Top 5 Takeaways

1. Reduction in Polio Cases: Afghanistan reported only two cases of wild poliovirus type 1 (WPV1) in 2022 up to September, a reduction from previous years, with no cases of type 2 circulating vaccine-derived poliovirus (cVDPV2) compared to 43 in 2021.
2. Vaccination Expansion Post-Political Transition: Post August 2021 political changes, 3.5–4.5 million previously unreachable children were vaccinated, though supplementary immunization activity (SIA) restrictions continue in the South Region.
3. Immunization Coverage: National immunization coverage with oral poliovirus vaccine among children aged 12–23 months was 71% in 2021, and injectable inactivated poliovirus vaccine coverage was 67%.
4. Challenges and Opportunities: Despite improvements, significant subnational coverage gaps, data quality issues, and ongoing SIA restrictions in high-risk areas pose challenges.
5. Cross-Border Transmission and Surveillance: Genetic analysis indicates cross-border poliovirus transmission with Pakistan. Afghanistan’s AFP surveillance network covers a vast network, but gaps in surveillance persist.

Original Article Author and Citation

Corresponding Author

Abdinoor Mohamed, wyr5@cdc.gov.

Suggested Citation

Mohamed A, Akbar IE, Chaudhury S, et al. Progress Toward Poliomyelitis Eradication ― Afghanistan, January 2021–September 2022. MMWR Morb Mortal Wkly Rep 2022;71:1541–1546, DOI: http://dx.doi.org/10.15585/mmwr.mm7149a1.

Summary

The report details the efforts and progress in eradicating poliomyelitis in Afghanistan from January 2021 to September 2022. It highlights the significant reduction in polio cases, with only two WPV1 cases reported in 2022 compared to previous years. The political transition in August 2021 enabled the vaccination of millions of previously unreachable children, despite ongoing SIA restrictions in high-risk areas. The article emphasizes the importance of maintaining high-quality SIAs across Afghanistan, particularly in the South Region, to further reduce poliovirus transmission.

Methods

The study used various methods, including AFP (acute flaccid paralysis) surveillance, environmental surveillance, and lot quality assurance sampling, to assess the effectiveness of SIAs and monitor poliovirus transmission. Routine immunization data quality was scrutinized, and caregiver recall was used as a proxy in some cases.

Discussion

The report discusses challenges such as data quality issues, subnational immunization coverage gaps, and SIA restrictions in high-risk areas. It underscores the necessity of continuous and expanded SIAs throughout Afghanistan to eradicate WPV1, especially in the South Region. The analysis also indicates cross-border transmission between Afghanistan and Pakistan, highlighting the need for coordinated efforts.

Conclusion

The report concludes that while significant progress has been made in reducing polio cases in Afghanistan, challenges remain. The key to eradicating WPV1 lies in ensuring comprehensive immunization coverage, overcoming data quality and coverage gaps, and addressing SIA restrictions in high-risk areas. The opportunity to end WPV1 transmission in Afghanistan by the end of 2023 is attainable but requires sustained and expanded efforts.

Engage with the full report to explore more detailed insights and strategies for poliomyelitis eradication in Afghanistan.