Top 5 Takeaways

1. Significant Reduction in WPV1 Cases: Pakistan reported an 84% reduction in WPV1 cases from 2019 to 2021, with only one case reported in 2021 as of August 25.
2. Challenges with cVDPV2: The number of cVDPV2 cases surged in 2020 but showed a significant decline in 2021 due to large-scale immunization activities.
3. Impact of COVID-19: The pandemic caused a temporary suspension of supplementary immunization activities, but these resumed with minimal quality reduction.
4. Immunization Coverage Disparities: Immunization coverage varied significantly by province, with some areas like Balochistan showing much lower rates compared to Punjab.
5. Environmental Surveillance: A decrease in WPV1-positive sewage samples was observed, indicating a reduction in poliovirus circulation.

Original Article Author and Citation

Corresponding Author

Chukwuma Mbaeyi, cmbaeyi@cdc.gov, 404-823-7764

Suggested Citation

Mbaeyi C, Baig S, Khan Z, et al. Progress Toward Poliomyelitis Eradication — Pakistan, January 2020–July 2021. MMWR Morb Mortal Wkly Rep 2021;70:1359–1364. DOI: http://dx.doi.org/10.15585/mmwr.mm7039a1

Summary

This report highlights Pakistan’s progress in polio eradication from January 2020 to July 2021. The country saw a significant reduction in WPV1 cases, from 84 cases in 2020 to just one case in 2021. However, challenges remain with cVDPV2, which saw a spike in cases in 2020 but a decline in 2021 due to targeted vaccination efforts. The COVID-19 pandemic impacted immunization activities, but these resumed with minimal quality loss. Immunization coverage varied widely across provinces, and environmental surveillance indicated a reduction in poliovirus circulation.

Methods

The study utilized data from national immunization days (NIDs), subnational immunization days (SNIDs), and environmental surveillance. Acute flaccid paralysis (AFP) surveillance and stool adequacy rates were also monitored. Lot quality assurance sampling (LQAS) surveys were conducted to assess the performance of supplementary immunization activities (SIAs).

Discussion

The report discusses the reduction in WPV1 cases and the challenges posed by cVDPV2. It highlights the impact of the COVID-19 pandemic on immunization activities and the disparities in immunization coverage across different provinces. The findings suggest that while progress has been made, persistent gaps in vaccination coverage and surveillance need to be addressed to achieve polio eradication.

Conclusion

Pakistan has made significant strides in reducing WPV1 cases, but challenges with cVDPV2 and disparities in immunization coverage remain. Enhanced efforts in program management, accountability, and community engagement are essential to eliminate all virus transmission by the end of 2022.

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