Resumed immunization campaigns are critical to preventing COVID-19 as well as polio.

Resumed immunization campaigns are critical to preventing COVID-19 as well as polio.

Shabana, a frontline Polio Worker, administers polio drops to children in Roshvala, Faisalabad (Pakistan). Photo: UNICEF

Local adaptation and innovation has allowed the resumption of polio immunization campaigns — and points the way to more effective, community-based delivery of a whole range of basic health services.

Countries including Afghanistan, Angola, Burkina Faso, Pakistan and the Philippines recently re-started polio immunization campaigns that had been on hold for four long months. The campaigns are a critical component of the Global Polio Eradication Initiative, a public-private partnership that delivers polio vaccines door-to-door in vulnerable communities. This initiative has achieved stunning success – saving more than 13 million children from paralysis over the past four decades – but has struggled to eradicate polio entirely, often due to community mistrust of the vaccine.

In March 2020, as COVID-19 raced around the world, health officials halted polio eradication activities and redirected staff and resources to instead support COVID-19 efforts. But they warned the consequences of this redirection could be severe. Modeling shows that tens of millions of children have missed out on vaccination, with potentially devastating health consequences. And most countries continue to report serious disruptions to their overall immunization efforts.

That’s what makes the resumption of these campaigns so important. Vaccinators have received special training in how to protect themselves and others from COVID-19 by wearing masks, using hand sanitizer and practicing physical distancing, including using a “no-touch” vaccination method. They are screened for COVID-19 before making their visits. Perhaps most importantly, vaccination teams work in their own communities –which reduces the possibility of transmission from town to town.

These workers are glad to be back on the polio front lines. As Nuzhat Seema, who has been administering polio drops in Pakistan for the past four years, explains, “I have a daughter living with disability and that motivates me to protect other Pakistani kids from polio. Going door-to-door on foot and in this heat is not easy, but I’m very happy that polio vaccinations have restarted because this is a mission that I really believe in.”

As part of their household visits, the polio workers also share information about how to prevent COVID-19, which program administrators hope will further aid in building community trust and acceptance of the polio vaccine. All these innovations and adaptations point the way to more effective delivery of other basic health services too – today, in light of COVID restrictions, and into the future. HIV medications, family planning supplies and insecticide-treated bed nets — all can be delivered door-to-door. Indeed, polio vaccinators have long supported community health by offering vitamin supplements and basic maternal health care.

The tremendous 30-year success of the global campaign against polio powerfully demonstrates that some of the most difficult health challenges can be overcome at the local level. Trained community members can share educational materials on how to prevent transmission of a host of infectious diseases, from COVID-19 to influenza to typhoid. And they can support community efforts to quickly identify and halt outbreaks when they occur — just as polio contact tracers already do. As COVID-19 continues to strain hospitals and disrupt travel, we need to think creatively about how all kinds of health care can be provided by, for and in communities.

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