PESHAWAR: Officials associated with the polio eradication initiative in Khyber Pakhtunkhwa have pinned their hopes on the chief secretary for the smooth-sailing of the vaccination programme through administrative measures in the province.

“Given the interest with which the chief secretary is pursuing polio-related issues, we are confident that chronic problems, such as vaccination refusals and fake finger-marking, will be resolved,” a senior official told Dawn.

According to him, chief secretary Shahab Ali Shah has chaired eight meetings on polio since mid-February during which he discussed all issues in detail and issued strict directives to the district administrations and police.

In the last polio campaign, which ran from Feb 3 to Feb 5, vaccinators covered 5,970,196 (93 per cent) of the total target of 6,450,977, missing 116,813, including 97,743 children who were unavailable when vaccinators visited their homes and 19,070 whose parents refused vaccination.

Insist interest of chief secretary will help address vaccine refusal, fake finger-marking issues

According to officials, if administrative support had been available, these children could have been reached. The issue has persisted for the last two decades, with people in certain areas either directly refusing or pretending to be unavailable during the anti-polio campaign.

They said another major issue was fake finger-marking, which required attention.

“We mark the fingers of children with indelible ink after administering polio drops to them record them as vaccinated. However, the problem arises when people opposed to immunisation force health workers to mark the fingers of their children without administering the vaccine,” an official told Dawn.

He said vaccinators, who feared for their lives, didn’t argue with parents requesting fake finger-marking.

In 2024, 20 people, including 16 police constables, lost their lives in terrorist attacks during anti-polio campaigns in Khyber Pakhtunkhwa. Fifty-three people, including 43 policemen, were injured in such attacks.

In 2025, a policeman on polio duty was killed in Khyber tribal district, while another constable (Levies official) was shot dead in Bajaur tribal district. Overall, 112 people, more than half of whom were policemen, have been killed during polio campaigns, and more than 300 have been injured since 2012.

All these issues have been brought to the attention of the chief secretary, who has issued clear instructions to the deputy commissioners and district police officers to ensure the security of vaccinators and to make sure that all children receive two drops in every campaign until the age of five, according to officials.

They said the country recorded 74 polio cases last year, including 27 in Balochistan, 23 in Sindh, 22 in Khyber Pakhtunkhwa and one each in Punjab and Islamabad.

Pakistan has already reported six cases of poliovirus from Punjab, Sindh and Khyber Pakhtunkhwa in the first three months of the current year.

A recent study found that working mothers in Peshawar are three times more likely to oppose the vaccination of their children compared to housewives.

It also revealed that parents who are hesitant about vaccinations are less convinced that the vaccine protects their children against childhood diseases, due to misconceptions about vaccine safety.

According to the study, authored by Vice Chancellor of the Khyber Medical University Prof Ziaul Haq, Dr Saima Afaq and others, and published by BioMed Central, a UK-based journal, only 77 per cent of hesitant parents acknowledged the importance of vaccines, compared to 98 per cent among those who accepted immunisation.

It also revealed that misinformation and concerns about vaccine safety were prevalent among parents, with 43 per cent of vaccine-refusing people expressing doubts about the necessity of vaccines. All these issues can be addressed through administrative measures.

“It is a government programme and therefore, it can be implemented through the administrative machinery. We hope that the chief secretary will make a difference,” said a health official told Dawn.

Published in Dawn, March 27th, 2025