Pulse Polio is an immunisation campaign established by the government of India to eliminate poliomyelitis (polio) in India by vaccinating all children under the age of five years against the polio virus. The project fights polio through a large-scale, pulse vaccination programme and monitoring for poliomyelitis cases.[ citation needed ]
In India, vaccination against polio started in around 1972 with Expanded Programme on Immunization (EPI). By 1999, it covered around 60% of infants, giving three doses of OPV to each.[ citation needed ]
In 1985, the Universal Immunization Programme (UIP) was launched to cover all the districts of the country. UIP became a part of child survival and safe motherhood program (CSSM) in 1992 and Reproductive and Child Health Program (RCH) in 1997 . This program led to a significant increase in coverage, up to 5%. The number of reported cases of polio also declined from thousands during 1987 to 42 in 2010.[ citation needed ]
In 1995, following the Global Polio Eradication Initiative of the World Health Organization (1988), India launched Pulse Polio immunization program with Universal Immunization Program which aimed at 100% coverage.[ citation needed ]
The last reported cases of wild polio in India were in West Bengal and Gujarat on 13 January 2011. [1] On 27 March 2014, the World Health Organization (WHO) declared India a polio free country, since no cases of wild polio been reported in for five years. [2]
The Pulse Polio Immunization (PPI) aims at covering every individual in India. It aspires to reach even children in remote communities through an improved social mobilisation plan. [3]
Publicity was extensive and included replacing the national telecoms' authority ringtone with a vaccination day awareness message, posters, TV and cinema spots, parades, rallies, and one-to-one communication from volunteers. Vaccination booths were set up, with a house-to-house campaign for remote communities. [4]
Testing showed that three doses of vaccine was enough to protect children in developed countries, but it became obvious that this was not enough in some areas of India. The Ministry of Health and Family Welfare recommended eight to ten doses for each child.[ citation needed ]
Children in some areas of India are weaker and often had diarrhea, which reduced the efficiency of the vaccine. Open defecation, monsoon flooding, and a lack of water treatment made it easier for a child to swallow more polio virus. As a result, children with too few doses of vaccine were not fully protected and sometimes got polio. [4]
The eradication program therefore gave drops over and over again, to boost children's immunity higher and as a precaution against missed children. Few parents initially knew that the vaccination campaign was trying to eradicate the disease, so they did not understand the reasons for the increasing intensity of vaccination. The increasing frequency of the drops and cases of polio among partially vaccinated children, caused rumours that the drops did not work. [4]
On July 30, 2013 a nine-month-old boy from Navi Mumbai tested positive for vaccine-derived poliovirus (VDPV) type 2. This was the fourth such case recorded in the country in 2013. [5]
Many parts of India are remote and hard to access. People in some areas had had poor and caste-discriminatory treatment by government health authorities, which made them less willing to assist in the vaccination programme. The time demands of polio vaccination sometimes left health care workers with less time for other services. The absence of any free health services other than polio vaccination and contraception lead to rumours that the drops caused infertility. [4]
Rumours about vaccinations varied by area, but were clustered, so that there was a greater risk of a cluster of unvaccinated children. Some believed that vaccinating newborns, children who are ill, or previously vaccinated children was not safe; [4] the last polio case in India was a girl who had not been vaccinated because she was sick. [6] There were also rumours that the polio drops were made from the blood of pigs, dogs, or mice, or from pig fat. [7]
Poor participation of doctors and nurses, difficulty in maintaining and procuring vaccine, difficulty in procuring vehicles, and a lack of support from community members have caused problems in the program, [8] as has fatigue at the length of the anti-polio campaign. [4]
The campaign was supported by organisations including the Indian federal and state governments, international institutions, and non-governmental organisations. It is part of the Global Polio Eradication Initiative, spearheaded by Rotary International, the World Health Organization, UNICEF, and the U.S. Centers for Disease Control and Prevention.[ citation needed ]
