During the COVID-19 pandemic, 63 polio cases were reported in Pakistan. Four months after the COVID-19 outbreak occurred in Pakistan, more than 50 million children did not receive a polio vaccination, as immunization in Pakistan was delayed. At the end of July 2020, Pakistan was able to complete a round of vaccinations to cover 780,000 children.

Vaccinations and COVID-19

On April 1, 2020, Pakistan went into a nationwide lockdown for a month due to COVID-19. During the lockdown, immunization in Pakistan reduced by more than 50%. This reduction occurred mainly in impoverished regions and areas that were far from service delivery.

Healthcare workers’ contracting COVID-19 led to a halt in immunization services in some areas. More than 150 Expanded Programme on Immunization healthcare workers contracted COVID-19. Additionally, shortages of personal protective equipment (PPE) further reduced immunization, as healthcare workers were concerned about the risk of transmission while providing immunizations without proper PPE.

Transportation Interruptions Delay Immunization

Many immunizations in Pakistan were not delivered due to flight disruptions from COVID-19. Reduced immunization in Pakistan can lead to new outbreaks of other preventable diseases, like measles. The Khyber Pakhtunkhwa Province, an area with a large refugee population and limited healthcare access, has already seen an increase in measles cases.

The lack of public transportation available during the pandemic also made it difficult for many to travel to receive immunizations. People who are at high risk of contracting COVID-19 were often afraid to go out in public and get immunized.

New mothers in particular were not willing to risk the travel to hospitals to get their children vaccinated. One new mother expressed her concern that the absence of vaccinations could lead to contracting preventable diseases, but she was also worried about the coronavirus. Furthermore, multiple private and public hospitals were overwhelmed with COVID-19 and did not allow babies and mothers to receive their immunizations.

WHO’s Restrictions Led to Vaccination Difficulties

After the World Health Organization advised countries to postpone their immunization campaigns, Pakistan halted its door-to-door polio immunization program. The postponement of mass vaccination programs may lead to 117 million children worldwide not receiving a measles vaccine. Countries that have low immunization rates are at the highest risk. Pakistan’s routine vaccination campaign for tuberculosis, for example, reached only 66% of its slated coverage this year, compared to 88% in 2019.

In Karachi, the Health Education and Literacy Programme (HELP) works to support maternal and child health and maximize vaccination coverage. Founder of HELP, Dr. D. S. Akram, said that the delay in immunization could lead to hundreds of thousands of young Pakistanis missing their tuberculosis and polio vaccines. On average, 12,000 to 15,000 children are born in Pakistan every day. Since polio is still endemic in Pakistan, the suspension of the door-to-door polio immunization program may lead to more outbreaks in the future.

Once Pakistan started to come out of its lockdown in May 2020, clinics began to reopen in an effort to continue vaccination campaigns. Pakistan faced two obstacles in attempting to increase routine vaccinations: both opening hospitals and ensuring that parents felt safe to bring their children there. Hospitals had to ensure not only that there were enough vaccinations in supply but also that parents would be willing to get their children immunized.

In Pakistan, children who belong to poor households are affected by vaccination coverage the most. The reduction of immunization in Pakistan has occurred mainly in slum areas, where it is difficult to deliver healthcare products. Despite the delay in immunization caused by COVID-19, Pakistan continues to adapt in its efforts to return to routine vaccination.

– Ann Ciancia
Photo: Flickr