[Re: https://www.hifa.org/dgroups-rss/polio-vaccine-communication-10-national... ]
Dear Neil,
The goal of the Global Polio Eradication Initiative (GPEI) is not merely to prevent polio — as vaccination aims to prevent many diseases — but to eradicate it. The first eradication goal was 2000. By that date the number of global polio cases was reduced by 99%, yet ever since the situation has remained similar, with ups and downs. Twenty-six years after the original target date, eradication still seems difficult to achieve.
Massive, noisy vaccination campaigns using the oral polio vaccine (OPV) during National Immunization Days (NIDs) made it possible to achieve good vaccination coverage in most parts of the world. However, in two regions (northern Nigeria and some parts of India, Pakistan, and Afghanistan), in very deprived communities where strong opposition to central authority exists, these NIDs have fueled mistrust and hostility (1). How can people who often lack access to basic health care services understand such massive efforts for a disease, polio, that they are often not aware of? It is not surprising that a rumor accusing the OPV of being a sterilizing agent intended to limit population growth emerged. It was identified in Nigeria as early as 1996 (2).
The multiplication of NIDs over 30 years has not made it possible to achieve the expected vaccine coverage, while fueling mistrust and hostility. The pockets of non-immunized children have allowed wild polio viruses to continue spreading and new epidemics of vaccine-derived viruses to emerge. It is time to acknowledge the failure to gain public adherence to NIDs and to change strategy.
In the same regions, there is a good adherence to routine vaccination through the Expanded Program of Immunization (EPI). From the 90s on, pediatricians and virologists have recommended to stop the NIDs and concentrate the efforts on EPI (3-5). Some recommend replacing the goal of virus with the control of polio cases. As a specialist in public health communication, I argue that renouncing NIDs is the only way to stop fueling rumors and win adhesion to polio vaccination.
1. Seytre B. Vaccine Refusal: A Major, Underestimated Obstacle for the Poliomyelitis Eradication Initiative. Am J Trop Med Hyg. 2023 May 15;109(1):6-9. doi: 10.4269/ajtmh.23-0154.
2. Renne EP. Perceptions of population policy, development, and family planning programs in Northern Nigeria. Stud Fam Plann. 1996 May-Jun;27(3):127-36. doi: 10.2307/2137918.
3. Schlumberger M. Augmentation de l’efficience d’un PEV en stratégie mobile utilisant le vaccin polio injectable en Afrique. Med Trop Sante Int. 2023 Jun 2;3(2):mtsi.v3i2.2023.344. doi:10.48327/mtsi.v3i2.2023.344
4. John TJ, Dharmapalan D, Hirschhorn N, Steinglass R. How to avoid causing polio in the name of its eradication. Lancet. 2023 Jul 15;402(10397):179-180. doi: 10.1016/S0140-6736(23)01069-3.
5. Hirschhorn N, John TJ, Steinglass R, Dharmapalan D. Polio eradication: 25 years overdue, US$25 billion overrun. Lancet. 2024 Oct 26;404(10463):1637-1638. doi: 10.1016/S0140-6736(24)01913-5.
-------------
Tél. : +33 6 03 54 88 13 (WhatsApp)
santepublique-com.fr
HIFA profile: Bernard Seytre is a Consultant at BNSCommunication in France. Professional interests: Health communication and education. seytre AT bnscom.fr