ISLAMABAD
HAMID KHAN WAZIR
Though the government has succeeded in bringing down polio cases drastically, complete elimination of the virus from the country might remain a distant dream until ensuring affective use of inactivated polio vaccine (IPV) along with oral polio vaccine (OPV).
There are two types of vaccines: one that uses inactivated polio virus and is given by injection (IPV), and one that uses weakened polio virus and is given by mouth (OPV) that helped in elimination of polio from most of the world and reduced the number of cases each year from an estimated 350,000 in 1988 to 37 in 2016.
However, the inactivated polio vaccines are very safe as compared to oral polio vaccines, because the latter cause about three cases of vaccine-associated paralytic poliomyelitis per million doses given.
A senior official wishing anonymity told Pakistan Today that complete eradication of polio from the country could be possible only through OPV; hence there is need to gradually switch to IPV to rid the country of the menace once for all.
He said that the OPV played an effective role in bringing down the polio cases; however it could be even counter-productive for children with weak immunity.
The official further said that the OPV was no more in use in developed countries, as IPV was the only polio vaccine that has been given in the United States since 2000.
He said that the IPV was expensive and it needed proper trained team due to which the authority was reluctant to introduce it across-the-country.
However, he added that the calculated cost of OPV including spending on polio day celebration, transportation cost of staffers, hiring teachers and youth for administering polio drops could exceed the price of IPV.
He said that the parents took their children to the hospitals for routine immunization schedule willingly; hence it proved more effective if it be given along with routine immunization.
Another official said that oral polio drops cause five to ten paralysis cases per one million doses given to children. He said that children with weak immunity could automatically affect from OPV; hence, IPV along with OPV should be ensured to ensure complete polio eradication.
He said that there were almost untrained youths being hired to administer polio drops during polio campaign who know nothing about child health condition, which could also prove counter-productive.
In Pakistan, the IPV was administered along with nine target diseases under Expanded Programme on Immunization (EPI).
However, he said that the programme was not being strictly implemented in hospitals located in remote areas and was mainly limited to the major cities of the country.
He said that the government should give a serious consideration to the issue, as Pakistan was among the three countries where still the virus was prevalent due to which the countrymen were facing great problems while going abroad.
When contacted, National Coordinator for Emergency Operation Centre (EOC), Dr Rana Safdar said that it was a must to give oral polio vaccination, which he said played key role in polio eradication across the world.
However, he accepted that the IPV played an added benefit role in a situation when children were given multiple doses, but even then their protection level did not improve due to malnutrition, repeated infection or any other reason. So, he said that IPV and OPV have in combination role but not a replacement of one another.
“We identified around 5.9 million children under polio eradication program whose immunity was not increasing at optimal level due to malnutrition or some other reason, so they were specially vaccinated to build their immune level,” Rana added.
He said that mainly there are two reasons not to switch to IPV i.e. logistically it was not possible to outreach 38 million children door-to-door and the second is IPV could not generate specifically the gut immunity needed to stop virus transmission.
He said that IPV dose has been giving to a child at the age of 14 week under routine immunization schedule for the last three years after three doses of OPV.
To a question regarding the use of IPV in US, he said that the US was not polio endemic, as in 1988, it instantly interrupted the virus and only such countries could afford to switch to IPV where the virus not widely circulated and over 90 percent of population are giving routine immunization vaccine.
He said that Pakistan, Afghanistan and Nigeria could switch to IPV when they reached to level of interruption.
