Humanitarian pauses key to critical polio vaccination campaign in Gaza Strip

Two rounds of polio vaccination campaigns are expected to be launched in late August and in September 2024 across the Gaza Strip to prevent the spread of circulating poliovirus type 2 (cVDPV2).

WHO and UNICEF are asking all parties to the conflict to implement a seven-day humanitarian pause in the Gaza Strip to allow two rounds of vaccination campaigns to take place. These breaks in the fight would allow children and families to safely reach health facilities and community outreach workers to reach children who cannot access health facilities for polio vaccinations. Without humanitarian breaks, the implementation 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 the new oral polio vaccine type 2 (nOPV2) to more than 640,000 children under the age of ten.

Poliovirus was detected in July 2024 in environmental samples from Khan Younis and Deir al-Balah. Worryingly, since then, three children have been reported in the Gaza Strip with suspected acute flaccid paralysis (AFP), a common symptom of polio. Their stool samples were sent to Jordan's National Polio Laboratory for testing.

Over 1.6 million doses of nOPV2, which is used to stop the transmission of cVDPV2, will be delivered to the Gaza Strip. Shipments of vaccines and cold chain equipment are expected to pass through Ben Gurion Airport before reaching the Gaza Strip by the end of August. It is crucial to facilitate the transportation of vaccines and cold chain at every step of the journey to ensure their timely receipt, customs clearance and ultimately delivery in time for the campaign.

Detailed plans have been finalized to support vaccinators and community mobilizers to reach eligible children across the Gaza Strip. Vaccination will be carried out by 708 teams, including hospitals, field hospitals and primary health care centers in every municipality of the Gaza Strip. About 2,700 health workers, including mobile teams and community outreach workers, will support the implementation of both rounds of the campaign. This will be supported by awareness efforts to reduce the risks of polio infection.

At least 95 percent 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 implementation include sufficient cash, fuel and a functioning telecommunications network to reach communities with information about the campaign.

Further efforts are underway to strengthen and expand poliovirus surveillance and routine immunization.

There has been no polio in the Gaza Strip for the past 25 years. His reappearance, which the humanitarian community has been warning about for the past ten months, represents another threat to children in the Gaza Strip and neighboring countries. A ceasefire is the only way to ensure the safety of public health in the Gaza Strip and the region.

Notes for editors

• On July 16, 2024, wastewater test results confirmed that cVDPV2 was detected in six samples collected on June 23, 2024 from Khan Younis and Deir al Balah ES sites in the Gaza Strip. Further sequencing analysis confirmed that these cVDPV2 isolates were related to a variant poliovirus strain last detected in Egypt in 2023.

• The Gaza Strip had a high level of population vaccination 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) fell from 99 percent in 2022 to less than 90 percent in the first quarter 2024, increasing the risk of vaccine-preventable diseases for children, including polio.

• The risk of the spread of cVDPV2, within the Gaza Strip and internationally, remains high given the deficiencies in children's immunity due to disruptions in routine vaccinations, the decimation of the health system, constant displacement of the population, malnutrition and severely damaged water supply 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.