“Every Last Child”

The slogan emphasized on the Polio Global Eradication Initiative, “every last child,” is the goal for this public-private partnership. The World Health Organization (WHO), Rotary International, US Centers for Disease Control and Prevention (CDC), United Nations Children’s Fund (UNICEF), Bill and Melinda Gates Foundation and Gavi have banded together to become the core partners for this initiative of a polio-free world through vaccination(s). Since their creation, many countries (56, to be exact) have either been declared polio free or involved with the initiative. Though in the last six months, there has been issues arising in terms of the IPV and OPV vaccinations for polio–further hindering the progression of a polio-free world.

Before jumping into the frightening re-emerging polio cases in the Philippines or the controversy growing in Pakistan–trust me, we will get there–distinction between the two prevalent polio vaccines must be understood. Along with the different serotypes of poliovirus.

Serotypes of any virus are synonymous of the different strains of a microorganism. The poliovirus has three. And in the 1950s, the Salk vaccine was created to prevent all three serotypes from the inactivated virus particles of all together. Today, this vaccine is referred to as the inactivated polio vaccine (IPV). The downside of this vaccine were the abundant injections needed for polio protection–and as we all know, the more subsequent injections that follow an initial injection, the larger the margin of error for us to forget or neglect the next. Therefore, in 1961 the oral polio vaccine (OPV) was successfully created from the attenuated strains that target replication in the throat and intestinal tract. For simplicity, we progressed from injecting individuals with dead poliovirus serotypes to taking live (but attenuated) poliovirus.

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Now, let’s talk about the Philippines and Pakistan in terms of polio and poliovirus vaccination.

In the Philippines, two polio cases have re-emerged after nineteen years and have been deemed vaccine-derived poliovirus infections. These two cases were diagnosed within a span of two days but were almost 1,000 miles apart within the Philippines. Both WHO and UNICEF are concerned with the causative serotype of the two cases–wild poliovirus type 2 (WPV) or vaccine-derived polioviruses (VDPV). Especially since WPV was declared eradicated in 2015 and the bivalent OPV against type 1 and 3 have since only been given. Though the reason it has re-emerged in the Philippines is from it circulating within local sewage and waterways. Geneva has already sent the Philippines a stock of monovalent type 2 vaccine but has foreseen troubles of getting through security and logistics of the area. Unfortunately, even once the monovalent vaccine arrives, all three doses of OPV and one IPV dose of the vaccine are needed for full protection–which the Philippines cannot provide due to inadequate delivery and care extending to highly rural areas. Officials are actively doing anything they can to fix this issue, though only so many resources and finances are available.

Another issue involving polio vaccination is the arise of anti-vaccination movement in Pakistan. Initially it took intervening of religious extremism, government officials and global political interests to push for vaccination. Though now, there has been retaliation and propaganda within the public for regular poliovirus vaccinations. This in turn is causing false linkages to mishandling of the vaccine to side-effects patients have been experiencing after receiving the vaccination. And to make matters worse, there is poor awareness for booster doses for those that are getting vaccinated.

After doing research on polio, a virus I believed no one was diagnosed with in our day and age, further made me more aware of the bubble I live in. I am very fortunate to live in both a financially stable home, along with easy access to both general education and health education. Though, in other countries this is not the case. Every day countries like the Philippines and Pakistan have to attend to obstacles I never could imaged, just to receive vaccinations that are quite literally required for certain things in the USA. So for everyone reading, take advantage and be thankful for the small things, such as vaccinations, that are taken for granted because of our privilege.