Actor Amitabh Bachchan volunteered with the campaign, filming TV and radio spots urging against complacency [4] [9] and personally vaccinating children. [10]
The Indian and Afghan cricket teams have supported their national and international polio eradication efforts. [11]
The Pulse Polio Vaccination Campaign in Jharkhand set up 24,334 polio booths across the state. A total of 48,669 polio teams are working towards this goal. [12]
A study observing data till the end of 2017 correlates non-polio acute flaccid paralysis (AFP) rates with pulse polio frequency in India. To cast a wider net for poliovirus detection and to maximize sensitivity so that every poliomyelitis case is detected, in 2005, the Global Poliomyelitis Eradication Initiative adapted AFP as a surveillance tool and broadened the case definition of AFP in India. The expanded case definition of AFP encompasses causes of nonpolio AFP (NP-AFP), including Guillian-Barré syndrome, transverse myelitis and traumatic neuritis, and ambiguous cases. [13] The WHO is attempting to phase out the use of live oral polio vaccine to eliminate the risk that the active virus in the vaccine could mutate into a form that can harm unvaccinated children. [14] [15]
Poliomyelitis, commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 75% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe symptoms develop such as headache, neck stiffness, and paresthesia. These symptoms usually pass within one or two weeks. A less common symptom is permanent paralysis, and possible death in extreme cases. Years after recovery, post-polio syndrome may occur, with a slow development of muscle weakness similar to that which the person had during the initial infection.
Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease. When a sufficiently large percentage of a population has been vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world. However, some diseases, such as measles outbreaks in America, have seen rising cases due to relatively low vaccination rates in the 2010s – attributed, in part, to vaccine hesitancy. According to the World Health Organization, vaccination prevents 3.5–5 million deaths per year.
Polio vaccines are vaccines used to prevent poliomyelitis (polio). Two types are used: an inactivated poliovirus given by injection (IPV) and a weakened poliovirus given by mouth (OPV). The World Health Organization (WHO) recommends all children be fully vaccinated against polio. The two vaccines have eliminated polio from most of the world, and reduced the number of cases reported each year from an estimated 350,000 in 1988 to 33 in 2018.
Immunization, or immunisation, is the process by which an individual's immune system becomes fortified against an infectious agent.
A vaccination schedule is a series of vaccinations, including the timing of all doses, which may be either recommended or compulsory, depending on the country of residence. A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or reduce the effects of infection by any natural or "wild" pathogen. Vaccines go through multiple phases of trials to ensure safety and effectiveness.
Contact immunity is the property of some vaccines, where a vaccinated individual can confer immunity upon unimmunized individuals through contact with bodily fluids or excrement. In other words, if person “A” has been vaccinated for virus X and person “B” has not, person “B” can receive immunity to virus X just by coming into contact with person “A”. The term was coined by Romanian physician Ioan Cantacuzino.
Polio eradication, the permanent global cessation of circulation of the poliovirus and hence elimination of the poliomyelitis (polio) it causes, is the aim of a multinational public health effort begun in 1988, led by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF) and the Rotary Foundation. These organizations, along with the U.S. Centers for Disease Control and Prevention (CDC) and The Gates Foundation, have spearheaded the campaign through the Global Polio Eradication Initiative (GPEI). Successful eradication of infectious diseases has been achieved twice before, with smallpox in humans and rinderpest in ruminants.
Flaccid paralysis is a neurological condition characterized by weakness or paralysis and reduced muscle tone without other obvious cause. This abnormal condition may be caused by disease or by trauma affecting the nerves associated with the involved muscles. For example, if the somatic nerves to a skeletal muscle are severed, then the muscle will exhibit flaccid paralysis. When muscles enter this state, they become limp and cannot contract. This condition can become fatal if it affects the respiratory muscles, posing the threat of suffocation. It also occurs in the spinal shock stage in complete transection of the spinal cord occurring in injuries such as gunshot wounds.
