The first two rounds of polio immunizations are being provided this month in Myanmar, buttressed by the World Health Organization (WHO) which is supporting the country’s launch of a massive vaccination campaign targeting 1.4 million children ages 5 and under.
“The challenge will be to reach every eligible child with a polio vaccination, especially those living in hard-to-reach and remote areas,” Dr. Rajendra Bohara, lead technical officer of the WHO Expanded Programme on Immunization, told Vaccine News Daily.
For instance, in northern Rakhine State and Chin State, there are “many accessibility problems, such as dirt roads or waterways, that require the use of boats,” Bohara said. “Good micro-planning will help in meeting these challenges and all partners in Rakhine have committed to support the campaign.”
The recent outbreak of the vaccine-derived poliovirus (VDPV) was due to low routine polio vaccine coverage, Bohara said.
In response, “the government is mobilizing all health staff and health volunteers in 15 townships for the mop-up campaign,” Bohara told Vaccine News Daily.
Thus far, “several activities, including training of volunteers and health staff, micro-planning and advocacy meetings, have been completed,” Bohara said. “The doses of vaccine as well as other logistics material have already reached the mop-up townships."
Polio, a highly infectious viral disease spread through person-to-person contact, invades the nervous system and can cause irreversible paralysis in a matter of hours. When a child is infected, the virus enters the body through the mouth, multiplies in the intestine, and then is shed into the environment through the feces where it can spread rapidly through a community, especially in situations of poor hygiene and sanitation, according to WHO.
“The polio vaccine, given multiple times, almost always protects a child for life,” according to the nonprofit. “If a sufficient number of children are fully immunized against polio, the virus is unable to find susceptible children to infect and dies out.”
To increase the vaccine’s success across Myanmar, Bohara said the government has planned to conduct three rounds of “mop-up oral polio vaccinations” in 15 townships; 10 in Rakhine, two in Chin and one each in the Bago, Magway and Ayeyarwady regions.
These new vaccine rounds are in response to a VDPV outbreak this year in Maungdaw Township, Rakhine State, where the routine immunization coverage has been less than 80 percent for the last several years. In fact, during 2014 in Rakhine, the WHO reported that only 27 percent of children received the three recommended doses of the oral polio vaccine.
Bohara told Vaccine News Daily that "the three rounds of mop up starting this month will help boost the population immunity and stop transmission of the VDPV in the affected area.
“In addition to the mop-up campaign, the additional rounds will be in line with the immediate plan to raise routine immunization coverage among the population so that no outbreak of WPV or VDPV will occur in the future,” Bohara said.
The doctor added that all the countries will carry out immediate response activities to outbreaks of any wild poliovirus or VDPV in their country.
“This is considered a public health emergency and has to be responded to immediately with quality immunization rounds,” Bohara told Vaccine News Daily. “All children should be reached during these campaigns.”
WHO-developed guidelines on how to respond to any VDPV outbreak are being followed in the polio campaign in Myanmar, and the country also plans to conduct a routine polio campaign in an additional 87 townships thought to be at risk, Bohara said.
“Myanmar health authorities are also planning to improve overall routine immunization coverage,” Bohara said. “A big communication campaign – conducted by the government in collaboration with WHO and UNICEF -- is planned in January through February to increase awareness for routine immunization among parents and caregivers, and increase demand for routine immunization services from the population.”