already in a child’s body, nerve injury from an incorrect injection can allow it to reach the nervous system and cause paralysis.
In Balochistan, the NEOC also highlighted concerns around data integrity, citing reports of false finger-marking by polio workers, which skews vaccination coverage data. Corrective measures, such as stricter monitoring and penalties for data falsification, are being implemented.
NEOC officials continue to call on parents to vaccinate their children, emphasizing that parental engagement is vital to safeguarding children against polio. “With sustained, widespread vaccination, Pakistan can eliminate polio, just as other nations have,” they noted, stressing that the goal of eradication requires collective effort to achieve comprehensive vaccine coverage.
