اختر لغتك
Second round of polio vaccination in the Gaza Strip aims to vaccinate over half a million children
11 October 2024 - The second round of an emergency polio vaccination campaign is scheduled to start on 14 October 2024 in Gaza, to vaccinate an estimated 591 700 children under ten years of age with a second dose of the novel oral polio vaccine type 2 (nOPV2) vaccine.
This follows a first round, which was successfully implemented from 1-12 September 2024 and vaccinated 559 161 children, or an estimated 95% of eligible children at governorate level, according to independently conducted post-campaign monitoring. As with the first round, the second round will have three phases, each involving three campaign days and one catch-up day.
A minimum of two doses of nOPV2 are needed to interrupt poliovirus transmission. However, this will only be achieved if at least 90% of all children are vaccinated in all communities and neighbourhoods. In this round, vitamin A will be co-administered alongside polio vaccine, to help boost overall immunity among children between the ages of two and ten years.
The campaign, being conducted by the Palestinian Ministry of Health in collaboration with the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Relief and Works Agency for Palestinian Refugees (UNRWA), and other partners is part of emergency efforts to stop the polio outbreak in Gaza, which was detected on 16 July 2024, and prevent further spread of poliovirus.
Once again, meticulous planning, coordination and implementation will see an extensive network of teams vaccinating at selected health facilities and outreach posts. Mobile teams will actively reach out to families living in shelters, tents and camps for internally displaced people. Local teams will be deployed in areas that need special coordination to reach children, including those who could not receive vaccine in the first round. The first round demonstrated that overwhelming logistical challenges — including operating amid devastated infrastructure and constant population movements — can be overcome through an extraordinarily resilient and dedicated health workforce and strong community demand for polio vaccination, if all parties respect the planned humanitarian pauses.
More than 800 social mobilizers will reach out to families to raise awareness on the importance of taking the second dose as well as on the dates and locations. Radio spots, short message services (SMS) and all digital channels available in Gaza will also amplify these messages. This outreach will continue until the round concludes.
Additionally, logistical and programmatic needs, such as training health and community workers, provision of adequate supplies, recording of data by independent monitors, and demarcation of areas being covered by mobile teams, have been streamlined for the second round.
To cover the two rounds, 1.6 million doses of the vaccines were delivered in the past two months as well as 20 refrigerators, 10 freezers, 100 ice boxes, and 800 vaccine carriers — all equipment required to maintain vaccines at a temperature between 2 and 8°C.
Once again, a humanitarian pause will be a pre-requisite to implementing a successful second round, particularly to ensure all polio workers can operate in a safe and secure environment, and communities and families can obtain vaccination for children without fear.
A substantial constraint to the polio campaign will again be reaching children living in areas outside humanitarian pauses , who were not covered in the last round. This requires coordination and approvals to allow programme supervision and monitoring, which would contribute significantly to ensuring all children, regardless of their location, are vaccinated.
WHO and UNICEF renew their urgent request to all parties to the conflict to implement the necessary humanitarian pauses in Gaza for this second round. This is particularly critical as new evacuation orders in the north of Gaza are threatening access to hospitals and protection of health facilities and health and community workers. Vaccination teams must be protected and allowed to conduct the campaigns safely. We urge all parties to ensure their protection, and that of health facilities and children.
Editors’ notes
Circulating variant poliovirus type 2 was confirmed in Gaza in six environmental samples in July 2024, in a ten-month-old paralysed child in July 2024, and in another five environmental samples collected on 5 September 2024.
More information on the Global Polio Eradication Initiative, and daily updates on the outbreak response campaign, are available on the initiative's website. Scroll down the page to the list of polio-affected countries and click on ‘occupied Palestinian territory’).
