Polio Eradication FAQs — Programme and Campaign Questions

These questions come up most often about how the eradication programme itself operates. For questions about the disease and the vaccine, see the main polio FAQs; for travel documents, see the polio certificate guide.

Campaigns

Why does a vaccination team come back so often? Each dose of oral polio vaccine gives partial protection, and full protection builds up over several doses. In areas with heavy diarrhoeal disease, more doses are needed. Campaigns also catch children born since the last round and those who were away when teams last called.

What is the difference between a national and a sub-national campaign? A national immunisation day targets every child under five in the country — about 45 million. A sub-national round targets selected districts chosen by risk assessment, so that the districts where the virus is actually circulating get more frequent coverage than the rest.

Who are the people at my door? Two-person teams, usually including a woman, recruited locally and trained before each round. They carry vaccine in a cool box, mark the finger of each vaccinated child, and record the household. Supervisors and independent monitors check their work afterwards.

Why do they mark my child's finger? The marker is how independent monitors verify afterwards whether children in an area were genuinely vaccinated. It is the programme's main defence against coverage being reported that did not happen.

Cases and response

How is a polio case confirmed? Every child under 15 with sudden onset of floppy paralysis is investigated and stool samples are collected. Those samples are tested at the WHO-accredited Regional Reference Laboratory at the National Institute of Health in Islamabad. Only laboratory confirmation makes a case official, which is why announcements sometimes lag the illness by weeks.

What happens after a case is confirmed? An outbreak response is triggered: immediate house-to-house vaccination around the case, investigation of the child's vaccination history, a search for other paralysis cases in the area, and additional environmental sampling. See the eradication strategy.

Why do you report sewage results when nobody is paralysed? Because most poliovirus infections cause no symptoms. Finding virus in sewage means it is circulating in that community even though no child has been paralysed yet — which is the moment when intervention is most useful. See surveillance.

Eradication

When can Pakistan be declared polio-free? Certification requires at least three consecutive years with no wild poliovirus detected in people or in the environment, backed by surveillance good enough to be trusted. A quiet year is not enough on its own.

Why has it taken so long? The remaining transmission is concentrated in the hardest places to work — districts with security-related access problems, highly mobile populations, dense underserved urban neighbourhoods, and communities where refusals cluster. Progress in those places is slow by nature. The high-risk areas page explains how they are identified.

What can an ordinary family do? Open the door every round, let every child under five receive the drops every time, complete the routine immunisation schedule, and call 1166 if a team never arrives.