In a sad knock-on effect of the COVID-19 pandemic, the Global Polio Eradication Initiative (GPEI) abruptly halted all mass vaccination campaigns in March, worried they could inadvertently spread the novel coronavirus. The move further imperiled the troubled 3-decade drive to wipe out polio.
But now, armed with new data and perspective, GPEI and the countries it supports are resuming vaccination campaigns. Burkina Faso was first out of the gate in early July; Pakistan followed yesterday. Polio cases are surging in many countries, and models paint a “pretty bleak picture” if campaigns don’t restart soon, says Michel Zaffran, who heads the effort at the World Health Organization (WHO). For now, countries will only be responding to outbreaks; preventive campaigns remain on hold.
Back in March, when COVID-19 began to spread around the world, no one knew whether door-to-door polio campaigns would make things worse, says Hil Lyons, a statistician at the Institute for Disease Modeling (IDM) in Bellevue, Washington. Without answers, “The default was to shut things down,” he says.
The cost was enormous. “There’s a growing sense that the collateral damage [of pausing campaigns] is really substantial,” says Nick Grassley of Imperial College London (ICL), who heads one of the groups modeling the impact of the pause and how best to respond. In “urgent” recommendations in late May, GPEI said it expected circulation of polioviruses “to increase exponentially during the upcoming high season,” raising the possibility of “uncontrolled multi-country outbreaks.
IDM models also suggest the effect of polio campaigns on the pandemic is likely small in places where the virus is already raging. “The outbreak has its own momentum and acceleration,” Lyons explains. In areas where COVID-19 has yet to hit, however, the risks are substantial. To lower them, vaccinators will be screened for COVID-19, wear masks, use hand sanitizer, and practice physical distancing as much as possible. Most important, says Hamid Jafari, WHO’s head for polio eradication in Pakistan and Afghanistan, teams will work in their own communities. “We don’t want to bring workers from infected areas to uninfected areas,” he says.