First phase of polio campaign concludes successfully in Gaza
4 September 2024, over 187 000 children under ten years of age were vaccinated with novel oral polio vaccine type 2 (nOPV2) in central Gaza during the first phase of a two-round polio vaccination campaign, conducted between 1–3 September 2024. Vaccination coverage in this phase exceeded the initial estimated target of 157 000 children due to population movement towards central Gaza, and expanded coverage in areas outside the humanitarian pause zone.
To ensure no child is missed in this area, polio vaccination will continue at four large health facilities in central Gaza over the next few days. Vaccine doses have been supplied to these sites to meet any additional needs.
“It has been extremely encouraging to see thousands of children being able to access polio vaccines, with the support of their resilient families and courageous health workers, despite the deplorable conditions they have braved over the last 11 months. All parties respected the humanitarian pause and we hope to see this positive momentum continue,” said Dr Richard Peeperkorn, WHO Representative for the occupied Palestinian territory.
The first phase of the campaign was conducted by 513 teams, consisting of over 2180 health and community outreach workers. Vaccination was provided at 143 fixed sites, including hospitals, medical points, primary care centres, camps where displaced people are living, key public gathering spaces such as temporary learning spaces, food and water distribution points, and transit routes leading from central towards northern and southern Gaza. Additionally, mobile teams visited tents and hard to-reach areas to ensure they reached families who were unable to visit fixed sites. The presence of a substantial number of children eligible for vaccination who were unable to reach vaccination sites due to insecurity, necessitated special missions to Al-Maghazi, Al-Bureij and Al-Mussader – areas just outside of the agreed zone for the humanitarian pause.
Preparations are underway to roll out the next phase of the campaign, which will be conducted in southern Gaza from 5–8 September 2024, targeting an estimated 340 000 children below ten years of age. Some 517 teams, including 384 mobile teams, will be deployed. Nearly 300 community outreach workers have already begun outreach to families in southern Gaza to raise awareness about the campaign, while 490 vaccine carriers, 90 cold storage boxes, and other supplies have been transferred to Khan Younis for distribution to vaccination sites.
The third and last phase of the polio vaccination campaign will be implemented in northern Gaza from 9–11 September 2024, targeting around 150 000 children.
At least 90% vaccination coverage during each round of the campaign is needed to stop the outbreak, prevent the international spread of polio and reduce the risk of its re-emergence, given the severely disrupted health, water and sanitation systems in the Gaza Strip. Vaccination coverage will be monitored throughout the campaign, and, when necessary, vaccinations will be extended to meet coverage targets as part of flexible strategies to ensure every eligible child receives their vaccine dose.
The two-round campaign, being conducted by the Palestinian Ministry of Health (MOH), in collaboration with the World Health Organization (WHO) and United Nations Children Fund (UNICEF), the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) and many partners, aims to provide two drops of nOPV2 to around 640 000 children during each round.
"The successful delivery of the first phase of the campaign in central Gaza is a culmination of immense coordination among various partners, including the Global Polio Eradication Initiative (GPEI) and donors, and underscores the importance of peace for the health and well-being of people in Gaza. We call on all parties to continue fulfilling their commitment to the humanitarian pauses as the second phase of the campaign begins tomorrow,” said Dr Peeperkorn.
Notes to editors
The campaign is part of an urgent response to prevent the spread of polio after circulating variant poliovirus type 2 (cVDPV2) was detected in Gaza, after 25 years of being polio-free. cVDPV2 has been detected in six environmental samples – or wastewater – collected from central Gaza in June 2024. Gaza has reported four cases of children with acute flaccid paralysis (AFP), including one case of confirmed polio in a child who tested positive for circulating variant poliovirus type 2 (cVDPV2). Two of the reported cases tested negative for poliovirus. Laboratory results are pending on samples from the fourth AFP case.
Novel oral polio vaccine (nOPV2) is a polio vaccine being used to stop transmission of variant poliovirus type 2 (cVDPV2), currently the most prevalent form of the variant poliovirus.
nOPV2 is safe and effective and offers protection against paralysis and community transmission. It is the vaccine globally recommended for variant type 2 poliovirus outbreaks – the type that has been found in the recent samples from Gaza.