The Expanded Program on Immunization(EPI) in the Philippines began in 1976 through Presidential Decree No. 996 signed by President Ferdinand Marcos. And, in 1986, made a response to the Universal Child Immunization goal. The four major strategies include:
A vaccination policy is a health policy adopted in order to prevent the spread of infectious disease. These policies are generally put into place by state or local governments, but may also be set by private facilities, such as workplaces or schools. Many policies have been developed and implemented since vaccines were first made widely available.
Mass vaccination is a public policy effort to vaccinate a large number of people, possibly the entire population of the world or of a country or region, within a short period of time. This policy may be directed during a pandemic, when there is a localized outbreak or scare of a disease for which a vaccine exists, or when a new vaccine is invented.
The Expanded Program on Immunization is a World Health Organization program with the goal to make vaccines available to all children.
Universal Immunisation Programme (UIP) is a vaccination programme launched by the Government of India in 1985. It became a part of Child Survival and Safe Motherhood Programme in 1992 and is currently one of the key areas under the National Health Mission since 2005. The programme now consists of vaccination for 12 diseases- tuberculosis, diphtheria, pertussis, tetanus, poliomyelitis, measles, hepatitis B, rotaviral gastroenteritis, Japanese encephalitis, rubella, pneumonia and Pneumococcal diseases. Hepatitis B and Pneumococcal diseases were added to the UIP in 2007 and 2017 respectively. The cost of all the vaccines are borne entirely by the Government of India and is funded through taxes with a budget of ₹7,234 crore (US$910 million) in 2022 and the program covers all residents of India, including foreign residents.
Pakistan is one of the two remaining countries in the world where poliomyelitis (polio) is still categorized as an endemic viral infection, the other one being Afghanistan. While it has yet to fully eradicate Polio, there has been a downwards trend in the number of reported cases per year; the total count of wild poliovirus cases in Pakistan in 2019 was 147, compared to 84 in 2020, 1 in 2021, 20 in 2022, 6 in 2023 and 2 to date in 2024.
The pulse vaccination strategy is a method used to eradicate an epidemic by repeatedly vaccinating a group at risk, over a defined age range, until the spread of the pathogen has been stopped. It is most commonly used during measles and polio epidemics to quickly stop the spread and contain the outbreak.
Mission Indradhanush is a health mission of the Government of India. It was launched by Union Health Minister J. P. Nadda on 25 December 2014. The scheme this seeks to drive towards 90% full immunisation coverage of India and sustain the same by year 2022. Vaccination is being provided against eight vaccine-preventable diseases nationally, i.e. Diphtheria, Whooping Cough, Tetanus, Polio, Measles, severe form of Childhood Tuberculosis and Hepatitis B and meningitis & pneumonia caused by Haemophilus influenza type B; and against Rotavirus Diarrhea and Japanese Encephalitis in selected states and districts respectively.
India National PolioPlus Society is a non-profit organization. The Initiative has achieved significant progress toward its goals. There has been a dramatic decline in cases everywhere in the seventeen years since the target was set in 1988.
The Global Polio Eradication Initiative is an initiative created in 1988, just after the World Health Assembly resolved to eradicate the disease poliomyelitis. Led by the World Health Organization, it is the largest international public health initiative in history.
DTaP-IPV-HepB vaccine is a combination vaccine whose generic name is diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis B (recombinant) and inactivated polio vaccine or DTaP-IPV-Hep B. It protects against the infectious diseases diphtheria, tetanus, pertussis, poliomyelitis, and hepatitis B.
The World Health Organization (WHO) created the Global Commission for the Certification of the Eradication of Poliomyelitis in 1995 to independently verify the eradication of wild poliovirus. The GCC certified the worldwide eradication of indigenous wild poliovirus type 2 on 20 September 2015, and wild poliovirus type 3 on 17 October 2019. In addition, five of the six World Health Organization Regions certified their status as free of indigenous transmission of all three serotypes of wild poliovirus :
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