PESHAWAR: Refusals against polio vaccination continue to haunt children as the last campaign has shown that 200,000 children remained unimmunised in Khyber Pakhtunkhwa due to reluctance by their parents to get their children vaccinated.

A report, prepared after the 3-day vaccination drive and launched on August 13, showed that of the total 2.5 million target children in 22 districts of Khyber Pakhtunkhwa, 201,268 didn’t get vaccine. They included 71,170 refusal cases. Peshawar, the provincial capital, top scored in the list of refusals with 41,541 cases. Others, who were not available to vaccinators during door-to-door campaign, were marked as “not available” while those, who could not be reached by health workers, were termed “missed children.”

However, they all did not get vaccine and hence have the potential to hamper the government’s plan to see eradication of the childhood ailment from the country anytime soon in future.

In Mardan, the second largest city of the province, 6,537 defied vaccination, mostly on the old arguments that these were designed to render recipients infertile and impotent, or vaccination was disallowed in Islam, or medication was not permitted by religion before occurrence of the disease.

Over 200,000 children in 22 districts remained unimmunised in last campaign

Most of these reasons cited by parents have been the cause of refusals against vaccination in the province since long.

Bannu, another polio endemic district, saw non-vaccination of 5,404 children due to refusal by parents. Parents’ defiance against vaccination has been a chronic problem hampering the government’s resolve to do away with poliomyelitis, which has been eradicated worldwide except in Pakistan and the neighbouring Afghanistan.

The saga of refusals is widespread in the province. On average, 200,000 children don’t receive drops in every campaign and different strategies by the authorities to ensure 100 per cent vaccination is yet to materialise.

Lakki Marwat has 3,753 refusal cases, Swabi has 3,677, Nowshera 1,676, Karak 1,822 and Charsadda has 1,467 refusal cases, which are the major sources of concern as these districts don’t have any influence of alleged terrorists, who are often slammed for prevention of polio drives.

The health workers have been trying their level best to ensure vaccination but cannot put their lives at stake and often register the name of unvaccinated child as “vaccinated” for fear of reprisals, according to sources.

Since 2012, when militants began targeting polio teams, a total of 47 people have been killed in the incidents linked to polio vaccination in the country. The dead included 36 polio workers and 11 security men.

In Khyber Pakhtunkhwa, 25 persons have been killed including 18 polio workers and seven policemen in such incidents. The latest incident was murder of two female polio workers in Swabi district in January.

A three-member committee, formed on the directives of chief minister to hold a fact-finding probe into their killing, found that security lapse made the slain vaccinators a soft target.

There was no security for the teams in the rural area that allowed the suspected militants to fire at the health workers. Every polio drive is run with a lot of media campaign to create demand for vaccine but health workers say that are recording reluctance against vaccine from the area where people seldom watches TV or read newspapers.

The propaganda against polio vaccination is deep-rooted. The refusing parents also include white collar and educated people, who do not get their children vaccinated for almost the same reasons. The workable option is only to convince the parents so they can start vaccination of their children.

KP is in spotlight as it continues to stay a bigger contributor to the nationwide polio cases. The province recorded 93 of 147 wild poliovirus type 1 (WPV1) and 16 of 22 circulating vaccine-derived poliovirus (cVDPV2) in 2019. In 2020, KP has recorded 22 of 70 national WPV1 and 42 of 60 cVDPV2 cases.

Published in Dawn, September 14th, 2020