Humanitarian pauses vital for critical polio vaccination campaign in the Gaza Strip
16 August 2024, two rounds of a polio vaccination campaign are expected to be launched at the end of August and September 2024 across the Gaza Strip to prevent the spread of circulating variant type 2 poliovirus (cVDPV2).
WHO and UNICEF request all parties to the conflict to implement humanitarian pauses in the Gaza Strip for seven days to allow for two rounds of vaccination campaigns to take place. These pauses in fighting would allow children and families to safely reach health facilities and community outreach workers to get to children who cannot access health facilities for polio vaccination. Without the humanitarian pauses, the delivery of the campaign will not be possible.
During each round of the campaign, the Palestinian Ministry of Health (MoH), in collaboration with the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) and partners, will provide two drops of novel oral polio vaccine type 2 (nOPV2) to more than 640 000 children under ten years of age.
The poliovirus was detected in July 2024 in environmental samples from Khan Younis and Deir al-Balah. Worryingly, three children presenting with suspected acute flaccid paralysis (AFP), a common symptom of polio, have since been reported in the Gaza Strip. Their stool samples have been sent for testing to the Jordan National Polio Laboratory.
Over 1.6 million doses of nOPV2, which is used to stop cVDPV2 transmission, will be delivered to the Gaza Strip. The deliveries of the vaccines and the cold chain equipment are expected to transit through Ben Gurion Airport before arriving in the Gaza Strip by the end of August. It is essential that the transport of the vaccines and cold chain is facilitated at every step of the journey to ensure their timely reception, clearance and ultimately delivery in time for the campaign.
Detailed plans to support vaccinators and social mobilizers to reach eligible children across the Gaza Strip have been finalized. Vaccination will be administered by 708 teams, including at hospitals, field hospitals, and primary health care centres in each municipality of the Gaza Strip. Around 2700 health workers, including mobile teams and community outreach workers, will support the delivery of both rounds of the campaign. This will be supported by awareness-raising efforts to mitigate the risks of polio infection.
At least 95 per cent vaccination coverage during each round of the campaign is needed to prevent the spread of polio and reduce the risk of its re-emergence, given the severely disrupted health, water and sanitation systems in the Gaza Strip.
Other requirements for successful campaign delivery include sufficient cash, fuel and functional telecommunication networks to reach communities with information about the campaign.
Further efforts are underway to strengthen and expand poliovirus surveillance and routine immunization.
The Gaza Strip has been polio-free for the last 25 years. Its reemergence, which the humanitarian community has warned about for the last ten months, represents yet another threat to the children in the Gaza Strip and neighboring countries. A ceasefire is the only way to ensure public health security in the Gaza Strip and the region.
Notes for editors
On 16 July 2024, wastewater test results confirmed that cVDPV2 was detected in six samples collected on 23 June 2024 from Khan Younis and Deir al Balah ES sites in the Gaza Strip. Further sequencing analysis confirmed that these cVDPV2 isolates are linked to a variant poliovirus strain last detected in Egypt in 2023.
The Gaza Strip had a high level of vaccination coverage across the population before the escalation of hostilities in October 2023. However, due to the impact of the conflict, routine immunization coverage (for the second dose of inactivated polio vaccine) dropped from 99 per cent in 2022 to less than 90 per cent in the first quarter of 2024, increasing the risk of vaccine-preventable diseases to children, including polio.
The risk of cVDPV2 spread, within the Gaza Strip and internationally, remains high given gaps in children's immunity due to disruptions in routine vaccination, decimation of the health system, constant population displacement, malnutrition and severely damaged water and sanitation systems. The situation has also increased the risk of the spread of other vaccine-preventable diseases such as measles as well as cases of diarrhoea, acute respiratory infections, hepatitis A and skin diseases among children
